Psychiatry: Mental Status Examination

Today's Case A 61-year-old male arrives at the emergency department by ambulance after being in a three-vehicle collision resulting in two fatalities. After the event he is openly joking about the accident, appears apathetic to the loss of life, and has urinary incontinence while speaking to the police. Field sobriety tests are conducted by the police in response to his behavior. The test is quickly suspended when the patient takes more than the instructed nine steps forward on three attempts. A breatha- lyzer test shows negative for alcohol. He denies having any discomfort and tries to leave the hospital (requiring redirection by staff ). He does not ask why he was brought to the hospital. His only visible injuries are minor chest contusions, likely from impact with the steering wheel. When asked how he’s feeling, he repeatedly (and at times inappropriately) responds, “Right as rain.” His wife has been contacted and is on her way to the hospital. Today's Reader Ryan O'Connell is a junior biology major at Loyola Marymount University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Dr. Raj on Instagram⁠⁠⁠⁠⁠ Want more board review content? ⁠⁠⁠⁠⁠USMLE Step 1 Ad-Free Bundle⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Crush Step 1⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Step 2 Secrets⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Beyond the Pearls⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Beyond the Pearls Premium⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠USMLE Step 3 Review⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠MedPrepTGo Step 1 Questions⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠MedPrepTGo Step 2 Questions⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices