LMR STUDY EXAM GUIDE QUESTIONS AND ANSWERS
SURE A+
✔✔What are CYP450 inducers? - ✔✔Decrease serum level of other drugs
✔✔What are CYP450 inhibitors? - ✔✔Increase serum level of other drugs
**Inhibitors win**
✔✔Inducers - ✔✔Tegretol
St. John's Wort
✔✔Inhibitors - ✔✔Doxycycline
Erithromycin
Clarithomycin
✔✔Medications that can cause mania - ✔✔Steroids
Disulfiram (Antabuse)
Isoniazid (INH)
Antidepressants in persons with bipolar
✔✔Medications that can cause depression - ✔✔Steroids (can cause psychosis)
Beta blockers
Liothyronine
Interferon
Isotretinoin (can also cause birth defects and liver function)
Some retrovirals
BZOs
Progesterone
✔✔What is "floppy baby syndrome"? - ✔✔A newborn condition characterized by
hypotonia (low muscle tone) and sedation
SXS: Hypotonia, weak cry, poor feeding, sedation, respiratory depression
Risk highest in late pregnancy (3rd trimester) or during labor/delivery
✔✔Which drug class is associated with floppy baby syndrome? - ✔✔Benzodiazepines
(Diazepam, Lorazepam)
**Buspar is safer in pregnancy**
**Sertraline is safer in pregnancy**
✔✔DIGFAST (Mania/Hypomania) - ✔✔Distractibility
Indiscretion
,Grandiosity
Flight of Ideas
Activity Increase
Sleep Disturbance
Talkativeness
Mania/hypomania: Irritable mood, uncooperative, agitation
✔✔How heritable is bipolar disorder? - ✔✔Highly
A family hx of the condition across multiple generations is one of the strongest risk
factors for developing it
✔✔Bipolar 1 vs Bipolar 2 - ✔✔Bipolar 1: Full manic episode, sxs at least a week
Bipolar 2: Less severe sxs, at least four days, less severe
✔✔Borderline Personality disorder (BPD) - ✔✔Impulsivity (often with self-damaging
behavior)
Recurrent suicidal behavior
Pattern of unstable, intense interpersonal relationships
Frantic efforts to avoid real or imagined abandonment
✔✔BPD Treatment - ✔✔Nonpharm: DBT
Irritability, anger, self-harm: Lithium
Depressed mood, emotional lability, interpersonal problems, rejection sensitivity,
aggression, hostility: Depakote
SSRis can manage depression and anxiety
✔✔Schizoid personality disorder - ✔✔Voluntary social isolation
Indifferent to other people (lack of care in relation to how others perceive them)
Shows little to no interest in sexual activity
Derives no pleasure in social activities
Lacks close friends or social supports
Appears cold and detached
Exhibits affective flattening
✔✔Avoidant Personality Disorder - ✔✔Avoidance of activities involving significant
interpersonal contact
Fear of criticism, disapproval, or rejection
Unwillingness to be involved with people unless sure of being liked
Restraint in intimate relationships for fear of being shamed
Preoccupation with being criticized or rejected in social settings
View of self as socially inept, personally unappealing, or inferior
, ✔✔Functional neurologic disorder (conversion disorder) - ✔✔Person has a blindness,
mutism, paralysis, or paresthesia (glove stocking syndrome), other nervous system
(neurologic) symptoms that cannot be explained by medical evaluation
Treatment: CBT, Physical therapy
✔✔Oppositional defiant disorder (ODD) - ✔✔Enduring pattern of angry or irritable mood
and argumentative, defiant, or vindictive that lasts for at least **6 months** with at least
*4 symptoms of 8**
> loses temper
> touchy or easily annoyed
> angry or resentful
> actively defies or refuses to comply with request or rules from authority figures
> blames others
> deliberately **annoys** others
> spiteful or vindictive
✔✔Nonpharmacological management of ODD - ✔✔Therapy!!!
Family therapy (emphasis on parenting skills)
✔✔Conduct disorder - ✔✔Repetitive and persistent pattern of behavior in which the
rights of others or societal norms or rules are violated
Aggression toward people or animals, bullies, threatens, intimidates, initiates physical
fights, uses a weapon, stealing while confronting a victim, forced sexual activity on
someone, destruction of poverty, fire-setting, destroys others' property, lack of remorse
✔✔Conduct disorder treatment - ✔✔Target mood and aggression
SSRIS, alpha agonists (clonidine and guanfacine)
✔✔ADHD (What structures are involved) - ✔✔Dopamine, Norepinephrine, and
Serotonin (DNS)
Frontal cortex, basal ganglia
Abnormalities of reticular activating system
Abnormalities in the prefrontal cortex - inattentive type
✔✔ADHD screening tools - ✔✔Conner's Parent and Teacher Rating Scales
Vanderbilt ADHD Diagnostic Parent and Teacher Rating Scales
Adult Self-Report Scale (ASRS)
✔✔ADHD Treatment - ✔✔Stimulant
SURE A+
✔✔What are CYP450 inducers? - ✔✔Decrease serum level of other drugs
✔✔What are CYP450 inhibitors? - ✔✔Increase serum level of other drugs
**Inhibitors win**
✔✔Inducers - ✔✔Tegretol
St. John's Wort
✔✔Inhibitors - ✔✔Doxycycline
Erithromycin
Clarithomycin
✔✔Medications that can cause mania - ✔✔Steroids
Disulfiram (Antabuse)
Isoniazid (INH)
Antidepressants in persons with bipolar
✔✔Medications that can cause depression - ✔✔Steroids (can cause psychosis)
Beta blockers
Liothyronine
Interferon
Isotretinoin (can also cause birth defects and liver function)
Some retrovirals
BZOs
Progesterone
✔✔What is "floppy baby syndrome"? - ✔✔A newborn condition characterized by
hypotonia (low muscle tone) and sedation
SXS: Hypotonia, weak cry, poor feeding, sedation, respiratory depression
Risk highest in late pregnancy (3rd trimester) or during labor/delivery
✔✔Which drug class is associated with floppy baby syndrome? - ✔✔Benzodiazepines
(Diazepam, Lorazepam)
**Buspar is safer in pregnancy**
**Sertraline is safer in pregnancy**
✔✔DIGFAST (Mania/Hypomania) - ✔✔Distractibility
Indiscretion
,Grandiosity
Flight of Ideas
Activity Increase
Sleep Disturbance
Talkativeness
Mania/hypomania: Irritable mood, uncooperative, agitation
✔✔How heritable is bipolar disorder? - ✔✔Highly
A family hx of the condition across multiple generations is one of the strongest risk
factors for developing it
✔✔Bipolar 1 vs Bipolar 2 - ✔✔Bipolar 1: Full manic episode, sxs at least a week
Bipolar 2: Less severe sxs, at least four days, less severe
✔✔Borderline Personality disorder (BPD) - ✔✔Impulsivity (often with self-damaging
behavior)
Recurrent suicidal behavior
Pattern of unstable, intense interpersonal relationships
Frantic efforts to avoid real or imagined abandonment
✔✔BPD Treatment - ✔✔Nonpharm: DBT
Irritability, anger, self-harm: Lithium
Depressed mood, emotional lability, interpersonal problems, rejection sensitivity,
aggression, hostility: Depakote
SSRis can manage depression and anxiety
✔✔Schizoid personality disorder - ✔✔Voluntary social isolation
Indifferent to other people (lack of care in relation to how others perceive them)
Shows little to no interest in sexual activity
Derives no pleasure in social activities
Lacks close friends or social supports
Appears cold and detached
Exhibits affective flattening
✔✔Avoidant Personality Disorder - ✔✔Avoidance of activities involving significant
interpersonal contact
Fear of criticism, disapproval, or rejection
Unwillingness to be involved with people unless sure of being liked
Restraint in intimate relationships for fear of being shamed
Preoccupation with being criticized or rejected in social settings
View of self as socially inept, personally unappealing, or inferior
, ✔✔Functional neurologic disorder (conversion disorder) - ✔✔Person has a blindness,
mutism, paralysis, or paresthesia (glove stocking syndrome), other nervous system
(neurologic) symptoms that cannot be explained by medical evaluation
Treatment: CBT, Physical therapy
✔✔Oppositional defiant disorder (ODD) - ✔✔Enduring pattern of angry or irritable mood
and argumentative, defiant, or vindictive that lasts for at least **6 months** with at least
*4 symptoms of 8**
> loses temper
> touchy or easily annoyed
> angry or resentful
> actively defies or refuses to comply with request or rules from authority figures
> blames others
> deliberately **annoys** others
> spiteful or vindictive
✔✔Nonpharmacological management of ODD - ✔✔Therapy!!!
Family therapy (emphasis on parenting skills)
✔✔Conduct disorder - ✔✔Repetitive and persistent pattern of behavior in which the
rights of others or societal norms or rules are violated
Aggression toward people or animals, bullies, threatens, intimidates, initiates physical
fights, uses a weapon, stealing while confronting a victim, forced sexual activity on
someone, destruction of poverty, fire-setting, destroys others' property, lack of remorse
✔✔Conduct disorder treatment - ✔✔Target mood and aggression
SSRIS, alpha agonists (clonidine and guanfacine)
✔✔ADHD (What structures are involved) - ✔✔Dopamine, Norepinephrine, and
Serotonin (DNS)
Frontal cortex, basal ganglia
Abnormalities of reticular activating system
Abnormalities in the prefrontal cortex - inattentive type
✔✔ADHD screening tools - ✔✔Conner's Parent and Teacher Rating Scales
Vanderbilt ADHD Diagnostic Parent and Teacher Rating Scales
Adult Self-Report Scale (ASRS)
✔✔ADHD Treatment - ✔✔Stimulant
