Ch 1 - Psych assessment and consultation

Qs

When to consider Neuroimaging?

• New onset psychosis

• New onset dementia

• Acute delirium without known cause prior to ECT

• Acute change in mentation with abnormal neuro exam in a patient with head trauma or age > 50y/o.

EEG can be useful in which situations?

• Distinguish b/w neuro and psych etiologies in mute patients

• EEG with video monitoring for PNES or complex partial seizures.

• EEG points out delirium with generalized slowing when it may be confused as psychosis.

What kind of attention is of most importance in psych evaluations?

Sustained attention.

Tested by moderately demanding non-automatic tasks like months of the year backwards, spelling WORLD backwards and serials ( 7s of 100, 3s of 50 or 1s of 20)

Types of memory to be tested

• Working memory/Recent memory: 3 words immediate and delayed recall

• Semantic memory: facts such as name of the president or naming tasks

• Episodic memory: personal experiences and events

• Procedural memory: skills and tasks learned through practice, like riding a bike or playing an instrument ( observed during the evaluation).

What are the different types of Apraxia?

• Constructional Apraxia is which individuals have difficulty with spatial organization and drawing tasks.

• Dressing Apraxia is inability to coordinate spatial arrangement of clothing

• etc

What kind of hallucination indicate medical etiologies?

Prominent visual, olfactory, gustatory and tactile hallucinations

• olfactory, gustatory - seizures

• Visual and tactile - substance withdrawal