GEORGETTE'S - LMR FINAL EXAM
QUESTIONS AND ANSWERS 2025
,What is the normal range for TSH? - ANSWER0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism - ANSWERDecreased TSH
Increased T4 and T3
What are labs in Hypothyroidism? - ANSWERIncreased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism? - ANSWERHeat intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
What are 4 primary symptoms of Hypothyroidism? - ANSWERCold intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder? - ANSWERDepression
Hyperthyroidism mimics symptoms of what psychiatric disorder? - ANSWERMania
Valproic acid produces what teratogenic effect? - ANSWERSpina bifida (neural tube
defect)
What is the primary organ where valproic acid is toxic? - ANSWERLiver (hepatoxicity)
What are 4 signs of hepatoxicity? - ANSWERAbdominal pain in the RUQ
Reddish-brown urine
Yellowing of the skin/sclera
Fatigue
What is the therapeutic range for valproic acid? - ANSWER50-125 mcg/ml
What is a toxic level of valproic acid? - ANSWER>150 mcg/ml
What are 4 signs of valproic acid toxicity? - ANSWERDisorientation
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? - ANSWERSuspect: hepatotoxicity
Interventions:
-hold med
-draw LFT's (priority)
-VPA/DVP level
With suspected toxicity with valproic acid, what steps/labs should be drawn? -
ANSWERD/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? - ANSWERAccutane
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? - ANSWERKava
Kava
What is a major side effect of Kava Kava? - ANSWERLiver damage (hepatotoxicity)
What drugs should be avoided with Kava Kava? - ANSWERAlprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
What are 5 symptoms of Stephen's Johnson Syndrome (SJS)? - ANSWERKey
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? - ANSWERLamotrigine (Lamictal)
Which 3 SGAs cause the least weight gain? - ANSWERLurasidone (Latuda)
Aripiprazole (Abilify)
Ziprasidone (Geodon)
Which SGA is the least sedating? - ANSWERAripiprazole (Abilify)
, Your patient is taking Kava Kava and you need to add an antipsychotic to manage their
schizophrenia. Which medication do you add? - ANSWERAripiprazole (least sedating)
What are 2 hallmark symptoms of delirium? - ANSWERAcute onset
Altered LOC
impaired cognition
inattention
How are agitation and psychotic symptoms treated in delirium? - ANSWERLow-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? - ANSWERObtain a UDS
They may be abusing other substances
What 4 drugs can cause mania? - ANSWER"SAID"
Steroids
Antidepressants (in bipolar disorder)
Isoniazid (INH)
Disulfiram (Antabuse)
What 6 drugs can induce depression? - ANSWER"SIP BARB"
Steroids
Interferon
Progesterone
Beta blockers
Accutane, (Isotretinoin)
Retroviral drugs, Antineoplastic drugs
Benzodiazepines
Steroids can induce what 3 psychiatric states? - ANSWERMania
Depression
Psychosis
You see a patient after an assault. Your initial action is_____.
What is the best environment to interview this patient in? - ANSWERInitial action:
reassure safety, provide environment of safety
Environment: private area with door open/partially open
QUESTIONS AND ANSWERS 2025
,What is the normal range for TSH? - ANSWER0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism - ANSWERDecreased TSH
Increased T4 and T3
What are labs in Hypothyroidism? - ANSWERIncreased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism? - ANSWERHeat intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
What are 4 primary symptoms of Hypothyroidism? - ANSWERCold intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder? - ANSWERDepression
Hyperthyroidism mimics symptoms of what psychiatric disorder? - ANSWERMania
Valproic acid produces what teratogenic effect? - ANSWERSpina bifida (neural tube
defect)
What is the primary organ where valproic acid is toxic? - ANSWERLiver (hepatoxicity)
What are 4 signs of hepatoxicity? - ANSWERAbdominal pain in the RUQ
Reddish-brown urine
Yellowing of the skin/sclera
Fatigue
What is the therapeutic range for valproic acid? - ANSWER50-125 mcg/ml
What is a toxic level of valproic acid? - ANSWER>150 mcg/ml
What are 4 signs of valproic acid toxicity? - ANSWERDisorientation
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? - ANSWERSuspect: hepatotoxicity
Interventions:
-hold med
-draw LFT's (priority)
-VPA/DVP level
With suspected toxicity with valproic acid, what steps/labs should be drawn? -
ANSWERD/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? - ANSWERAccutane
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? - ANSWERKava
Kava
What is a major side effect of Kava Kava? - ANSWERLiver damage (hepatotoxicity)
What drugs should be avoided with Kava Kava? - ANSWERAlprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
What are 5 symptoms of Stephen's Johnson Syndrome (SJS)? - ANSWERKey
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? - ANSWERLamotrigine (Lamictal)
Which 3 SGAs cause the least weight gain? - ANSWERLurasidone (Latuda)
Aripiprazole (Abilify)
Ziprasidone (Geodon)
Which SGA is the least sedating? - ANSWERAripiprazole (Abilify)
, Your patient is taking Kava Kava and you need to add an antipsychotic to manage their
schizophrenia. Which medication do you add? - ANSWERAripiprazole (least sedating)
What are 2 hallmark symptoms of delirium? - ANSWERAcute onset
Altered LOC
impaired cognition
inattention
How are agitation and psychotic symptoms treated in delirium? - ANSWERLow-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? - ANSWERObtain a UDS
They may be abusing other substances
What 4 drugs can cause mania? - ANSWER"SAID"
Steroids
Antidepressants (in bipolar disorder)
Isoniazid (INH)
Disulfiram (Antabuse)
What 6 drugs can induce depression? - ANSWER"SIP BARB"
Steroids
Interferon
Progesterone
Beta blockers
Accutane, (Isotretinoin)
Retroviral drugs, Antineoplastic drugs
Benzodiazepines
Steroids can induce what 3 psychiatric states? - ANSWERMania
Depression
Psychosis
You see a patient after an assault. Your initial action is_____.
What is the best environment to interview this patient in? - ANSWERInitial action:
reassure safety, provide environment of safety
Environment: private area with door open/partially open
