What is the normal range for TSH? -
ANSWER :
0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism -
ANSWER :
Decreased TSH
Increased T4 and T3
What are labs in Hypothyroidism? -
ANSWER :
Increased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism? -
ANSWER :
Heat intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
What are 4 primary symptoms of Hypothyroidism? -
1
,ANSWER :
Cold intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder? -
ANSWER :
Depression
Hyperthyroidism mimics symptoms of what psychiatric disorder? -
ANSWER :
Mania
Valproic acid produces what teratogenic effect? -
ANSWER :
Spina bifida (neural tube defect)
What is the primary organ where valproic acid is toxic? -
ANSWER :
Liver (hepatoxicity)
What are 4 signs of hepatoxicity? -
ANSWER :
Abdominal pain in the RUQ
Reddish-brown urine
Yellowing of the skin/sclera
2
,Fatigue
What is the therapeutic range for valproic acid? -
ANSWER :
50-125 mcg/ml
What is a toxic level of valproic acid? -
ANSWER :
>150 mcg/ml
What are 4 signs of valproic acid toxicity? -
ANSWER :
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? -
ANSWER :
Suspect: hepatotoxicity
Interventions:
-hold med
-draw LFT's (priority)
-VPA/DVP level
With suspected toxicity with valproic acid, what steps/labs should be drawn? -
3
, ANSWER :
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 dis-
continued? -
ANSWER :
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? -
ANSWER :
Kava Kava
What is a major side effect of Kava Kava? -
ANSWER :
Liver damage
What drugs should be avoided with Kava Kava? -
ANSWER :
Alprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
What are 5 symptoms of Stephen's Johnson Syndrome (SJS)? -
4
ANSWER :
0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism -
ANSWER :
Decreased TSH
Increased T4 and T3
What are labs in Hypothyroidism? -
ANSWER :
Increased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism? -
ANSWER :
Heat intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
What are 4 primary symptoms of Hypothyroidism? -
1
,ANSWER :
Cold intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder? -
ANSWER :
Depression
Hyperthyroidism mimics symptoms of what psychiatric disorder? -
ANSWER :
Mania
Valproic acid produces what teratogenic effect? -
ANSWER :
Spina bifida (neural tube defect)
What is the primary organ where valproic acid is toxic? -
ANSWER :
Liver (hepatoxicity)
What are 4 signs of hepatoxicity? -
ANSWER :
Abdominal pain in the RUQ
Reddish-brown urine
Yellowing of the skin/sclera
2
,Fatigue
What is the therapeutic range for valproic acid? -
ANSWER :
50-125 mcg/ml
What is a toxic level of valproic acid? -
ANSWER :
>150 mcg/ml
What are 4 signs of valproic acid toxicity? -
ANSWER :
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? -
ANSWER :
Suspect: hepatotoxicity
Interventions:
-hold med
-draw LFT's (priority)
-VPA/DVP level
With suspected toxicity with valproic acid, what steps/labs should be drawn? -
3
, ANSWER :
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 dis-
continued? -
ANSWER :
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? -
ANSWER :
Kava Kava
What is a major side effect of Kava Kava? -
ANSWER :
Liver damage
What drugs should be avoided with Kava Kava? -
ANSWER :
Alprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
What are 5 symptoms of Stephen's Johnson Syndrome (SJS)? -
4
