Mental Status Exam on CS?

[Medstart108]

Does anyone know if you get a psych case on Step 2 CS, if you need to do a mental status exam or if you shouldn't do one and just write it as one of your orders instead? I'm asking this because in the first aid mini cases, they seem to suggest that MSE is a test to be ordered, but it also isn't one of the "physicals" that you can't do to the patient, so just not sure.

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[MaxillaryCa]

The mental status exam is a brief couple of questions you can use to assess the patient's cognition and orientation, and should be done in any psych or neuro case. The full MSE that you order in the labs is much more in depth. So you can order that as an extra test.

 

[Medstart108]

The mental status exam is a brief couple of questions you can use to assess the patient's cognition and orientation, and should be done in any psych or neuro case. The full MSE that you order in the labs is much more in depth. So you can order that as an extra test.

Ah I see, so we do a mini mental status, but we won't do something like this in the station, but we can order it as a lab:

1. General Observations
   1. Appearance
   2. Speech
   3. Behavior
   4. Cooperativeness
2. Thinking
   1. Thought Process
   2. Thought Content
   3. Perceptions
3. Emotion
   1. Mood
   2. Affect
4. Cognition
   1. Orientation/Attention
   2. Memory
   3. Insight
   4. Judgment

How about something like the dix-hallpike maneuveur, its included in the workup/labs section of first aid but i thought that would be a standard part of the physical exam you would do in a dizzyness case?

 

[MaxillaryCa]

Thats right, and you could just write full mental status examination as a lab.

Well I would stay away from that maneuver. That might hurt a patient (bad) and catch them off guard (bad). I would just stick to ear, CVS, and rhomberg's test for dizziness. Maybe a tandem gait test if you have time.