LMR EXAM 2025 QUESTIONS AND
ANSWERS
T3 and T4 decreased, TSH increased - ANS hypothyroidism
T3 T4 increased TSH decreased - ANS hyperthyroidism
sensitivity to cold - ANS check tsh (hypothyroidism)
sensitivity to heat - ANS check tsh (hyperthyroidism)
urinalysis = 4+ proteinuria - ANS lithium toxicity
neuroprotective for bipolar 1 disorder - ANS lithium
NSAIDs, ACE inhibitors (-prils), thiazides - ANS increase lithium levels by decreasing renal
clearance
lithium side effects - ANS gi upset, tremors coars, t wave inversion, hyponatremia
depakote - ANS spina bifida, hepatotoxicity
do LFTs
right upper quadrant pain and dark urine
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,kava kava - ANS stress and anxiety
causes hepatotoxicity, sedation (don't give with benzos)
do LFTs
can worsen depression
Lamictal - ANS SJS (fever, rash, joint pain, headache, painful mucous membranes)
Carbamezapine - ANS SJS (fever, rash, joint pain, headache, painful mucous membranes)
test HLAB 1502 allele in asians
agranulocytosis (ANC<1000 stop; also in clozaril)
agranulocytosis - ANS fever, chills, fatigue, sore throat
NMS and Serotonin Syndrome - ANS NMS:
caused by antipsychotics
muscle rigidity
mutism
rhabdomyolisis
myoglobinuria
increased CPK, LFTs, WBCs (leukocytosis)
Serotonin Syndrome
caused by antidepressants
hyperreflexia
myoclonic jerks
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,treatment for NMS - ANS bromocriptine as dopamine agonist (D2)
dantrolene as muscle relaxant
treatment for serotonin syndrome - ANS Cyproheptadine (5-HT2 receptor antagonist)
time frame to switch serotonin meds (MAOI)
(and fluoxetine?) - ANS 2 weeks
5 to 6 weeks with fluoxetine
antidepressant for cancer - ANS citalopram and escitalopram
less drug to drug interactions
contraindication for wellbutrin - ANS seizure d/o
eating d/o
antidepressant for low energy and fatigue - ANS NDRI
wellbutrin
medications for neuropathy - ANS SNRI/TCA
alpha 2 delta ligand (Gabapentin, lyrica)
what to ask when client is depressed (additional question) - ANS alcohol use
antidepressant efficacy time - ANS 4-6 weeks
Serotonin syndrome symptoms - ANS hypertension, tachycardia;
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, myoclonic jerking, tremors;
nausea, diarrhea, sweating, hyperthermia;
agitation, confusion
flu like symptoms
hypertensive crisis - ANS Severe Headache
Palpitations
Diaphoretic
Stiff Neck
pupillary dilation
MAOI with tyramine - ANS hypertensive crisis
treatment for hypertensive crisis - ANS Phentolamine
schizophrenia age of onset - ANS men 18-25
women 25-35
risk factors for schizophrenia - ANS genetic loading - first degree relative
prenatal exposure to flu or virus
prenatal malnutrition or illness
obstetrical complications
CNS infection in childhood
substance use
oxygen deprivation
excessive pruning
inadequate formation
COPYRIGHT © 2025 THESTAR ALL RIGHTS RESERVED 4
ANSWERS
T3 and T4 decreased, TSH increased - ANS hypothyroidism
T3 T4 increased TSH decreased - ANS hyperthyroidism
sensitivity to cold - ANS check tsh (hypothyroidism)
sensitivity to heat - ANS check tsh (hyperthyroidism)
urinalysis = 4+ proteinuria - ANS lithium toxicity
neuroprotective for bipolar 1 disorder - ANS lithium
NSAIDs, ACE inhibitors (-prils), thiazides - ANS increase lithium levels by decreasing renal
clearance
lithium side effects - ANS gi upset, tremors coars, t wave inversion, hyponatremia
depakote - ANS spina bifida, hepatotoxicity
do LFTs
right upper quadrant pain and dark urine
COPYRIGHT © 2025 THESTAR ALL RIGHTS RESERVED 1
,kava kava - ANS stress and anxiety
causes hepatotoxicity, sedation (don't give with benzos)
do LFTs
can worsen depression
Lamictal - ANS SJS (fever, rash, joint pain, headache, painful mucous membranes)
Carbamezapine - ANS SJS (fever, rash, joint pain, headache, painful mucous membranes)
test HLAB 1502 allele in asians
agranulocytosis (ANC<1000 stop; also in clozaril)
agranulocytosis - ANS fever, chills, fatigue, sore throat
NMS and Serotonin Syndrome - ANS NMS:
caused by antipsychotics
muscle rigidity
mutism
rhabdomyolisis
myoglobinuria
increased CPK, LFTs, WBCs (leukocytosis)
Serotonin Syndrome
caused by antidepressants
hyperreflexia
myoclonic jerks
COPYRIGHT © 2025 THESTAR ALL RIGHTS RESERVED 2
,treatment for NMS - ANS bromocriptine as dopamine agonist (D2)
dantrolene as muscle relaxant
treatment for serotonin syndrome - ANS Cyproheptadine (5-HT2 receptor antagonist)
time frame to switch serotonin meds (MAOI)
(and fluoxetine?) - ANS 2 weeks
5 to 6 weeks with fluoxetine
antidepressant for cancer - ANS citalopram and escitalopram
less drug to drug interactions
contraindication for wellbutrin - ANS seizure d/o
eating d/o
antidepressant for low energy and fatigue - ANS NDRI
wellbutrin
medications for neuropathy - ANS SNRI/TCA
alpha 2 delta ligand (Gabapentin, lyrica)
what to ask when client is depressed (additional question) - ANS alcohol use
antidepressant efficacy time - ANS 4-6 weeks
Serotonin syndrome symptoms - ANS hypertension, tachycardia;
COPYRIGHT © 2025 THESTAR ALL RIGHTS RESERVED 3
, myoclonic jerking, tremors;
nausea, diarrhea, sweating, hyperthermia;
agitation, confusion
flu like symptoms
hypertensive crisis - ANS Severe Headache
Palpitations
Diaphoretic
Stiff Neck
pupillary dilation
MAOI with tyramine - ANS hypertensive crisis
treatment for hypertensive crisis - ANS Phentolamine
schizophrenia age of onset - ANS men 18-25
women 25-35
risk factors for schizophrenia - ANS genetic loading - first degree relative
prenatal exposure to flu or virus
prenatal malnutrition or illness
obstetrical complications
CNS infection in childhood
substance use
oxygen deprivation
excessive pruning
inadequate formation
COPYRIGHT © 2025 THESTAR ALL RIGHTS RESERVED 4
