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Getting the research information out to those who need
to know it!
What is dissemination? Publication - highest level
Presenting at National Conference
Presenting at Local Conference
Journal Club where one person reviews an article
What does a 17 on MMSE mean? Moderate cognitive impairment
What is Tegretol in the CYP450 system? Inducer -->will lower dose of Lamictal and BCP's
What do BCP's do to Lamictal? Inducer - will lower dose of Lamictal
What is a Type I research error? There IS a ditterence but you say there isn't a ditterence.
What is a Type II research error? There is NO ditterence but you say there is a ditterence.
Cognitive impairment secondary to depression that clears
What is pseudo-dementia?
when treated in the elderly. Dementia won't improve.
Is it normal for a 1 month old to have a palmar grasp? Yes.
The time it takes for 50% of a drug to be eliminated from
What is a drug 1/2 life?
the body.
What 3 atypicals can be used with teens? Zyprexa, Abilify, Seroquel - low doses
What is a risk of using Tramadol? Serotonin Syndrome as it is very serotonergic.
What is the allele seen in Asians that increase the risk of
HLAB-1502
SJS?
When might you see toxic epidermal necrolysis? With worsening of SJS
1st degree - mother, father, siblings
How many generations do you include for a genogram? 2nd degree - grandparents & cousins
3rd degree -
What does messenger RNA code for? Amino Acids
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Factors that attect genes - environmental, smoking, stress,
What is epigenetics?
etc...
Basal Ganglia
What part of the brain is involved with OCD?
Occipito-Frontal
Dendritic pruning
What happens to the brain during adolescence? Emotions are controlled by amygdala
By adulthood, PFC involved as well
When do males typically present with schizophrenia? 10-25 yo
When do females typically present with schizophrenia? 25-35 yo
You will need to decreases the level because Trileptal(in-
What does Erythromycin to trileptal?
ducer) and erythromycin is a inhibitor
Heart Failure
ACE Inhibitors are the drug of choice for what?
HTN
Leukotriene receptor agonists - singulair, accolade, zyflo =
What are some psychiatric side ettects seen with some
agitation, aggression, anxiety, hallucinations, depression,
asthma drugs
insomnia, SI, tremor
What should you watch for with Tegretol? Agranulocytosis and Hyponatremia
What are the 3 CK muscle enzyme tests? CKBB, CKMM, CKMB
Which one of the 3 muscle enzymes are related to cardiac
CKMB
muscle damage?
Polymyositis
What is the risk of a seriously elevated CKMB?
Rhabdo
What is a normal CKMB? 0.3 mcg/L
Topamax
What psychoactives does Detrol interact with? KCL
Zonegran
CN XI - Spinal Accessory
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What CN are you assessing when you have the patient
shrug their shoulders?
CD4 <200
What do you see in labs with HIV & Dementia? Viral Load is high
<20% get it with antiretroviral treatment
Self-Report - 0-63
0-13 - minimal
What is the scoring with the Beck Depression Inventory? 14-19 - mild
20-28 - moderate
29-63 - severe
What is sensitivity? Helps rule-out disease = True Positive = Snout
What is specificity? Helps rule-in disease = True Negative = Spin
Inflammation (ESR - Erythrocyte Sedimentation Rate) =
What does a sed rate measure?
distance in mm RBC's have descended in 1 hour.
0-22 males
What is a normal sed rate or ESR?
0-29 females
Measures % of reticulocytes in blood (immature RBC's)
What is a retic count? Indicates whether enough RBC's are being produced by
bone marrow.
What does a decreased retic count indicate? Anemia - acute or chronic bleeding
What does an increased retic count indicate? Bone marrow disorder or Vitamin Deficiency
Doesn't diagnose anything. First step is ID source of the
What does an abnormal retic ount indicate in general?
issue.
What happens when you mix tegretol and macrolides? Increase tegretol levels.
What happens if a pregnant women takes Accutane? Birth defects.
Sed rate, RF, ANA, C reactive protein, CBC, CMP, CRP - helps
What labs do you get with RA?
confirm diagnosis.
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CRP and ESR are both increased in RA but NOT in os-
teoarthritis.
Where does the NP Code of Ethics come from? ANA
Unconscious
When do you assume informed consent? Incompetent
Life Threatening Situation
What are the legal ramifications of treating w/o informed
Same as with informed consent
consent?
Who can declare a patient incompetent and appoint a
Only a court
guardian?
Does impaired judgment mean one is incompetent? No.
Can an advanced directive ever be revoked? Yes, at any time.
What is the ditterent between a Healthcare Agent, Proxy,
Nothing. They are all the same.
Surrogate, and Attorney in Fact?
Does the de facto rule of proxy apply in same sex mar-
No.
riages?
As in a position of authority.
How do Asians see HC providers?
Expect to give instructions and help make decisions
What does it mean when an Asian patient does not make
SIgn of respect
eye contact with the NP?
When a stronger or more powerful person looks at a
weaker person - often infant/child resulting in a hex which
What is the evil eye?
presents in illness such as HA, fever, diarrhea, disturbed
sleep, increased fussiness.
Red ribbon on an infant
How do you protect from the evil eye?
Amulet for adults
How do you treat for evil eye? Access traditional healer + traditional care.