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Mental Health Assessment (Patient indicators for screening (what next:…

- - - - 1.5 mins w/ less than 4 errors = positive response
  - - - tell me why these are similar
        An orange and an apple
        A cat and a mouse
        A child and a dwarf A church and a theater
        A piano and a violin
      - Tell me what these proverbs mean
        People who live in glass houses should not throw stones.
        Don’t count your chickens before they’re hatched.
        A rolling stone gathers no moss.
        The squeaky wheel gets the grease.
    - - parietal lobe damage or dementia
- - - - facial expression
        at rest
        appropriate?
        anxiety, depression?
        immobility = > Parkinson's
        anger = > paranoia
        flat and remote = > schizophrenia
        apathy = > dementia
  - - - nasal?
        dysarthria = > defective articulation
        aphasia = disorder of language
        dysphonia = impaired volume, quality, pitch of voice
    - - hesitancy?
      - disturbed inflections (sudden monotone?)
      - circumlocutions
        e.g. what you write with = pen
      - paraphasias
      - may be:
        aphasia
        
        receptive (wernicke's)
        
        impaired comprehension and FLUENT speech
        
        expressive (broca's)
        
        preserved comprehention and slow nonfluent speech
        
        Further testing
        
        word comprehension
        point to your nose, then your knee
        
        repetition
        repeat: "no ifs, ands, or buts"
        
        naming
        "name parts of a cell phone"
        
        reading comprehension
        ask patient to read paragraph aloud
        
        writing
        "write a sentence"
        
        may be: vision problems
        hearing
        intelligence
        education
  - - - how do you feel about that?
      - what do their relatives say?
      - length
      - circumstances
      - episodes?
      - do you feel discouraged?
      - do you ever think of killing yourself? how would you do it?
        
        asking about suicide DOESN'T implant the idea in their mind
        
        Refer at-risk patients immediately for psychiatric care
  - - - obsessions
    - - schizophrenia, manic episodes, psychotic disorders
    - - manic episodes
    - - dementia, schizophrenia, psychotic disorders, aphasia
    - - Seen in Korsakoff syndrome from alcoholism.
  - - - stupor and coma
        
        stupor: unaware to surroundings & painful stimuli
        
        coma: unconscious and don't open their eyes or voice
- - - - document in parenthesis
        "major cognitive disorder (dementia)"