Georgettes LMR study set/PMHNP Review items
When questions ask for a priority action...think about...(Ans- ABC, airway breathing, circulation Maslows hierarchy
If undecided on an answer due to high similarities, choose:
(Ans- the umbrella answer
What is the most common side effect of olanzapine/zyprexa (Ans- metabolic syndrome
what is the difference between typical and atypical antipsychotics (Ans- Atypical 5HT2A specific
1st psychotic break... two actions to take (Ans- UDS and r/o sub Consider IM Geodon or Invega
Three AP with least weight gain (Ans- Latuda, Abilify, Geodon
Always encourage interprofessional collaboration (Ans- between therapists/pcps/SW/RN, the ENTIRE team
TSH High, then....t3/t4 (Ans- T3, T4 low
TSH low, then...t3/t4 (Ans- T3, T4 high
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cold/hot sensitivity with t3/t4 relationship (Ans- T3/T4 low, hypothyroid, cold, slow T3/T4 high, hyperthyroid, hot, flushed, tachy
What birth defect can be caused by depakote?(Ans- Spina bifida
What organ does depakote cause toxicity? and what sx would you expect to see? labs to run?
(Ans- Hepatotoxicity: RUQ pain, reddish brown urine-
Do LFTs
kava kava is used to treat (Ans- anxiety and insomnia
What allele is HLAB 1502 associated?(Ans- Asians. They CANNOT have tegretol. Test all asians for this allele.
what rare and dangerous side effects are associated with tegretol (Ans- Aplastic anemia Agranulocytosis-DC at ANC less than 1000
Sx's of agranulocytosis (Ans- unusual bleeding or bruising, mouth sores, infections, fever, sore throat, fatigue
if starting a woman on lithium what test should be done? why?(Ans- HCG--risk of ebstein anomaly
adverse s/e of lamictal/lamotrigine (Ans- SJS
labs to checke BEFORE starting on lithium (Ans- BUN 2 / 4
CRE urine protein
What does protein in urine indicate (Ans- kidney impairment; 4+ protein in urine=you cannot start on lithium
best choice med for decreasing si in bipolar disorder.(Ans- lithium
best choice med for si in schizophrenia (Ans- clozaril
best choice med for SI in borderline (Ans- lithium
What medications will INCREASE Li levels (Ans-
NSAIDS
ACE's Thiazides/HCTZ
Besides medications, what else can cause increased Li levels (Ans- dehydration hyponatremia lithium s/e inc N/V, which will effect electrolytes, and dehydration status
what type of tremors will you see with lithium toxicity?(Ans- course tremors
lithium can cause what other comorbidities?(Ans- hypothyroidism maculopapular rash leukocytosis 3 / 4
twave inversion
what is a defining characteristic of NMS vs SS (Ans- muscle rigidity
Sx's/labs associated with NMS (Ans- Inc CPK, WBC, LFT Rhabdomyolosis myoglobinuria Can lead to mutism
myoglobinuria/rhabdo can cause cherry colored urine
Treatment for NMS and what each does (Ans- DC the offending agent bromocriptin-D2 agonis
dantrolene: muscle relaxant
Make sure if ? is asking for agonist or relaxant
Sx of SS (Ans-
HYPERREFLEXIA
myoclonic jerks
treatment for SS (Ans- ciproheptadine
how to best PREVENT SS (Ans- follow proper transition protocols SSRI to MAOI=14 days Prozac to MAOI=5-6 weeks Triptans can also cause SS due to serotonin increase with use
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