Physical examination maneuver
Physical Exam
Mental Status Assessment
also known as Mental status examination
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Through conversation and targeted tasks, assess the domains of the mental status examination: level of consciousness and arousal; appearance and behavior; attention (for example, spelling "world" backwards); orientation to person, place, and time; memory (immediate, recent, and remote); language (fluency, naming, repetition, comprehension); and higher cognitive functions (calculation, abstraction, and judgment). Standardized instruments may be used to score cognition.
How to Interpret
Showing 22 of 25 findings
Cirrhosis
Encephalopathy
Rule in
Very helpful
Rule out
Not helpful
Evidence:Strong
Delirium
Confusion Assessment Method for the ICU (CAM-ICU) positive in an ICU patient
Rule in
Very helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Strong
4 "A"s Test (4AT) score greater than 3 positive
Rule in
HelpfulDerived CI
Rule out
HelpfulDerived CI
Evidence:Strong
Confusion Assessment Method (CAM) positive
Rule in
Helpful
Rule out
Helpful
Evidence:Strong
Disorientation to time, place, or person
Rule in
Somewhat helpfulDerived CI
Rule out
HelpfulDerived CI
Evidence:Moderate
Intensive Care Delirium Screening Checklist (ICDSC) score ≥4
Rule in
Somewhat helpfulNo CI
Rule out
Somewhat helpfulNo CI
Evidence:Strong
Single Question in Delirium (SQID) positive
Rule in
Somewhat helpfulWide CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate
Dementia
Addenbrooke's Cognitive Examination-Revised (ACE-R) total score less than 88 positive
Rule in
Helpful
Rule out
Very helpful
Evidence:Strong
Mini-Cog score less than or equal to 2 (out of 5) positive in adults 60 or over
Rule in
Helpful
Rule out
Very helpful
Evidence:Moderate
Mini-Mental State Examination (MMSE) score less than 24 positive in adults 65 or over
Rule in
HelpfulDerived CI
Rule out
HelpfulDerived CI
Evidence:Moderate
Abbreviated Mental Test Score (AMTS/AMT-10, or AMT-4) below threshold
Rule in
Helpful
Rule out
Somewhat helpful
Evidence:Moderate
Montreal Cognitive Assessment (MoCA) score less than 26 positive
Rule in
Somewhat helpful
Rule out
Helpful
Evidence:Strong
Abnormal clock-drawing test
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Strong
Head-turning sign
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate
Hypovolemia
Confusion
Rule in
InconclusiveWide CI
Rule out
InconclusiveWide CI
Evidence:Moderate
Major Depressive Disorder
Whooley 2-question screen positive
Rule in
Somewhat helpful
Rule out
Very helpful
Evidence:Strong
Patient Health Questionnaire-9 (PHQ-9) score ≥10
Rule in
HelpfulDerived CI
Rule out
HelpfulDerived CI
Evidence:Strong
Geriatric Depression Scale 15-item short form (GDS-15) score ≥5
Rule in
Somewhat helpfulDerived CI
Rule out
HelpfulDerived CI
Evidence:Strong
Patient Health Questionnaire-2 (PHQ-2) score ≥3
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Strong
Stroke
Coma / unresponsiveness on level-of-consciousness assessment
Rule in
Helpful
Rule out
—
Evidence:StrongResearch in progress
Mental status alert
Rule in
—
Rule out
Somewhat helpful
Evidence:StrongResearch in progress
Mental status drowsy
Rule in
InconclusiveWide CI
Rule out
—
Evidence:StrongResearch in progress
Related Bedside Tests
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Pupillary Light Reaction
Rule in:VHSerious Eye Disease, HPoor Neurologic Outcome, HStructural Brain Lesion +11 more
Rule out:SHPoor Neurologic Outcome, SHSerious Eye Disease, SHStructural Brain Lesion +11 more
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Asterixis
aka Flapping tremor; liver flap
Rule in:IEMetabolic Encephalopathy, IEStructural Brain Lesion
Rule out:IEMetabolic Encephalopathy, IEStructural Brain Lesion
🎬Video coming soon
Gait Assessment
Rule in:VHStroke, HFalls, HVascular Parkinsonism +24 more
Rule out:SHDementia, SHVascular Parkinsonism, MHFalls +24 more
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Blood Pressure
Rule in:VHHypovolemia, VHMortality, VHStructural Brain Lesion +22 more
Rule out:VHCardiac Tamponade, VHHypovolemia, HLow Cardiac Output +22 more
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Heart Rate
Rule in:SHAtrial Fibrillation, SHDecompensation, SHHypothyroidism +15 more
Rule out:HDecompensation, SHAtrial Fibrillation, SHPostoperative Complication +15 more
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Extraocular Movements
Rule in:VHStroke, SHHyperthyroidism, SHMyasthenia Gravis +9 more
Rule out:HMyasthenia Gravis, SHHyperthyroidism, NHOrbital Fracture +9 more