Georgettes LMR study
When questions ask for a priority action...think about... Correct answers
ABC, airway
breathing,
circulation
Maslows
hierarchy
If undecided on an answer due to high similarities, choose: Correct
answers the
umbrella
answer
What is the most common side effect of olanzapine/zyprexa Correct answers
metabolic
syndrom
e
what is the difference between typical and atypical antipsychotics
Correct
Atypicalanswers
5HT2A
specific
1st psychotic break... two actions to take Correct answers UDS
and r/o sub
Consider IM Geodon or
Invega
Three AP with least weight gain Correct answers Latuda, Abilify,
Geodon
Always encourage interprofessional collaboration Correct answers
between
therapists/pcps/SW/RN, the ENTIRE
team
TSH High, then....t3/t4 Correct answers T3,
T4 low
TSH low, then...t3/t4 Correct answers T3,
T4 high
cold/hot sensitivity with t3/t4 relationship Correct answers T3/T4 low,
hypothyroid, cold,
slo
w
T3/T4 high, hyperthyroid, hot, flushed,
tachy
What birth defect can be caused by depakote? Correct answers
Spina bifida
What organ does depakote cause toxicity? and what sx would you expect to
see?
to labs
run? Correct answers Hepatotoxicity: RUQ pain, reddish
brown
Do LFTsurine-
kava kava is used to treat Correct answers anxiety and
insomnia
Rash and fever associated with tegretol, suspect Correct
answers
What allele is HLAB 1502 associated? Correct answers Asians. They
CANNOT Test
tegretol. haveall asians for this
allele.
,what rare and dangerous side effects are associated with tegretol
Correct answers
Aplastic
anemia
Agranulocytosis-DC at ANC less than
1000
Sx's of agranulocytosis Correct answers unusual bleeding or bruising,
mouth sores,
infections, fever, sore throat,
fatigue
if starting a woman on lithium what test should be done? why? Correct
answers
risk HCG--
of ebstein
anomaly
adverse s/e of lamictal/lamotrigine Correct
answers SJS
labs to checke BEFORE starting on lithium Correct
answers BUN
CRE
urine
protein
What does protein in urine indicate Correct answers kidney impairment;
4+ protein cannot
urine=you in start on
lithium
best choice med for decreasing si in bipolar disorder. Correct
answers lithium
best choice med for si in schizophrenia Correct answers
clozaril
best choice med for SI in borderline Correct answers
lithium
What medications will INCREASE Li levels Correct answers
NSAIDS
ACE'
s
Thiazides/
HCTZ
Besides medications, what else can cause increased Li levels Correct
answers
dehydratio
n
hyponatrem
ia
lithium s/e inc N/V, which will effect electrolytes, and
dehydration status
what type of tremors will you see with lithium toxicity? Correct answers
course tremors
lithium can cause what other comorbidities? Correct answers
hypothyroidism
maculopapular
rash
leukocytos
is
twave
inversion
what is a defining characteristic of NMS vs SS Correct answers
muscle rigidity
Sx's/labs associated with NMS Correct answers Inc CPK,
WBC, LFT
Rhabdomyolos
is
, myoglobinur
ia
Can lead to
mutism
myoglobinuria/rhabdo can cause cherry
colored urine
Treatment for NMS and what each does Correct answers DC the
offending agent
bromocriptin-D2
agonis
dantrolene: muscle
relaxant
Make sure if ? is asking for agonist or
relaxant
Sx of SS Correct answers
HYPERREFLEXIA
myoclonic
jerks
treatment for SS Correct answers
ciproheptadine
how to best PREVENT SS Correct answers follow proper transition
protocols
SSRI to MAOI=14
days
Prozac to MAOI=5-6
weeks
Triptans can also cause SS due to serotonin increase
with use
Why are SSRIs considered the safest for use in depression Correct answers
safest for
OD
depressed patient presents with fatigue and low energy, consider:
Correct answers
NDRI
wellbutrin
sexual s/e with ssri? try... Correct answers wellbutrin due to lower risk of
sexual s/e
What medication must be avoided if client has seizure history or eating
disorder?
Correct why? wellbutrin due to decreasing the seizure
answers
threshold
if client has depression and neuropathic pain Correct answers SNRI or
TCA for
treatment of
BOTH
What med class treats neuropathic pain well Correct answers alpha 2
delta ligands
Gabapenti
Lyric
n
a
What medication class is good for depression with comorbid CA Correct
answers
least SSRIof drug drug
chance
interactions
Celexa and lexapro are good
choices
Black box warning on SSRI Correct answers inc SI in
kids, esp
Required education for rx ssri Correct answers long time
for effect
side effects esp
n/v/d
When questions ask for a priority action...think about... Correct answers
ABC, airway
breathing,
circulation
Maslows
hierarchy
If undecided on an answer due to high similarities, choose: Correct
answers the
umbrella
answer
What is the most common side effect of olanzapine/zyprexa Correct answers
metabolic
syndrom
e
what is the difference between typical and atypical antipsychotics
Correct
Atypicalanswers
5HT2A
specific
1st psychotic break... two actions to take Correct answers UDS
and r/o sub
Consider IM Geodon or
Invega
Three AP with least weight gain Correct answers Latuda, Abilify,
Geodon
Always encourage interprofessional collaboration Correct answers
between
therapists/pcps/SW/RN, the ENTIRE
team
TSH High, then....t3/t4 Correct answers T3,
T4 low
TSH low, then...t3/t4 Correct answers T3,
T4 high
cold/hot sensitivity with t3/t4 relationship Correct answers T3/T4 low,
hypothyroid, cold,
slo
w
T3/T4 high, hyperthyroid, hot, flushed,
tachy
What birth defect can be caused by depakote? Correct answers
Spina bifida
What organ does depakote cause toxicity? and what sx would you expect to
see?
to labs
run? Correct answers Hepatotoxicity: RUQ pain, reddish
brown
Do LFTsurine-
kava kava is used to treat Correct answers anxiety and
insomnia
Rash and fever associated with tegretol, suspect Correct
answers
What allele is HLAB 1502 associated? Correct answers Asians. They
CANNOT Test
tegretol. haveall asians for this
allele.
,what rare and dangerous side effects are associated with tegretol
Correct answers
Aplastic
anemia
Agranulocytosis-DC at ANC less than
1000
Sx's of agranulocytosis Correct answers unusual bleeding or bruising,
mouth sores,
infections, fever, sore throat,
fatigue
if starting a woman on lithium what test should be done? why? Correct
answers
risk HCG--
of ebstein
anomaly
adverse s/e of lamictal/lamotrigine Correct
answers SJS
labs to checke BEFORE starting on lithium Correct
answers BUN
CRE
urine
protein
What does protein in urine indicate Correct answers kidney impairment;
4+ protein cannot
urine=you in start on
lithium
best choice med for decreasing si in bipolar disorder. Correct
answers lithium
best choice med for si in schizophrenia Correct answers
clozaril
best choice med for SI in borderline Correct answers
lithium
What medications will INCREASE Li levels Correct answers
NSAIDS
ACE'
s
Thiazides/
HCTZ
Besides medications, what else can cause increased Li levels Correct
answers
dehydratio
n
hyponatrem
ia
lithium s/e inc N/V, which will effect electrolytes, and
dehydration status
what type of tremors will you see with lithium toxicity? Correct answers
course tremors
lithium can cause what other comorbidities? Correct answers
hypothyroidism
maculopapular
rash
leukocytos
is
twave
inversion
what is a defining characteristic of NMS vs SS Correct answers
muscle rigidity
Sx's/labs associated with NMS Correct answers Inc CPK,
WBC, LFT
Rhabdomyolos
is
, myoglobinur
ia
Can lead to
mutism
myoglobinuria/rhabdo can cause cherry
colored urine
Treatment for NMS and what each does Correct answers DC the
offending agent
bromocriptin-D2
agonis
dantrolene: muscle
relaxant
Make sure if ? is asking for agonist or
relaxant
Sx of SS Correct answers
HYPERREFLEXIA
myoclonic
jerks
treatment for SS Correct answers
ciproheptadine
how to best PREVENT SS Correct answers follow proper transition
protocols
SSRI to MAOI=14
days
Prozac to MAOI=5-6
weeks
Triptans can also cause SS due to serotonin increase
with use
Why are SSRIs considered the safest for use in depression Correct answers
safest for
OD
depressed patient presents with fatigue and low energy, consider:
Correct answers
NDRI
wellbutrin
sexual s/e with ssri? try... Correct answers wellbutrin due to lower risk of
sexual s/e
What medication must be avoided if client has seizure history or eating
disorder?
Correct why? wellbutrin due to decreasing the seizure
answers
threshold
if client has depression and neuropathic pain Correct answers SNRI or
TCA for
treatment of
BOTH
What med class treats neuropathic pain well Correct answers alpha 2
delta ligands
Gabapenti
Lyric
n
a
What medication class is good for depression with comorbid CA Correct
answers
least SSRIof drug drug
chance
interactions
Celexa and lexapro are good
choices
Black box warning on SSRI Correct answers inc SI in
kids, esp
Required education for rx ssri Correct answers long time
for effect
side effects esp
n/v/d
