PMHNP-BC UPDATED Exam Questions
and CORRECT Answers only
Risk of Schizophrenia in monozygotic twins is? - Correct Answer- 46-50%
Family hx risk of schizophrenia - Correct Answer- 10x risk with 1st degree relative
brain changes in schizophrenia - Correct Answer- increase in ventricular volume (enlarged
cerebral ventricles)
Hippocampus volume decrease, 4% smaller
Decreased electrical activity in frontal lobes
Decrease glutamate and GABA release.
Decreased total brain volume
functional neuroimaging findings of schizophrenia - Correct Answer- Abnormal function of
frontal cortical regions
Including for solo lateral prefrontal and anterior cingulate cortices
Maximum dose of Celexa - Correct Answer- 40mg/day as higher doses can cause abnormal
electrical activity of the heart. Some experts still prescribe higher
What class of medication is bupropion - Correct Answer- NDRI boosts norepinephrine,
noradrenaline, and dopamine neurotransmitters
What hematologic change is associated with lithium? - Correct Answer- Leukocytosis.
Lithium raises WBC counts. Monitor CBC
GABA in terms of anxiety disorders - Correct Answer- Most abundant inhibitory
neurotransmitter. Decreasing GABA would increase anxiety. Benzos are used to bind with
GABA to potentiate the anxiolytic effects of GABA
,What to avoid while on Disulfiram - Correct Answer- Anything containing alcohol (vinegar,
mouthwash, aftershave, cough medicine). Avoid for 2 weeks after discontinuing disulfiram.
Lab effected by disulfiram that requires monitoring - Correct Answer- Disulfiram can elevate
liver function tests
A medication that can induce mania - Correct Answer- Corticosteroids
What finding would be associated with an acoustic neuroma? - Correct Answer- Unilateral
ringing in the ear (tinnitus) may be the first symptom of an acoustic neuroma.
What delay is expected in a 4 year old with Asperger's? - Correct Answer- Delay in social
skills development.
Unlike autistic disorder, no significant delays in language, cognitive development, or age
appropriate self help skills are observed.
Primary clinical features of Asperger's - Correct Answer- Qualitative social impairment
Markedly abnormal nonverbal communicative gestures
Failure to develop peer relationships
Lack of social or emotional reciprocity
Impaired ability to express pleasure in other persons' happiness.
Chlorpromazine (Thorazine) and clozapine cause what troublesome side effect due to their
alpha 1-adrenergic blockade? - Correct Answer- Orthostatic hypotension. Manage by raising
dose of chlorpromazine and clozapine slowly.
What medication is strictly prohibited when the patient is on an MAOI such as selegiline due
to the risk of hypertensive crisis and death? - Correct Answer- Meperidine (Demerol)
Dopamine pathways in relation to clinical symptoms of schizophrenia - Correct Answer-
Negative symptoms are related to DA deficit in the cerebral cortex; positive symptoms are
related to DA excess in the nucleus accumbens and mesolimbic system.
Facial characteristics of child with fetal alcohol syndrome - Correct Answer- Small head
, Short eyelid opening
Flat midface
Smooth philtrum
Underdeveloped jaw
Thin upper lip
Short nose
(Can also have inner epicanthal folds, short palpebral fissure)
Physical features of prayer willi syndrome - Correct Answer- Obesity
Small stature
Small hands and feet
Hypotonia
Hypogonadism
Physical features of von recklinghausen's disease - Correct Answer- Café au lait spots
Neurofibromas
In what condition is the use of bupropion contraindicated? - Correct Answer- Bulimia. Do not
use bupropion in past or present eating disorders due to increased risk of seizures.
Predominant risk factor of antisocial personality disorder? - Correct Answer- Genetic
predisposition of first-degree family member.
Antisocial personality disorder is 5X more common among first-degree relative of men with
the disorder than the general population.
Risk of inhibition of platelet aggregation (risk of bleeding from SSRIs, NSAIDS, ASA) is an
example of this - Correct Answer- Pharmacodynamics
Rare but serious side effect of trazodone (Desyrel) - Correct Answer- Priapism
and CORRECT Answers only
Risk of Schizophrenia in monozygotic twins is? - Correct Answer- 46-50%
Family hx risk of schizophrenia - Correct Answer- 10x risk with 1st degree relative
brain changes in schizophrenia - Correct Answer- increase in ventricular volume (enlarged
cerebral ventricles)
Hippocampus volume decrease, 4% smaller
Decreased electrical activity in frontal lobes
Decrease glutamate and GABA release.
Decreased total brain volume
functional neuroimaging findings of schizophrenia - Correct Answer- Abnormal function of
frontal cortical regions
Including for solo lateral prefrontal and anterior cingulate cortices
Maximum dose of Celexa - Correct Answer- 40mg/day as higher doses can cause abnormal
electrical activity of the heart. Some experts still prescribe higher
What class of medication is bupropion - Correct Answer- NDRI boosts norepinephrine,
noradrenaline, and dopamine neurotransmitters
What hematologic change is associated with lithium? - Correct Answer- Leukocytosis.
Lithium raises WBC counts. Monitor CBC
GABA in terms of anxiety disorders - Correct Answer- Most abundant inhibitory
neurotransmitter. Decreasing GABA would increase anxiety. Benzos are used to bind with
GABA to potentiate the anxiolytic effects of GABA
,What to avoid while on Disulfiram - Correct Answer- Anything containing alcohol (vinegar,
mouthwash, aftershave, cough medicine). Avoid for 2 weeks after discontinuing disulfiram.
Lab effected by disulfiram that requires monitoring - Correct Answer- Disulfiram can elevate
liver function tests
A medication that can induce mania - Correct Answer- Corticosteroids
What finding would be associated with an acoustic neuroma? - Correct Answer- Unilateral
ringing in the ear (tinnitus) may be the first symptom of an acoustic neuroma.
What delay is expected in a 4 year old with Asperger's? - Correct Answer- Delay in social
skills development.
Unlike autistic disorder, no significant delays in language, cognitive development, or age
appropriate self help skills are observed.
Primary clinical features of Asperger's - Correct Answer- Qualitative social impairment
Markedly abnormal nonverbal communicative gestures
Failure to develop peer relationships
Lack of social or emotional reciprocity
Impaired ability to express pleasure in other persons' happiness.
Chlorpromazine (Thorazine) and clozapine cause what troublesome side effect due to their
alpha 1-adrenergic blockade? - Correct Answer- Orthostatic hypotension. Manage by raising
dose of chlorpromazine and clozapine slowly.
What medication is strictly prohibited when the patient is on an MAOI such as selegiline due
to the risk of hypertensive crisis and death? - Correct Answer- Meperidine (Demerol)
Dopamine pathways in relation to clinical symptoms of schizophrenia - Correct Answer-
Negative symptoms are related to DA deficit in the cerebral cortex; positive symptoms are
related to DA excess in the nucleus accumbens and mesolimbic system.
Facial characteristics of child with fetal alcohol syndrome - Correct Answer- Small head
, Short eyelid opening
Flat midface
Smooth philtrum
Underdeveloped jaw
Thin upper lip
Short nose
(Can also have inner epicanthal folds, short palpebral fissure)
Physical features of prayer willi syndrome - Correct Answer- Obesity
Small stature
Small hands and feet
Hypotonia
Hypogonadism
Physical features of von recklinghausen's disease - Correct Answer- Café au lait spots
Neurofibromas
In what condition is the use of bupropion contraindicated? - Correct Answer- Bulimia. Do not
use bupropion in past or present eating disorders due to increased risk of seizures.
Predominant risk factor of antisocial personality disorder? - Correct Answer- Genetic
predisposition of first-degree family member.
Antisocial personality disorder is 5X more common among first-degree relative of men with
the disorder than the general population.
Risk of inhibition of platelet aggregation (risk of bleeding from SSRIs, NSAIDS, ASA) is an
example of this - Correct Answer- Pharmacodynamics
Rare but serious side effect of trazodone (Desyrel) - Correct Answer- Priapism
