LMR - Georgette's 2023 Qbank Georgette's PMHNP Certification Exam Review; Latest 2023

LMR - Georgette's 2023 Qbank What drugs should be avoided with Kava Kava? Alprazolam CNS depressants (e.g., phenobarbital, zolpidem) Cultural Formulation Interview perform what 3 functions? Clarify meaning of illness Empower the patient Validate symptoms within cultural context What does a cultural formulation interview do? cultural assessment What is the normal range for TSH? 0.5 - 5.0 mu/L What are lab values in Hyperthyroidism Decreased TSH Increased T4 and T3 What are labs in Hypothyroidism? Increased TSH Decreased T4 and T3 What are 5 primary symptoms of Hyperthyroidism? Heat intolerance Agitation, Anxiety, Irritability Tachycardia Mood swings Weight loss What are 4 primary symptoms of Hypothyroidism? Cold intolerance Lethargy Weight gain Decreased libido Hypothyroidism mimics symptoms of what psychiatric disorder? Depression Hyperthyroidism mimics symptoms of what psychiatric disorder? Mania Valproic acid produces what teratogenic effect? Spina bifida (neural tube defect) What is the primary organ where valproic acid is toxic? Liver (hepatoxicity) What are 4 signs of hepatoxicity? Abdominal pain in the URQ Reddish-brown urine Yellowing of the skin and sclera Fatigue Abdominal pain in the URQ, Reddish-brown urine, Yellowing of the skin and sclera, and Fatigue are signs of Hepatoxicity What is the therapeutic range for valproic acid? 50-125 mcg/ml What is a toxic level of valproic acid? >150 mcg/ml What are 4 signs of valproic acid toxicity? Disorientation Lethargy Respiratory depression Nausea/vomiting Disorientation, Lethargy, Respiratory depression, and Nausea/vomiting are symptoms of toxicity with what drug? Valproic acid With suspected toxicity with valproic acid, what labs should be drawn? DC drug Check drug level Obtain LFTs Obtain ammonia level What is the major side effect with Kava Kava? Liver damage What herbal supplement is sued for anxiety, stress, and insomnia? Kava Kava What are 5 symptoms of Stephen's Johnson Syndrome? Fever Body aches Severe red rash Peeling skin Facial and tongue swelling Severe red rash, Fever, Body aches, Peeling skin, and Facial and tongue swelling are symptoms of Stephen's Johnson Syndrome Which mood stabilizer causes the least weight gain? Lamotrigine (Lamictal) Which 3 SGAs cause the least weight gain? Lurasidone (Latuda) Aripiprazole (Abilify) Ziprasidone (Geodon) Which SGA is the least sedating? Aripiprazole (Abilify) What are 3 hallmark symptoms of delirium? Acute disturbance of LOC impaired cognition inattention Acute disturbance of LOC, cognition, and inattention are hallmark symptoms of Delirium How are agitation and psychotic symptoms treated in delirium? Low dose Haldol What 4 drugs can cause mania? Steroids Disulfiram (Antabuse) Isoniazid (INH) Antidepressants (in BPD) Steroids, Disulfiram (Antabuse), and Isoniazid (INH) can induce Mania What 6 drugs can induce depression? Steroids Beta blockers Interferon, Isotretinoin (Accutane) Retroviral drugs, Antineoplastic drugs Benzodiazepines Progesterone Steroids can induce what 3 psychiatric states? Mania Depression Psychosis What medication to treat acne cause cause birth defects? Isotretinoin (Accutane) What is the therapeutic range for lithium? 0.6-1.2 mEq/L What medication has a neuroprotective effect for bipolar disorder? Lithium What is the gold standard for treating manic episodes Lithium What mood stabilizer has anti-suicidal effects? Lithium What 5 labs should be drawn with lithium? Thyroid panel (TSH) Serum creatinine BUN Urinalysis HCG What is a normal SCr range? 0.6-1.2 mg/dL What is the normal range for BUN? 10-20 mg/dL When should you suspect kidney disease with a urinalysis? 4+ protein 4+ protein in the kidney suggests Kidney disease What are 7 side effects of lithium? Hypothyroidism Fine hand tremors Maculopapular rash