PMHNP certification ALREADY PASSED
CAGE - ✔✔items responses are scored either 1 or 0. A score 2 or higher is considered clinically
significant
OCD - ✔✔obsessive thoughts interfere with your daily life
-are you concern about things being contaminated, keeping things in perfect order
-do you feel driven to perform certain acts over and over again?
-have unwanted images or thought that you cant seem to get out of your head
layman's explanation of mental illness - ✔✔Abnormal functioning of neurotransmitters.
Neuroanatomical differences have been found in some cases.
-can arise from multiple sources, not a single or consistent cause has been established
biomedical psychiatry - ✔✔mental illness is conceptualized as a disorder of the brain circuit caused
by a complex interplay of genetic and environmental factor
state-dependent learning - ✔✔when a memory is formed a new neural pathway is created. If the
memory was formed under specific chemical conditions (on a drug, manic), then the pathway will be
primed to work most effectively under these circumstances.
-state-dependent learning in bipolar. Bipolar individuals in a depressed episode may not be able to
recall details of manic episodes. Corroboration is needed.
Assessment tools to screen for cognitive impairment - ✔✔-folstein mini-mental: perfect score is 30.
<24 impairment. If only 9th grade education <17
Abnormal sodium levels - ✔✔-increased: dehydration, methyldopa,
-decreased: SIADH, heart failure, nephrotic syndrome, hepatic disease.
Abnormal Potassium levels - ✔✔Increased: amiloride, spirolactone, lithium, propranolol.
Decreased
,alpha 1 antagonists - ✔✔-vasodilator and used for hypertension
-raynauds
-PTSD and GAD
-benign prostatic hyperplasia (tamsulosin)
-agonism: vasoconstrictor
-trazadone and many antipsychotics
ESR-erythrocyte sedimentation rate - ✔✔high values indicate autoimmune, malignancies, infections
absolute neurophil count calculations - ✔✔total WBC x percentage of neurophil in differential=ANC
Calcium - ✔✔-increased: >10.8 caused by hyperparathyroidism from tumor of renal disease, lithium
PET vs. fMRI - ✔✔measures brain activity by associated changes in blood flow. Relies on fact that
cerebral blood flow and neuronal activity are coupled.
-In addition, PET has the advantage of being able to identify specific receptors associated with
neurotransmitter through its ability to image radioactive ligands
ELISA testing - ✔✔-first screen with ELISA. ELISA tests for HIV antibodies. Vast majority of HIV
positive people have detectable antibodies by 3 months after exposure.
Splitting - ✔✔the individual segregates experiences in to all-good or all-bad, with no room for
ambiguity or ambivalence.
displacement - ✔✔separation of emotion from it object of discontent and redirected to a less
threatening and intimidating
--example: displaced aggression- If expressing or dismay to the source of the anger could lead to
negative consequences, we may rather than express our angry to a person or object that pose no
threat.
introjecion - ✔✔a process whereby an individual unconsciously incorporates the qualities of another
person into his or her ego structure
, Gestalt Therapy - ✔✔emphasizes personal responsibility. Cultivate a greater self-awareness and
mindfulness.
-greater self-awareness of mind and body
-chair technique: a role-playing exercise. The client is asked to adopt one role in one chair, and
another in the other chair (e.g. plays parent and then plays child)
Hyperprolactinemia and Risperidone - ✔✔-prolactin levels peak the first 6 to 8 weeks
-returns to normal range in 3 t0 5 months
-hyperprolactinemia is dose-dependent
-osteopenia, amenorrhea, galactorrhea, gynecomastia
-get baseline, repeat in two months. ask about nipple discharge, menstruation, sexual dysfunction. If
the patient has elevated prolactin after 2 months but no symptoms, repeat test in two months.
Antipsychotics that cause the most hypotension - ✔✔olanzapine, risperidone, quetiapine
Rett Syndrome - ✔✔-more common in females--the mutation arises from the X chromosome.
-onset before first birthday
-loss of skills already acquired: speech and purposeful hand movement
-delayed head growth, scoliosis, ataxia
Tourettes - ✔✔-tics must be present for at least a year before diagnosis
-must have motor and vocal tic
-abnormalities in the basal ganglia andd dopamine system are implicated
-First use guanfascine or clonidine. if doesnt work then use risperidone
autism - ✔✔appears before the age of 3. Difficulty with communication
-pervasive failure to form social relationships
-problems with communication
-ritualistic behaviors
-stereotyped behavior
-circumscribed range of interests
CAGE - ✔✔items responses are scored either 1 or 0. A score 2 or higher is considered clinically
significant
OCD - ✔✔obsessive thoughts interfere with your daily life
-are you concern about things being contaminated, keeping things in perfect order
-do you feel driven to perform certain acts over and over again?
-have unwanted images or thought that you cant seem to get out of your head
layman's explanation of mental illness - ✔✔Abnormal functioning of neurotransmitters.
Neuroanatomical differences have been found in some cases.
-can arise from multiple sources, not a single or consistent cause has been established
biomedical psychiatry - ✔✔mental illness is conceptualized as a disorder of the brain circuit caused
by a complex interplay of genetic and environmental factor
state-dependent learning - ✔✔when a memory is formed a new neural pathway is created. If the
memory was formed under specific chemical conditions (on a drug, manic), then the pathway will be
primed to work most effectively under these circumstances.
-state-dependent learning in bipolar. Bipolar individuals in a depressed episode may not be able to
recall details of manic episodes. Corroboration is needed.
Assessment tools to screen for cognitive impairment - ✔✔-folstein mini-mental: perfect score is 30.
<24 impairment. If only 9th grade education <17
Abnormal sodium levels - ✔✔-increased: dehydration, methyldopa,
-decreased: SIADH, heart failure, nephrotic syndrome, hepatic disease.
Abnormal Potassium levels - ✔✔Increased: amiloride, spirolactone, lithium, propranolol.
Decreased
,alpha 1 antagonists - ✔✔-vasodilator and used for hypertension
-raynauds
-PTSD and GAD
-benign prostatic hyperplasia (tamsulosin)
-agonism: vasoconstrictor
-trazadone and many antipsychotics
ESR-erythrocyte sedimentation rate - ✔✔high values indicate autoimmune, malignancies, infections
absolute neurophil count calculations - ✔✔total WBC x percentage of neurophil in differential=ANC
Calcium - ✔✔-increased: >10.8 caused by hyperparathyroidism from tumor of renal disease, lithium
PET vs. fMRI - ✔✔measures brain activity by associated changes in blood flow. Relies on fact that
cerebral blood flow and neuronal activity are coupled.
-In addition, PET has the advantage of being able to identify specific receptors associated with
neurotransmitter through its ability to image radioactive ligands
ELISA testing - ✔✔-first screen with ELISA. ELISA tests for HIV antibodies. Vast majority of HIV
positive people have detectable antibodies by 3 months after exposure.
Splitting - ✔✔the individual segregates experiences in to all-good or all-bad, with no room for
ambiguity or ambivalence.
displacement - ✔✔separation of emotion from it object of discontent and redirected to a less
threatening and intimidating
--example: displaced aggression- If expressing or dismay to the source of the anger could lead to
negative consequences, we may rather than express our angry to a person or object that pose no
threat.
introjecion - ✔✔a process whereby an individual unconsciously incorporates the qualities of another
person into his or her ego structure
, Gestalt Therapy - ✔✔emphasizes personal responsibility. Cultivate a greater self-awareness and
mindfulness.
-greater self-awareness of mind and body
-chair technique: a role-playing exercise. The client is asked to adopt one role in one chair, and
another in the other chair (e.g. plays parent and then plays child)
Hyperprolactinemia and Risperidone - ✔✔-prolactin levels peak the first 6 to 8 weeks
-returns to normal range in 3 t0 5 months
-hyperprolactinemia is dose-dependent
-osteopenia, amenorrhea, galactorrhea, gynecomastia
-get baseline, repeat in two months. ask about nipple discharge, menstruation, sexual dysfunction. If
the patient has elevated prolactin after 2 months but no symptoms, repeat test in two months.
Antipsychotics that cause the most hypotension - ✔✔olanzapine, risperidone, quetiapine
Rett Syndrome - ✔✔-more common in females--the mutation arises from the X chromosome.
-onset before first birthday
-loss of skills already acquired: speech and purposeful hand movement
-delayed head growth, scoliosis, ataxia
Tourettes - ✔✔-tics must be present for at least a year before diagnosis
-must have motor and vocal tic
-abnormalities in the basal ganglia andd dopamine system are implicated
-First use guanfascine or clonidine. if doesnt work then use risperidone
autism - ✔✔appears before the age of 3. Difficulty with communication
-pervasive failure to form social relationships
-problems with communication
-ritualistic behaviors
-stereotyped behavior
-circumscribed range of interests
