LMR Georgette's PMHNP Certification Exam.

LMR Georgette's PMHNP Certification Exam. What drugs should be avoided with Kava Kava? {{Ans- Alprazolam CNS depressants (e.g., phenobarbital, zolpidem) Cultural Formulation Interview perform what 3 functions? {{Ans- Clarify meaning of illness Empower the patient Validate symptoms within cultural context What does a cultural formulation interview do? {{Ans- cultural assessment What is the normal range for TSH? {{Ans- 0.5 - 5.0 mu/L What are lab values in Hyperthyroidism {{Ans- Decreased TSH Increased T4 and T3 What are labs in Hypothyroidism? {{Ans- Increased TSH Decreased T4 and T3 What are 5 primary symptoms of Hyperthyroidism? {{Ans- Heat intolerance Agitation, Anxiety, Irritability Tachycardia Mood swings Weight loss What are 4 primary symptoms of Hypothyroidism? {{Ans- Cold intolerance Lethargy Weight gain Decreased libido Hypothyroidism mimics symptoms of what psychiatric disorder? {{Ans- Depression Hyperthyroidism mimics symptoms of what psychiatric disorder? {{Ans- Mania Valproic acid produces what teratogenic effect? {{Ans- Spina bifida (neural tube defect) What is the primary organ where valproic acid is toxic? {{Ans- Liver (hepatoxicity) What are 4 signs of hepatoxicity? {{Ans- Abdominal pain in the URQ Reddish-brown urine Yellowing of the skin and sclera Fatigue Abdominal pain in the URQ, Reddish-brown urine, Yellowing of the skin and sclera, and Fatigue are signs of {{Ans- Hepatoxicity What is the therapeutic range for valproic acid? {{Ans- 50-125 mcg/ml What is a toxic level of valproic acid? {{Ans- >150 mcg/ml What are 4 signs of valproic acid toxicity? {{Ans- Disorientation Lethargy Respiratory depression Nausea/vomiting Disorientation, Lethargy, Respiratory depression, and Nausea/vomiting are symptoms of toxicity with what drug? {{Ans- Valproic acid With suspected toxicity with valproic acid, what labs should be drawn? {{Ans- DC drug Check drug level Obtain LFTs Obtain ammonia level What is the major side effect with Kava Kava? {{Ans- Liver damage What herbal supplement is sued for anxiety, stress, and insomnia? {{Ans- Kava Kava What are 5 symptoms of Stephen's Johnson Syndrome? {{Ans- Fever Body aches Severe red rash Peeling skin Facial and tongue swelling Severe red rash, Fever, Body aches, Peeling skin, and Facial and tongue swelling are symptoms of {{Ans- Stephen's Johnson Syndrome Which mood stabilizer causes the least weight gain? {{Ans- Lamotrigine (Lamictal) Which 3 SGAs cause the least weight gain? {{Ans- Lurasidone (Latuda) Aripiprazole (Abilify) Ziprasidone (Geodon) Which SGA is the least sedating? {{Ans- Aripiprazole (Abilify) What are 3 hallmark symptoms of delirium? {{Ans- Acute disturbance of LOC impaired cognition inattention Acute disturbance of LOC, cognition, and inattention are hallmark symptoms of {{Ans- Delirium How are agitation and psychotic symptoms treated in delirium? {{Ans- Low dose Haldol What 4 drugs can cause mania? {{Ans- Steroids Disulfiram (Antabuse) Isoniazid (INH) Antidepressants (in BPD) Steroids, Disulfiram (Antabuse), and Isoniazid (INH) can induce {{Ans- Mania What 6 drugs can induce depression? {{Ans- Steroids Beta blockers Interferon, Isotretinoin (Accutane) Retroviral drugs, Antineoplastic drugs Benzodiazepines Progesterone Steroids can induce what 3 psychiatric states? {{Ans- Mania Depression Psychosis What medication to treat acne cause cause birth defects? {{Ans- Isotretinoin (Accutane) What is the therapeutic range for lithium? {{Ans- 0.6-1.2 mEq/L What medication has a neuroprotective effect for bipolar disorder? {{Ans- Lithium What is the gold standard for treating manic episodes {{Ans- Lithium What mood stabilizer has anti-suicidal effects? {{Ans- Lithium What 5 labs should be drawn with lithium? {{Ans- Thyroid panel (TSH) Serum creatinine BUN Urinalysis HCG What is a normal SCr range? {{Ans- 0.6-1.2 mg/dL What is the normal range for BUN? {{Ans- 10-20 mg/dL When should you suspect kidney disease with a urinalysis? {{Ans- 4+ protein 4+ protein in the kidney suggests {{Ans- Kidney disease What are 7 side effects of lithium? {{Ans- Hypothyroidism Fine hand tremors Maculopapular rash GI upset (N/V/D, cramps, anorexia) Polyuria, polydipsia, diabetes insipidus T-wave inversions Leucocytosis What are 7 signs of lithium toxicity? {{Ans- Severe nausea, vomiting, diarrhea Confusion Drowsiness Muscle weakness Heart palpitations Coarse hand tremor Unsteadiness while standing or walking Which 3 drugs can increase lithium levels by decreasing renal clearance? {{Ans- NSAIDs (ibuprofen, indomethacin) Thiazides ACEI What is a toxic level of lithium? {{Ans- 1.5 mEq/L or higher At what level do you monitor lithium closely (but not discontinue)? {{Ans- 1.3 mEq/L or higher With suspected lithium toxicity, what do you do first? {{Ans- Lithium level (not VS) What is the appropriate action if lithium level is 1.5 mEq/L? {{Ans- DC lithium Check lithium level What 2 conditions can increase lithium levels? {{Ans- Dehydration Hyponatremia What birth defect can lithium cause? {{Ans- Ebstein anomaly (congenital heart defect) What 3 neurotransmitters are associated with ADHD? {{Ans- DNS What 3 parts of the brain are affected with ADHD? {{Ans- Frontal cortex Basal ganglia Reticular Activating System The Frontal cortex, Basal ganglia, Reticular Activating System are associated with which psychiatric disorder? {{Ans- ADHD Inattentive Type ADHD demonstrates abnormalities in which part of the brain? {{Ans- Prefrontal cortex What should be done before placing a patient on stimulants for ADHD (priority)? {{Ans- Cardiac history Excessive worry, apprehension, or anxiety about events or activities that occurs more days than not for a period of at least 6 months is {{Ans- GAD If a patient is receiving Haldol 5 mg PO bid, how much Haldol Decanoate should they receive? {{Ans- 20 x 10 mg = 200 mg (q month) What is the formula for converting oral Haldol to depot form? {{Ans- 20 x daily dose What does thought process assess? {{Ans- thoughts and ideas The way a patient organizes his thoughts and ideas is called {{Ans- Thought process A normal thought process is described as {{Ans- Logical Linear Coherent Goal-oriented Moving from thought to thought and never getting to the point is called {{Ans- Tangentiality ("goes on tangent").