This document provides an overview of how to conduct a mental status examination (MSE). An MSE systematically evaluates a patient's appearance, behavior, mood, thought processes, cognition and insight. It covers domains like speech, thought content, perception, orientation, attention/concentration, memory, intelligence and judgment. The MSE gives clinicians a snapshot of a patient's current mental well-being and helps with diagnostic formulation and treatment planning. A thorough MSE is an important psychiatric evaluation tool.
Diagnostic Criteria:
exposure to actual or threatened death, serious, or sexual violence in one( or more) of the following ways:
1) Directly experiencing the traumatic events.
2) Witnessing in person
3) Learning that the traumatic event occur to close family member or friend.
4) Experiencing repeated or extreme exposure to aversive details of the traumatic events.
The main objective of this study was to better understand the underlying behavioral and cognitive interactions of autism. We used a bottom-up approach to analyze the patterns of behavior and cognitive development among autistic individuals to define probable interactions between the two. More specifically, we used the Social Communication Questionnaire to quantify the behavioral symptoms and the Simon, First-Order False Belief, and Global/Local tasks to quantify the cognitive abilities of autistic children in the age range of 5 and 13 years old (n = 20; 17 males and 3 females). Results showed a positive correlation between communication problems and exaggerated inhibitory processes (reflected in less interference on the Simon task). Results also showed a positive correlation between more social interaction problems and a better understanding of first-order mental states. Finally, more restricted and repetitive behaviors were related to an improved performance on global as opposed to local processing tasks. These interaction findings could eventually lead to cognitive, theory-based, intervention methods to treat the behavioral symptoms found in autistic individuals.
Diagnostic Criteria:
exposure to actual or threatened death, serious, or sexual violence in one( or more) of the following ways:
1) Directly experiencing the traumatic events.
2) Witnessing in person
3) Learning that the traumatic event occur to close family member or friend.
4) Experiencing repeated or extreme exposure to aversive details of the traumatic events.
The main objective of this study was to better understand the underlying behavioral and cognitive interactions of autism. We used a bottom-up approach to analyze the patterns of behavior and cognitive development among autistic individuals to define probable interactions between the two. More specifically, we used the Social Communication Questionnaire to quantify the behavioral symptoms and the Simon, First-Order False Belief, and Global/Local tasks to quantify the cognitive abilities of autistic children in the age range of 5 and 13 years old (n = 20; 17 males and 3 females). Results showed a positive correlation between communication problems and exaggerated inhibitory processes (reflected in less interference on the Simon task). Results also showed a positive correlation between more social interaction problems and a better understanding of first-order mental states. Finally, more restricted and repetitive behaviors were related to an improved performance on global as opposed to local processing tasks. These interaction findings could eventually lead to cognitive, theory-based, intervention methods to treat the behavioral symptoms found in autistic individuals.
ARTE Y CIENCIA DE LA CLINICA_ DANIELA DR..pptxAleynadDiaz
El presente trabajo habla sobre las principales funciones del psicólogo clínico: desde la anamnesis y la importancia de la entrevista psicológica, el proceso de evaluación clínica y el probable diagnóstico que puede tener el paciente, así como la propuesta de un tratamiento o intervención pertinente, según sea el caso y la necesidad del paciente.
Mood and affect
Feeling and emotion
Normal emotional reactions
Classification of emotion
Abnormal emotional reactions
Abnormal expression of emotion
Abnormal predispositions
Morbid expression of emotion
Disorder of emotion
ADHD: Biopsychosocial Approaches to Treatment of ADHD in Children and AdultsMichael Changaris
This presentation explored the underlying biology of attention, impulsivity and the social/psychological factors impacting treatment. Pharmacotherapy, social and psychological interventions are discussed. The ADHD brain is highly conserved across multiple contexts and present in countries around the world. The ADHD brain has important gifts for human ecologic context adding to insight, creativity and innovation. Supporting people with an ADHD brain to develop skills, self-care and means to channel their abilities can allow many of the struggles of ADHD to manifest as gifts.
Borderline Personality Disorder Presentation given in Psychopathology II class.
Summer 2010 Argosy University San Francisco
By Lucia Merino, Psychology Doctor Candidate
ARTE Y CIENCIA DE LA CLINICA_ DANIELA DR..pptxAleynadDiaz
El presente trabajo habla sobre las principales funciones del psicólogo clínico: desde la anamnesis y la importancia de la entrevista psicológica, el proceso de evaluación clínica y el probable diagnóstico que puede tener el paciente, así como la propuesta de un tratamiento o intervención pertinente, según sea el caso y la necesidad del paciente.
Mood and affect
Feeling and emotion
Normal emotional reactions
Classification of emotion
Abnormal emotional reactions
Abnormal expression of emotion
Abnormal predispositions
Morbid expression of emotion
Disorder of emotion
ADHD: Biopsychosocial Approaches to Treatment of ADHD in Children and AdultsMichael Changaris
This presentation explored the underlying biology of attention, impulsivity and the social/psychological factors impacting treatment. Pharmacotherapy, social and psychological interventions are discussed. The ADHD brain is highly conserved across multiple contexts and present in countries around the world. The ADHD brain has important gifts for human ecologic context adding to insight, creativity and innovation. Supporting people with an ADHD brain to develop skills, self-care and means to channel their abilities can allow many of the struggles of ADHD to manifest as gifts.
Borderline Personality Disorder Presentation given in Psychopathology II class.
Summer 2010 Argosy University San Francisco
By Lucia Merino, Psychology Doctor Candidate
It is very useful for mental health nursing student...
Mental health assessment determine patient is experiencing abnormalities in thinking and reasoning ability, feelings or behavior....
This slide contains information regarding assessment in psychiatry. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated.
Abnormal Psychology: Concepts of NormalityMackenzie
Notes for section 5.1 of my psych textbook for the option of "Abnormal Psychology" on the I.B. HL Psychology test. All about cultural norms, normal vs. abnormal, diagnosing processes,validity and whatnot.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. Contents
• Introduction
• General appearance and behavior
• Psychomotor activity
• Speech
• Thought
• Mood
• Perception
• Cognitive functions
• Conclusion
3. Introduction
• It is a tool that covers how the patient is feeling and thinking at the
moment as he or she responds to the specific questions asked by the
examiner.
• It is functionally equivalent to physical examination in other areas of
medicine.
• It is a systematic collection of the observations and reported mental
experiences that gives a picture of the patients current mental status.
4. General appearance and behavior:
• Give a good observational description.
• General appearance and grooming: Kempt/ un kempt, body build,
hygiene
• Awareness of surroundings: In touch with or with out surroundings,
• Co- operative/not
• Rapport – could be established/very easily established and
overfamiliar/difficult to establish – guarded/hostile
• Eye to eye contact – maintained/fleeting/hyper
vigilance/avoids/downcast
• Any observed repetitive motor movements –
tics/mannerisms/stereotypies/motor perseveration/catatonic signs
5. Psychomotor activity
• Note if the Psychomotor activity is increased, decreased or normal
• Increase in goal directed activity/retardation
• Agitation
• Hand gestures while conversation
• Hyperactivity
6. Speech
• Spontaneous / only in response to questions
• Amount – little / excessive
• Tone (loudness) – high / low
• Tempo (rate or speed) – fast / slow
• Volume (amount) of speech. Estimate words per minute –
verbose/pressure of speech/decreased
• Reaction time – increased / decreased
• Prosody ( emotional intonations of speech) – maintained or not
• Relevant and coherent
7. Thought
• Form: (Organisation and expression of thought)
Presence of formal thought disorder
• Stream:(Flow and continuity of thought process)
Flight of ideas, retardation of thinking, circumstantially,
perseveration, thought blocking
• Possessions: Ownership of thought
Self :Obsessions and compulsions, imagery, impulses and phobias.
External Agency : thought alienation,withdrawal, insertion and
broadcasting.
8. Content of thought
• Delusions
• Overvalued ideas
• Depressive cognitions
• Worries and Preoccupations
• Suicidal ideas and death wishes.
9. Delusion
• Detailed description of the phenomenon.
• Single or multiple
• Bizzare/Non – Bizzare
• Fleeting or fixed
• Systematized or poorly systematized
• Mood congruent or not
• Acting out
• Type of delusion (Grandiose,persecutory, nihilistic etc.)
10. Mood
• Assess subjective report and objective evaluation
• Assess both longitudinal (mood) & cross sectional (affect)
• Quality of emotion – happiness / sadness
• Intensity of emotional expression – flat / blunt / normal
• Range of affective responses – full / restricted
• Mobility & reactivity – change of emotions in relation to the
environmental factors
• Diurnal variations
• Congruity in relation to the thought process
• Appropriateness in relation to the situations
11. Perception
Modalities - vision, hearing, smell, taste, pain and deep sensations vestibular
sensations and sense of presence.
• Detailed description of Hallucination
• Auditory h. – Verbal / non verbal
• Continuous / intermittent
• Single voice / multiple voices
• Familiar voice / unfamiliar voice
• First person / sec. Person / third person
• Pleasant / unpleasant
• If unpleasant – commanding / abusive / threatening
• Whether mood congruent
12. • Distinguish hallucinations from imagery and pseudo-hallucinations.
Other perceptual disturbances, include
• Illusions
• Heightened perception
• Dulled perception
• Depersonalization
• Derealization
13. Orientation
• TIME : Approximately what time of the day is it ?
Is it morning / evening / afternoon / night ?
What is the date & day is today ?
• PLACE: What place is this ?
• PERSON:Tested by asking identity of the pt.
Inquire about the identity of the patients relatives and
family members.
14. Attention and Concentration
1. Digit span test
5-7-3 4-1-7
5-3-8-7 6-1-5-8
1-6-4-9-5 2-9-7-6-3
3-4-1-7-9-6 6-1-5-8-3-9
7-2-5-9-4-8-3 4-7-1-5-3-8-6
2. Serial subtraction
3. Days or months forward to backward
15. Memory
a) Immediate : tested by digit span test
b) Recent :
1) Address Test.
2) Asking the patient to recall events in the last 24 hours
e.g., details of the time and amount in a meal, visitors to the hospital
from an inpatient. Responses given by the patient should be noted of
any cross-checked from reliable source.
c) Remote : Information on life events.
16. Intelligence
Includes : General information, comprehension, arithmetic and
vocabulary.
• General information: information relevant to the patients literacy age
or occupation may be asked
In literate a) Name of Prime Minister b) 5 river, cities or states c)
Capitals of countries d) Current events (major)
For illiterates: a) Seasons b) Crops of fruits growing particular seasons
c) Prices of food grains or food items d) Prices of land
17. Intelligence(cont..)
• Comprehension
1. What will you do when you feel cold?
2. What will you do if it rains when you start to work?
3. What will you do when you miss the bus when you are on a journey?
• Arithmetic
18. Abstraction
• Similarities
Orange - Banana (fruits)
Dog - Lion (animals)
• Differences
Stone - Potato (not edible - edible/hard-soft)
TV- Radio (audio-visual-audio)
• Proverbs
1) Slow and steady wins the race.
2) A barking dog never bites.
19. Judgement
• Personal : Inquiries about the patients future plans.
• Social : observing behaviour in social situations.
• Test :
1. Fire problem: If the house in which you are catches fire, what is
the first thing you will do?
2. Letter problem: If when you are walking on the roadside you see a
stamped and sealed envelope with an address on it which someone
had dropped, what will you do?
20. Insight
GRADE 1 Complete denial of illness.
GRADE 2 Slight Awareness of being ill but denying it at the same
time.
GRADE 3 Awareness of being sick but blaming it on others ,
external factors, or medical or unknown organic
factors.
GRADE 4 Awareness that illness is due to something unknown in
the patient.
GRADE 5 Intellectual insight : Admission of illness & recognition
that symptoms or failure in social adjustment are due
to irrational feelings/disturbances, without applying
that knowledge to future experiences.
21. Diagnostic Formulation
• Index patient, Mr/Ms/ Mrs X, Age, sex, married/single, education,
occupation, religion, hailing from rural or urban place belongs to socio-
economic(LSES, MSES, USES), nuclear or joint family presenting with chief
complaints of (complaints in chronological order), with past history of
(medical or psychiatric), family history, personal history, with premorbid
personality suggestive of,
• On MSE findings- only positive findings which are supported to final
diagnosis
• Eg… general appearance, unkempt, untidy, non co-operative, incesed
psychomotor activity, speech soft, relevant, coherent, decresed reaction
time and productivity, affect- cheerful at time inappropriate, present
delusion of infidelity and persecution, impaired social and personal
judgment, Insight- Grade I.
• Diagnosis:
22. Diagnostic Clusters under ICD-10
F00-09 Organic including symptomatic, mental dis
F10-19 Mental & Behavioral dis. Due to psychoactive
substance use
F20-29 Schizophrenia, schizotypal & delusional dis.
F30-39 Mood (Affective) disorders
F40-49 Neurotic-stress related & Somatoform dis.
F50-59 Behavioral syndromes associated with physiological
disturbances & physical factors
F60-69 Dis. of adult personality & behavior
F70-79 Mental retardation
F80-89 Disorders of psychological development
F90-98 Behavioral & emotional dis. with onset usually occurring in
childhood and adolescence
23. Conclusion
• MSE is a tool that provides a picture of the patients current mental
status which include evaluating different aspects including cognitive
functions.
• Performing a detailed MSE is significant in determining how we can
manage as well as monitoring treatment response of the patient .
24. References
1.Comprehensive casework schedule , Dept. of Psychiatry, Pushpagiri
Institute of Medical Sciences and Research Centre, Thiruvalla.
2. NIMHANS Pro-forma for Case Taking.
3.Kaplan & Sadock’s Comprehensive Textbook of Psychiatry 10th
Edition.