Question

1. What are the elements of the Mental Status Exam, discuss one abnormal finding you would question in a young female patient you are examining.
2. What is the difference between substance abuse and drug abuse? Name six drugs that are often abused.
3. Review all the assessment techniques and give the order of assessment for ONE body system.

Answer 1

1- ELEMENTS OF MENTAL STATUS EXAMINATION

The mental status examination is an essential tool that aids physicians in making psychiatric diagnosis. It is an assessement of current mental capacitry through evaluation of general appearance ,behaviour ,any unusal or bizarre beleifs and perceptions ( delusions,hallucination ) mood and all aspects of cognotion ( attention,orientation ).

• Level of conciousness -
• Appearance and General Behaviour -Age ,sex,race,body build,posture,eye contact ,dress,grooming,manner,attentiveness to examiner ,distinguishing features ,prominent physical abnormalities,emotional fascial expression,alertness.
• Speech -Rate ,rhytham,volume,amount,articulation,spontaniety
• Motor Activity -retardation,agitaion ,abnormal movements ,gait , catatonia
• Affect and Mood - Stability,range,appopriateness,intensity,affect ,mood
• Thought content -Suicidal ideation,death wishes ,homicidal ideation ,depressive cognition ,obcession,rumination,phobias ,ideas of reference,paranoid ideation,magical ideation ,delusions,overvalued ideas.
• Thought process -assosiation,coherence,logic ,stream,clang assosiation,preservation,neologism,blocking,attention
• Perception -Hallucination,illusions,depersonalization,derealization,deja vu ,jamais vu
• Examiner's reaction to the patient
• Structured Examination of cognitive abilities.
• Insight -Awareness of illness
• Intellect -Global impression: average ,aboveaverage ,below average

Example - While examining a female patient

During mental status examination ,one women patient presents Derealization

Derealization is an alteration in the perception or experince of the external world so that it seems unreal.Other symptoms include feeling as though one's environment is lacking in spontaniety,emotional coloring,and depth.It is a dissosiative symptom that may appear in moments of severe stress.

2 - SUBSTANCE ABUSE AND DRUG ABUSE

SUBSTANCE ABUSE -The excessive use of a subsatnce especially alocohol or a drug.It refers to the harmful or hazardous use of psychoactive substances,includingh alcohol and illect drugs.

DRUG ABUSE - The use of illegal drugs or the use of perception or over the counter drugs for purpose other than those for which they are meant to be used ,or in large amounts. Drug abuse may lead to social ,physical ,emotional ,and job related problems.

Commonly used illegal drugs include Marijuana, Heroin ,Cocaine ,Amphetamines and methamphetamines and club drugs .

3 -ASSESSEMENT OF BODY SYSTEM

The techniques used are

• Inspection
• Palapation
• Percussion
• Auscultation

Palpation and percussion can alter bowel sounds ,so inspect ,auscultate ,percussion ,and then palpate the abdomen.