Georgette's LMR (Georgette's Last
Minute Review)
What should you not do when advocating for a patient? ✔️Ans - Judge or
confront
What class of medication is contraindicated with tics? ✔️Ans - Stimulants
What should you provide for prior to assessing abuse victims? ✔️Ans - A
safe environment
What are your actions if a child reports abuse? ✔️Ans - First interview
separately from parents then report to CPS
What should you do if a child plays with toys in a way that you suspect abuse?
✔️Ans - Report to CPS
In what setting as an inpatient provider should you interview a patient?
✔️Ans - Use a private room with the door partially open
How should you begin your interview with adolescents? ✔️Ans - By
building rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents? ✔️Ans -
Without
What if an adolescent tells you they are homosexual and they don't want their
parents to know? ✔️Ans - This is confidential
The patient is being discharged and would like their labs faxed to the rehab
facility. What is your initial action? ✔️Ans - Get informed consent/ROI
What do you do if a medical evaluation is needed? ✔️Ans - Refer out - this
is out of scope
What do you do if a patient is takes something and is feeling really
funny/unwell in your office? ✔️Ans - Collect UDS and then refer out
,Is it considered a mental illness if it is an expected response culturally? What
do you offer as treatment? ✔️Ans - No; brief supportive therapy - not
medication
A mother states her child is experiencing a cultural illness. What is your initial
action? ✔️Ans - Respect the mother's cultural understanding of illness
prior to assessment
Native Americans view mental illness and SUDs as? ✔️Ans - An imbalance
between the individual and the world
What ethnic group has the highest rate of suicidality in the US? ✔️Ans -
Native Americans
If a patient believes they need a healing stick in their room, but the staff
nurses removed it from them - what should you do? ✔️Ans - Teach cultural
sensitivity and make accommodations for patient to have healing stick
available such as 1:1
Psychoeducation should be based on? ✔️Ans - Cultural context
How do you promote health in a location with multiple ethnicities and
education levels? ✔️Ans - Multiple cultural education and ethnospecific
assessment parameters
What if a patient wants a traditional healer? ✔️Ans - Allow this -
remember ROI/informed consent
Normal TSH? ✔️Ans - 0.5-5.0
TSH < 0.5 = ? ✔️Ans - Hyperthyroidism
TSH > 5.0 = ? ✔️Ans - Hypothyroidism
Relationship between TSH & T3/T4? ✔️Ans - Inverse
Hyperthyroidism can present as? ✔️Ans - Mania
, Hypothyroidism can present as? ✔️Ans - Depression
Normal depakote level? ✔️Ans - 50-125
Toxic depakote level? ✔️Ans - 150+
Birth defect caused by depakote? ✔️Ans - Spina Bifida
S/S of depakote toxicity? ✔️Ans - Disorientation, lethargy, decreased
respiratory rate, and N/V
What to do if there is depakote toxicity? ✔️Ans - D/C depakote and check
VPA level, LFTs, and ammonia
S/S of hepatotoxicity? ✔️Ans - RUQ pain, reddish brown urine, jaundice,
fatigue, and elevated LFTs
Normal AST? ✔️Ans - 5-40
Normal ALT? ✔️Ans - 5-35
Kava kava can cause? ✔️Ans - Liver damage and heavy sedation
Kava kava is c/i with? ✔️Ans - Benzos or sedatives
Mood stabilizer most associated with SJS? ✔️Ans - Lamictal
Mood stabilizer with least weight gain? ✔️Ans - Lamictal
SGAs with least weight gain? ✔️Ans - ziprasidone, abilify, and latuda
Least sedating SGA? ✔️Ans - Abilify
Routine labs with SGAs? ✔️Ans - BMI, hip to waist ratio, glucose, A1C, and
lipid panel
Management of metabolic syndrome with SGAs? ✔️Ans - 1. Nonpharm =
exercise or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
Minute Review)
What should you not do when advocating for a patient? ✔️Ans - Judge or
confront
What class of medication is contraindicated with tics? ✔️Ans - Stimulants
What should you provide for prior to assessing abuse victims? ✔️Ans - A
safe environment
What are your actions if a child reports abuse? ✔️Ans - First interview
separately from parents then report to CPS
What should you do if a child plays with toys in a way that you suspect abuse?
✔️Ans - Report to CPS
In what setting as an inpatient provider should you interview a patient?
✔️Ans - Use a private room with the door partially open
How should you begin your interview with adolescents? ✔️Ans - By
building rapport with them by ensuring confidentiality absent exceptions
Should you interview adolescents with or without parents? ✔️Ans -
Without
What if an adolescent tells you they are homosexual and they don't want their
parents to know? ✔️Ans - This is confidential
The patient is being discharged and would like their labs faxed to the rehab
facility. What is your initial action? ✔️Ans - Get informed consent/ROI
What do you do if a medical evaluation is needed? ✔️Ans - Refer out - this
is out of scope
What do you do if a patient is takes something and is feeling really
funny/unwell in your office? ✔️Ans - Collect UDS and then refer out
,Is it considered a mental illness if it is an expected response culturally? What
do you offer as treatment? ✔️Ans - No; brief supportive therapy - not
medication
A mother states her child is experiencing a cultural illness. What is your initial
action? ✔️Ans - Respect the mother's cultural understanding of illness
prior to assessment
Native Americans view mental illness and SUDs as? ✔️Ans - An imbalance
between the individual and the world
What ethnic group has the highest rate of suicidality in the US? ✔️Ans -
Native Americans
If a patient believes they need a healing stick in their room, but the staff
nurses removed it from them - what should you do? ✔️Ans - Teach cultural
sensitivity and make accommodations for patient to have healing stick
available such as 1:1
Psychoeducation should be based on? ✔️Ans - Cultural context
How do you promote health in a location with multiple ethnicities and
education levels? ✔️Ans - Multiple cultural education and ethnospecific
assessment parameters
What if a patient wants a traditional healer? ✔️Ans - Allow this -
remember ROI/informed consent
Normal TSH? ✔️Ans - 0.5-5.0
TSH < 0.5 = ? ✔️Ans - Hyperthyroidism
TSH > 5.0 = ? ✔️Ans - Hypothyroidism
Relationship between TSH & T3/T4? ✔️Ans - Inverse
Hyperthyroidism can present as? ✔️Ans - Mania
, Hypothyroidism can present as? ✔️Ans - Depression
Normal depakote level? ✔️Ans - 50-125
Toxic depakote level? ✔️Ans - 150+
Birth defect caused by depakote? ✔️Ans - Spina Bifida
S/S of depakote toxicity? ✔️Ans - Disorientation, lethargy, decreased
respiratory rate, and N/V
What to do if there is depakote toxicity? ✔️Ans - D/C depakote and check
VPA level, LFTs, and ammonia
S/S of hepatotoxicity? ✔️Ans - RUQ pain, reddish brown urine, jaundice,
fatigue, and elevated LFTs
Normal AST? ✔️Ans - 5-40
Normal ALT? ✔️Ans - 5-35
Kava kava can cause? ✔️Ans - Liver damage and heavy sedation
Kava kava is c/i with? ✔️Ans - Benzos or sedatives
Mood stabilizer most associated with SJS? ✔️Ans - Lamictal
Mood stabilizer with least weight gain? ✔️Ans - Lamictal
SGAs with least weight gain? ✔️Ans - ziprasidone, abilify, and latuda
Least sedating SGA? ✔️Ans - Abilify
Routine labs with SGAs? ✔️Ans - BMI, hip to waist ratio, glucose, A1C, and
lipid panel
Management of metabolic syndrome with SGAs? ✔️Ans - 1. Nonpharm =
exercise or nutritional counseling
2. Pharm = switch to other SGA with lower chance of metabolic syndrome
