LMR Georgette’s PMHNP Final Certification Exam
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 RUQ
Reddish-brown urine
, Yellowing of the skin/sclera
Fatigue
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
A patient on depakote complains of abdominal pain in the RUQ and reddish-brown urine. What do you
suspect? What do you do?
Suspect: hepatotoxicity
Interventions:
-hold med
-draw LFT's (priority)
-VPA/DVP level
With suspected toxicity with valproic acid, what steps/labs should be drawn?
D/C drug
Check drug level
Obtain LFTs
Obtain ammonia level
A pregnant patient is taking accutane, zyprexa, and abilify. What medication needs to be discontinued?
Accutane
Accutane is used for acne and is contraindicated in pregnancy as it can cause birth defects
What herbal supplement is used for anxiety, stress, and insomnia?
Kava Kava
What is a major side effect of Kava Kava?
Liver damage
What drugs should be avoided with Kava Kava?
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 RUQ
Reddish-brown urine
, Yellowing of the skin/sclera
Fatigue
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
A patient on depakote complains of abdominal pain in the RUQ and reddish-brown urine. What do you
suspect? What do you do?
Suspect: hepatotoxicity
Interventions:
-hold med
-draw LFT's (priority)
-VPA/DVP level
With suspected toxicity with valproic acid, what steps/labs should be drawn?
D/C drug
Check drug level
Obtain LFTs
Obtain ammonia level
A pregnant patient is taking accutane, zyprexa, and abilify. What medication needs to be discontinued?
Accutane
Accutane is used for acne and is contraindicated in pregnancy as it can cause birth defects
What herbal supplement is used for anxiety, stress, and insomnia?
Kava Kava
What is a major side effect of Kava Kava?
Liver damage
What drugs should be avoided with Kava Kava?
