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PMHNP certification ALREADY PASSED

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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

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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.

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