Mental status exam

Other diagnostic tests to consider for differential diagnosis erythrocyte sedimentation rate, urinalysis, toxicology, chest x-ray, heavy metal screen, HIV testing, cerebrospinal fluid (CSF) examination, electroencephalography, and neuropsychological tests such as the Folstein Mini Mental Status Exam. 

VS blood pressure 128/62 mm Hg supine, pulse 77 beats per minute, respiratory rate 15/minutes, temperature 37°C (98.6°F) Gen Poorly-groomed, thin woman looks stated age Neuro Folstein Mini Mental Status Exam score 16/30 disoriented to month, date, and day of week, clinic name and floor poor registration with impaired attention and shortterm memory recalled 0 out of 3 items good language skills but problems with commands CT Scan Mild to moderate generalized cerebral atrophy... 

JVP Jugular venous pressure MSE Mental status exam... 

Physiological Measures BP, HR, neurological and mental status exams... 

Cognitive function (e.g., ADAS, Mini-Mental Status Exam [MMSE ), activities of daily living, global functioning, blood chemistry, complete blood counts, heart rate, blood pressure... 

To summarize, the mental status exam highlights several aspects of functioning. Each succeeding component requires that earlier aspects be intact for adequate reality testing, as well as the optimal expression of one s personality, as subjectively perceived and objectively observed, in terms of emotions, thoughts, and behavior. 

Ability to Communicate. The mental status exam is critical to the determination of a patient s capacity to consent, and the ability to communicate is an absolute prerequisite (see the section Diagnostic Assessment in Chapter 1). Psychomotor impairments such as mutism or catatonia (withdrawn type) would severely affect an individual s fundamental ability to communicate any appreciation of the issues involved and their ramifications. Although an individual may actually be well oriented and may intellectually appreciate and even later remember events that occurred and the issues involved, that person is not capable of consenting if unable to demonstrate these faculties. 

For methodology, the clinical assessment of mental state has always been achieved by an examination known as the mental status exam. Uniting neurology and psychiatry, the mental status exam is a comprehensive checklist of mind functions that are known to be disrupted by organic brain disease, i.e. brain disease caused by a physical rather than a mental condition. 

To introduce the far-reaching implications of dream science to a general science of consciousness, consider the following categories of the mental status exam ... 

Mental status exam (MSE) extent of detail varies from psychiatrist to primary... 

FIGURE 24.1 Age-related impairment in cognitive function as defined by six or more errors in the Mini-Mental Status Exam. (Data from Robins LN, Regier DA, editors. Psychiatric disorders in America the Epidemiolgic Catchment Area Study. New York The Eree Press 1991.)... 

These areas of functioning can be evaluated by the use of a brief neuro-cognitive mental status exam (see appendix E). Acute disorders affecting the CNS have mul-... 

There are a number of medical disorders that have little or no effect on cognitive function but can adversely affect the biochemistry of the limbic system and other subcortical brain areas. Thus, although individuals suffering from these conditions may appear intact on the brief neuro-cognitive mental status exam, they may exhibit... 

Figure E-1 is a short exam that can be administered to patients as an aid in making a diagnosis. Notes on each question appear below. For a more comprehensive review of a neurologically based mental status exam, the reader is referred to an excellent text The Mental Status Examination in Neurology (Strub and Black 1985).

Notes on the Use of the Brief Neurocognitive Mental Status Exam... 

Awareness of temporal specification, such as time of day, day of the week, or year. Orientation to time is one of the functions assessed in a psychiatric mental status exam. 

Extent of involvement varies across VA systems. For example, at the VA clinic in La Jolla, California, a psychiatric pharmacist s scope of practice includes 1) assessing clinical response to medication via mental status exam and psychiatric interviewing techniques 2) assessing development of adverse drug reactions 3) ordering and evaluating appropriate laboratory tests to assess cli-... 

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