Tell her you are going to ask her a few questions to test her memory

You do a Mini-Mental Status exam

Her score is 20/30 losing points on orientation- She is oriented to person but does not know which hospital she is in and is unsure of the date although she knows the season and the year.  She explains that she ‘wasn’t at work today so it must be the weekend. She can only recall one of the three objects and she misspells WORLD backwards.

She reluctantly completes the rest of the test and asks "Do you think I'm an idiot? Of course I can spell and write!"

What next?

 

*consider switch to MOCA since MMSE has copyright wrangles just now

Screen for mood disorders
Family history
Current medications
Ask her about other drug use
Move on to physical exam

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