Lab and Dx II Exam 1

Mental Status Exam

What gold standard clinical assessment tool is used for both neurological and psychiatric evaluations?

Not completely standardized

Is the Mental Status Exam completely standardized, or does it vary in clinical practice?

Arousal

Which domain of the Mental Status Exam evaluates if a patient is alert, attentive, sleepy, or unresponsive?

Attention and concentration

Which cognitive domain of the Mental Status Exam is tested using serial subtraction or spelling words backwards?

Recent vs. remote memory

What two specific types of memory are evaluated during the Mental Status Exam?

Language

Which Mental Status Exam domain assesses a patient's fluency, content, repetition, and naming abilities?

Visuospatial perception

Copying a diagram or performing a clock drawing test evaluates which domain of the Mental Status Exam?

Praxis

What is the term for the ability to perform learned motor movements tested during the Mental Status Exam?

Calculations

Adding a series of coins or performing serial 7 subtractions evaluates which domain of the Mental Status Exam?

Executive functioning

Asking a patient to imitate rhythms during a Mental Status Exam evaluates which specific cognitive domain?

Mood and thought content

Which part of the Mental Status Exam evaluates a patient's affect and the potential presence of hallucinations?

Lengthy and requires training

What are the key admin requirements that make the full Mental Status Exam unique compared to quick screening tools?

Part of full psychological exam

Under what context is a full Mental Status Exam typically administered rather than as a brief bedside check?

Formal DSM-V diagnosis

What administrative clinical milestone strictly requires the completion of a Mental Status Exam?

Five or more symptoms

How many DSM-5 symptoms must be present to diagnose a major depressive syndrome or episode?

Minimum of two consecutive weeks

What is the minimum duration of symptoms required to diagnose a major depressive syndrome under DSM-5?

Depressed mood or loss of interest or pleasure

To meet DSM-5 criteria for major depression, at least one of the presenting symptoms must be which specific core feature?

Insomnia or hypersomnia

What sleep disturbances are included in the DSM-5 diagnostic criteria for a major depressive episode?

Change in appetite or weight

What nutritional or physical body change is considered a diagnostic criterion for depression under the DSM-5?

Psychomotor retardation or agitation

What motor movement alterations are listed as diagnostic criteria for depression in the DSM-5?

Low energy

What energy-related symptom is a standard diagnostic criterion for a major depressive episode?

Poor concentration

What cognitive symptom is listed in the DSM-5 diagnostic criteria for a major depressive episode?

Thoughts of worthlessness or guilt

What cognitive or emotional self-evaluations are included in the DSM-5 criteria for depression?

Recurrent thoughts of death or suicide

What severe psychiatric symptom is a key diagnostic criterion for a major depressive episode under DSM-5?

Patient Health Questionnaire (PHQ-9)

Which common clinical depression screening tool is entirely self-administered by the patient?

88% sensitive and 85% specific

What are the clinical sensitivity and specificity percentages for the PHQ-9 depression screening tool?

Monitor patient's response to treatment

Besides initial screening, what is another primary clinical use of the PHQ-9 over time?

0-27

What is the complete scoring range for the Patient Health Questionnaire (PHQ-9)?

45% positive predictive value

What is the positive predictive value of a PHQ-9 score greater than 10?

99% negative predictive value

What is the negative predictive value of a PHQ-9 score less than 10?

First 2 questions of the PHQ-9

What exact items comprise the Patient Health Questionnaire (PHQ-2)?

Feeling down, depressed, or hopeless

What is the symptom evaluated in the first of the two questions on the PHQ-2?

Little interest or pleasure in doing things

What is the symptom evaluated in the second of the two questions on the PHQ-2?

Past two weeks

What is the specific retrospective timeframe evaluated by the questions on both the PHQ-2 and PHQ-9?

Brief and easily administered verbally

What are the primary administration advantages of the PHQ-2 over the PHQ-9?

Pre-screening followed by another instrument

What is the standard clinical strategy or workflow when utilizing the PHQ-2?

Similar sensitivity and specificity to PHQ-9

How do the sensitivity and specificity of the brief PHQ-2 compare to the full PHQ-9?

Edinburgh Postnatal Depression Scale

Which depression screening tool is specifically validated for both antenatal and postpartum use?

Self-administered

How is the Edinburgh Postnatal Depression Scale administered to patients?

10 items

How many total items make up the Edinburgh Postnatal Depression Scale?

Less than 5 minutes

What is the typical time required to complete the Edinburgh Postnatal Depression Scale?

Somatic symptoms like sleep and appetite

What specific symptoms are excluded from the Edinburgh Postnatal Depression Scale due to pregnancy variability?

30

What is the maximum possible score on the Edinburgh Postnatal Depression Scale?

Score of greater than 12

What specific cutoff score on the Edinburgh Postnatal Depression Scale identifies most women with major depression?

Geriatric Depression Scale

Which depression assessment tool uses a brief 5-item format targeted specifically at older adults?

2 out of 5 depressive responses

How many depressive responses on the Geriatric Depression Scale suggest a diagnosis of depression?

Basically satisfied with life

What is the only positive life evaluation question asked on the 5-item Geriatric Depression Scale?

Do you often get bored

Which question on the Geriatric Depression Scale specifically evaluates a patient's level of daily interest or activity?

Do you often feel helpless

Which question on the Geriatric Depression Scale specifically evaluates feelings of helplessness?

Do you prefer to stay at home

Which question on the Geriatric Depression Scale evaluates a patient's social withdrawal and preference to avoid going out?

Do you feel pretty worthless

Which question on the Geriatric Depression Scale directly evaluates a patient's current feelings of self-worth?

Inpatient, outpatient, and when physically ill

In what clinical settings has the 5-item Geriatric Depression Scale been validated and studied?

Excessive anxiety and worry

What is diagnostic Criterion A for Generalized Anxiety Disorder under the DSM-5?

At least six months

What is the minimum duration of symptoms required for a DSM-5 diagnosis of Generalized Anxiety Disorder?

Generalized Anxiety Disorder-7 (GAD-7)

What is the name of the 7-item self-report scale specifically used to measure and screen for anxiety?

Worry, tension, restlessness, muscle pain, fatigue, concentration difficulty, irritability

What are the 7 aspects of anxiety measured by the GAD-7 scale?

Delirium

What cognitive condition is an altered state of consciousness with episodes of confusion developing over hours or days?

Dementia

What is defined as the loss of cognitive abilities leading to an impaired ability to remember, think, or make decisions?

Depression (mood disorder)

What is a mood disorder characterized by a persistent feeling of sadness and loss of interest?

Mini-Mental State Exam (MMSE)

Which cognitive test has scores ranging from 0-30, takes 5-10 minutes, and is sensitive to mild-to-moderate dementia?

Memory and language

Which primary cognitive domains are assessed by the Mini-Mental State Exam (MMSE)?

Mild to moderate Alzheimer's

For which specific type and stages of dementia is the MMSE particularly sensitive?

Montreal Cognitive Assessment (MoCA)

Which cognitive test is more sensitive to earlier stages of cognitive decline than the MMSE?

Surveys broader range of cognitive function

Why is the Montreal Cognitive Assessment (MoCA) superior to the MMSE for early decline?

More executive functioning

What specific domain of cognitive function does the MoCA evaluate more extensively than the MMSE?

Advanced disease

In what clinical severity of cognitive impairment is the Montreal Cognitive Assessment (MoCA) less useful?

15 minutes

What is the average time required to administer the Montreal Cognitive Assessment (MoCA)?

Mini-Cog

Which brief cognitive test consists of word registration, clock drawing, and word recall?

Word registration, clock drawing, and word recall

What are the three steps of the Mini-Cog cognitive assessment tool?

Six tested sets of three words

How many tested word sets are available for the Word Registration step of the Mini-Cog?

Control, Continued use, Craving

What are the "3 C's" that summarize the diagnostic criteria for Substance Use Disorders?

DRINK TWO 6 PACK

What is the 11-letter mnemonic representing the DSM-5 criteria for substance use disorders?

Dangerous use

In the mnemonic DRINK TWO 6 PACK, what does the "D" stand for?

Role failure

In the mnemonic DRINK TWO 6 PACK, what does the "Ri" stand for?

No stopping despite physical/psychological problems

In the mnemonic DRINK TWO 6 PACK, what does the "No" stand for?

Keeps using despite social/interpersonal problems

In the mnemonic DRINK TWO 6 PACK, what does the "K" stand for?

Tolerance

In the mnemonic DRINK TWO 6 PACK, what does the "T" stand for?

Withdrawal

In the mnemonic DRINK TWO 6 PACK, what does the "W" stand for?

Occupational, social, or recreational activities given up

In the mnemonic DRINK TWO 6 PACK, what does the "O" stand for?

Persistent desire

In the mnemonic DRINK TWO 6 PACK, what does the "P" stand for?

Amount is larger or longer than intended

In the mnemonic DRINK TWO 6 PACK, what does the "A" stand for?

Cravings

In the mnemonic DRINK TWO 6 PACK, what does the "C" stand for?

Keeps spending a lot of time

In the mnemonic DRINK TWO 6 PACK, what does the last "K" stand for?

Mild substance use disorder

According to DSM-5, how is a substance use disorder classified if only 2 or 3 criteria are met?

Moderate substance use disorder

According to DSM-5, how is a substance use disorder classified if 4 or 5 criteria are met?

Severe substance use disorder

According to DSM-5, how is a substance use disorder classified if 6 or more criteria are met?

One symptom

According to the DSM-5 severity guidelines, what number of symptoms indicates an individual is "at risk" but not yet diagnosed with a mild disorder?

Cut down, Annoyed, Guilty, Eye-opener

What four concepts comprise the CAGE questionnaire for alcohol screening?

Cut down

What does the "C" stand for in the CAGE questionnaire?

Annoyed

What does the "A" stand for in the CAGE questionnaire?

Guilty

What does the "G" stand for in the CAGE questionnaire?

Eye-opener

What does the "E" stand for in the CAGE questionnaire?

Following up a single-item screening question

What is the primary clinical utility of the CAGE questions since they are not recommended for general screening?

Two or more

How many affirmative answers on the CAGE questionnaire indicate unhealthy alcohol use?

75% sensitive and specific

What are the sensitivity and specificity percentages of the CAGE questionnaire?

A single "yes" is positive

If CAGE is used for screening, a single "yes" is positive and should be followed by what step?

AUDIT (Alcohol Use Disorders Identification Test)

What is the most widely validated instrument for screening unhealthy alcohol use?

10 items

How many total items make up the AUDIT questionnaire?

2-3 minutes

What is the typical administration time for the full 10-item AUDIT?

Score of 8 or greater

What score on the AUDIT questionnaire is considered positive for unhealthy alcohol use?