[PT10116] [1T1S] [1.1] Mental Status Examination (LOMA)

LEVEL OF CONSCIOUSNESS

What level of consciousness is described below:

• No response to any kind of stimuli

Coma (Deep Coma)

LEVEL OF CONSCIOUSNESS

What level of consciousness is described below:

• Responds to painful stimuli only

Stupor (Semi-Coma)

LEVEL OF CONSCIOUSNESS

What level of consciousness is described below:

• Responds to loud voice and painful stimuli OR loud voice only

Obtunded

LEVEL OF CONSCIOUSNESS

What level of consciousness is described below:

• Sleeps when not stimulated, drowsy and inattentive

• Responds to normal voice

Lethargic

LEVEL OF CONSCIOUSNESS

What level of consciousness is described below:

• Aware of his environment

Alert

ORIENTATION

Four elements that are being identified in orientation?

1. Person

2. Place

3. Time

4. Situation

ORIENTATION

Questions that you can ask in assessing: Person

Name of patient/person they are with

• “What is your name?” “Sino po kasama niyo?”

ORIENTATION

Questions that you can ask in assessing: Place

Location where they currently are

• “Do you know where you are?”

ORIENTATION

Questions that you can ask in assessing: Situation

Why they went to the clinic

• “Ano pong nangyari?”

ORIENTATION

Questions that you can ask in assessing: Time

What day/date is it today OR what time of the day is it right now

• “What day is it today?”

• “Is it currently morning, afternoon, or evening?”

MEMORY

Considered to be the online or in-the-moment memory

Immediate memory

MEMORY

Involves testing a set of ideas registered with the patient, specifically queries by the examiner after several minutes of delay

Recent memory

MEMORY

Can either represent a more prolonged delay in testing response to the task of recollection or, in some other tasks, may instead represent long-term general or autobiographical knowledge

Long-term memory

MEMORY

How to test for Immediate Memory?

Say 3-5 common words/letters/numbers then ask the pt to repeat

MEMORY

How to test for Short-term Memory?

Tell a short story then ask pt to repeat 3-5 words mentioned before

MEMORY

How to test for Long-term Memory?

Ask questions about pt (autobiographically appropriate questions)

Ability to attend and focus on specific tasks in real-time

Attention and Concentration Span

ATTENTION AND CONCENTRATION SPAN

How to test for Attention Span?

Let the patient stack cups (for 5 trials)

ATTENTION AND CONCENTRATION SPAN

How to test for Concentration Span? (3)

1. Serial subtraction

2. Reverse

3. Spelling backwards

ATTENTION AND CONCENTRATION SPAN

How to perform Serial Subtraction? And what considerations must you take note in performing this test?

Procedures:

• Start with a number (usually 100) and ask the patient to continuously subtract that number with another given number

• If the patient got it wrong, do not correct and let them continue on

• RESULT:

  • Correct-wrong-correct-wrong = impaired concentration span

Considerations:

• Do not use if pt is illiterate

• If only 1 answer is wrong but the rest are correct, give another number to subtract with to double check

ATTENTION AND CONCENTRATION SPAN

How to perform Reverse? And what considerations must you take note in performing this test?

Procedures:

• Ask the patient to recite the months of the year/days of the week backward; OR

• Ask the patient to count backwards (from 10); OR

• Ask the patient to recite the alphabet backwards

Considerations:

• Used as an alternative to serial subtraction (if the pt is illiterate)

ATTENTION AND CONCENTRATION SPAN

How to perform Spelling Backwards? And what considerations must you take note in performing this test?

Procedures:

• Give a common 5-letter word and ask the pt to spell it the right way first

• Ask the pt to spell the same word backwards

Considerations:

• If the pt corrects themselves = intact concentration span