Ugh: MMSE?

[omores]

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Hi all.

Taking Step 2CS in 2 days and starting to panic (as usual).

I figure I might have to evaluate a "forgetful" elderly patient. In real life, I'd probe for s/sx of depression, do a diet history, perform a full neuro exam, and order standard "reversible causes of dementia" labs. And of course I'd do an MMSE, using my handy-dandy cheat sheet.

Is there even time for an MMSE (let alone full neuro exam)? Should I be attempting to re-memorize the MMSE questions? Or have people just opted to do an abbreviated let's-see-how-oriented-you-are kind of thing?

Thanks!

 

[future_OB]

Hi all.

Taking Step 2CS in 2 days and starting to panic (as usual).

I figure I might have to evaluate a "forgetful" elderly patient. In real life, I'd probe for s/sx of depression, do a diet history, perform a full neuro exam, and order standard "reversible causes of dementia" labs. And of course I'd do an MMSE, using my handy-dandy cheat sheet.

Is there even time for an MMSE (let alone full neuro exam)? Should I be attempting to re-memorize the MMSE questions? Or have people just opted to do an abbreviated let's-see-how-oriented-you-are kind of thing?

Thanks!

Hi. Bear in mind you only have 12 patients. Not all will be the same case. I think just memorize the First Aid MMSE questions. I forgot which page it is but its in the chapter before the minicases. Good luck! I dont know if I passed but all I can say is read First Aid before sleeping, the cases I mean there are only 27 of them anyway.

Good luck.

 

[omores]

Thanks for the luck!!!

See, First Aid is what has gotten me freaked out in the first place. It talks about asking all the screening (depression, dietary, hypothyroid, vascular dz, syphilis) + dementia vs. delirium questions -- and then advises you to do a whole neuro + MMSE exam. And counsel. In 15 minutes. Yeah, right.

In one of FA's 27 cases, the patient checklist includes an MMSE, but the sample patient note doesn't include the MMSE score -- it only says something like "pt was oriented x 3, spells backwards but can't recall 3 objects". Ahhh, but how were her intersecting pentagons?

So my plan (such as it is) would be to just to the first part of the MMSE -- orientation, remembering 3 objects and spelling "world" backwards -- and skip the intersecting pentagons and "write a sentence" kind of thing. Unless of course I have scads of time, which would probably indicate that I'd left out something else of importance.

Off to have a cup of coffee and write some more barely legible 10-minute practice notes. And I'll be sure to read those 27 cases again before the test. I think that'll be really helpful. Thanks!

 

[future_OB]

Thanks for the luck!!!

See, First Aid is what has gotten me freaked out in the first place. It talks about asking all the screening (depression, dietary, hypothyroid, vascular dz, syphilis) + dementia vs. delirium questions -- and then advises you to do a whole neuro + MMSE exam. And counsel. In 15 minutes. Yeah, right.

In one of FA's 27 cases, the patient checklist includes an MMSE, but the sample patient note doesn't include the MMSE score -- it only says something like "pt was oriented x 3, spells backwards but can't recall 3 objects". Ahhh, but how were her intersecting pentagons?

So my plan (such as it is) would be to just to the first part of the MMSE -- orientation, remembering 3 objects and spelling "world" backwards -- and skip the intersecting pentagons and "write a sentence" kind of thing. Unless of course I have scads of time, which would probably indicate that I'd left out something else of importance.

Off to have a cup of coffee and write some more barely legible 10-minute practice notes. And I'll be sure to read those 27 cases again before the test. I think that'll be really helpful. Thanks!

Hey, gets tons of sleep. Its one of those times when its best if youre well rested otherwise it will be terrible to concentrate. stop drinking coffee. forget about the pentagons. no need to score for the MMSE. just do what first aid tells you.

again good luck!

 

[Mr. Plow]

I recently took the exam and agree with you regarding First Aid. It is ridiculous. Just do a basic MMSE with ADLs and IADLs, basic neuro exam, general exam and your PAMHUGSFOSS.. you'll be in pretty good shape. Just remember, there are 12 cases and this is only one of them. 🙂

Thanks for the luck!!!

See, First Aid is what has gotten me freaked out in the first place. It talks about asking all the screening (depression, dietary, hypothyroid, vascular dz, syphilis) + dementia vs. delirium questions -- and then advises you to do a whole neuro + MMSE exam. And counsel. In 15 minutes. Yeah, right.

In one of FA's 27 cases, the patient checklist includes an MMSE, but the sample patient note doesn't include the MMSE score -- it only says something like "pt was oriented x 3, spells backwards but can't recall 3 objects". Ahhh, but how were her intersecting pentagons?

So my plan (such as it is) would be to just to the first part of the MMSE -- orientation, remembering 3 objects and spelling "world" backwards -- and skip the intersecting pentagons and "write a sentence" kind of thing. Unless of course I have scads of time, which would probably indicate that I'd left out something else of importance.

Off to have a cup of coffee and write some more barely legible 10-minute practice notes. And I'll be sure to read those 27 cases again before the test. I think that'll be really helpful. Thanks!

 

[omores]

Thanks everybody.

As it turns out, it was a non-issue: not a forgetful elderly lady in sight. There was somebody I probably should have screened for dementia, but it wasn't his presenting complaint, and he was completely functional and with it, so I let it slide (OK, OK -- I forgot).

On the whole it was a pretty straightforward test. First Aid had made me a bit paranoid -- I ended up asking questions that were not really relevant to the case, because I was afraid of missing something. When an SP mentioned that her condition was causing some tension in her relationship, I immediately launched into questions about spousal abuse -- which got me a very confused look. Oh well.

I'll write more about my experience after I get my results. Too superstitious to talk about it much now!

 

[omores]

Hey, gets tons of sleep. Its one of those times when its best if youre well rested otherwise it will be terrible to concentrate. stop drinking coffee. forget about the pentagons. no need to score for the MMSE.

Excellent advice. The night before the test, I ended up putting away my First Aid, turning on the TV, and watching the season premiere of Real World Key West. Perfect. Got me in the right frame of mind.