Georgette's - LMR final | with complete solution | Rated A+

Georgette's - LMR final | with complete solution | Rated A+ What is the normal range for TSH? 0.5 - 5.0 mu/L What are lab values in Hyperthyroidism Decreased TSH Increased T4 and T3 What are labs in Hypothyroidism? Increased TSH Decreased T4 and T3 What are 5 primary symptoms of Hyperthyroidism? Heat intolerance Agitation, Anxiety, Irritability Tachycardia Mood swings Weight loss What are 4 primary symptoms of Hypothyroidism? Cold intolerance Lethargy Weight gain Decreased libido Hypothyroidism mimic s symptoms of what psychiatric disorder? Depression Hyperthyroidism mimics symptoms of what psychiatric disorder? Mania Valproic acid produces what teratogenic effect? Spina bifida (neural tube defect) What is the primary organ where valproic acid is toxic? Liver (hepatoxicity) What are 4 signs of hepatoxicity? Abdominal pain in the RUQ Reddish -brown urine Yellowing of the skin/sclera Fatigue What is the therapeutic range for valproic acid? 50-125 mcg/ml What is a toxic level of valproic acid? >150 mcg/ml What are 4 signs of valproic acid toxicity? 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? Suspect: hepatotoxicity Interventions: -hold med -draw LFT's (priority) -VPA/DVP lev el With suspected toxicity with valproic acid, what steps/labs should be drawn? 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 discontinued? 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? Kava Kava What is a major side effect of Kava Kava? Liver damage What drugs should be avoided with Kava Kava? Alprazolam CNS depressants (e.g., phenobarbital, zolpidem) What are 5 symptoms of Stephen's Johnson Syndrome (SJS)? Key symptoms: -Fever -Burning of mouth/eyes Additional symptoms: Body aches Severe red rash Peeling skin Facial and tongue swelling Which mood stabilizer causes the least weight gain? Lamotrigine (Lamictal) Which 3 SGAs cause the least weight gain? Lurasidone (Latuda) Aripiprazole (Abilify) Ziprasidone (Geodon) Which SGA is the least sedating? Aripiprazole (Abilify) Your patient is taking Kava Kava and you need to add an antipsychotic to manage their schizophrenia. Which medication do you add? Aripiprazole (least sedating) What are 2 hallmark symptoms of delirium? Acute onset Altered LOC impaired cognition inattention How are agitation and psychotic symptoms treated in delirium? Low-dose Haldol Ensure you check QTc first as Haldol can cause QTc prolongation Your 16 year old patient complains of feeling "funny" after inhaling Acetone (nail polish remover). What is your action? Obtain a UDS They may be abusing other substances What 4 drugs can cause mania? "SAID" Steroids Antidepressants (in bipolar disorder) Isoniazid (INH) Disulfiram (Antabuse) What 6 drugs can induce depression? "SIP BAR B" Steroids Interferon Progesterone Beta blockers Accutane, (Isotretinoin) Retroviral drugs, Antineoplastic drugs Benzodiazepines Steroids can induce what 3 psychiatric states? Mania Depression Psychosis You see a patient after an assault. Your initial action is_____. What is the best environment to interview this patient in? Initial action: reassure safety, provide environment of safety Environment: private area with door open/partially open What is the therapeutic range for lithium? 0.6-1.2 mEq/L Many postpartum women have SI after delivery, yet they don't have psychiatric evaluations performed prior to leaving the hospital. What could a possible solution be? COLLABORATING CARE between psychiatry and OBGYN to provide the best care for that patient If you are collaborating with a provider who is not in the same clinic or hospital, the informed consent _________ [does/does not] apply? DOES NOT The patient will n eed to sign consent for labs/ chart to be sent When discharging from inpatient, you want to ______ [fax/print/give to patient] their labs for the outpatient provider before discharge? FAX So that the new provider has them for follow -up appointment Before referring a patient out or discharging them, it is good to ask yourself _______ [what question]? Is there something I can do for this patient first? What 3 things should every provider know about Lithium? Lithium has a neuroprotective effect for bipolar di sorder Lithium is the gold standard for treating manic episodes Lithium is a mood stabilizer with anti-suicidal effects What mood stabilizer has anti -suicidal effects? Lithium What 5 labs should be drawn with lithium? Thyroid panel (TSH) Serum creatinine BUN UA HCG What is a normal Serum Cr range? 0.6-1.2 mg/dL What is the normal range for BUN? 10-20 mg/dL When should you suspect kidney disease with a urinalysis? 4+ protein If your patient is on Lithium, you must monitor closely TOXICITY What are 7 side effects of lithium? Hypothyroidism Fine hand tremors Maculopapular rash GI upset (N/V/D, cramps, anorexia) Polyuria, polydipsia, diabetes insipidus T-wave inversions Leukocytosis What are 7 signs of lithium toxicity? Key findings: Severe nausea, vomiting, diarrhea