UPDATED LMR - Georgette's PMHNP Certification Exam Review; Latest 2023..2024

What drugs should be avoided with Kava Kava? Alprazolam CNS depressants (e.g., phenobarbital, zolpidem) 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 mimics 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 URQ Reddish-brown urine Yellowing of the skin and 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 pt on Depakote C/O Abdominal pain in the URQ and Reddish-brown urine. What do you suspect? What do you do? Hepatotoxicity; hold med, draw LFT's (priority), DVP level 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 pt is taking accutane, zyprexa and abilify; what med needs to be d/c'd? Accutane (used for acne; Causes birth Defects!!!) What herbal supplement is used for anxiety, stress, and insomnia? What is the major side effect with Kava Kava? Kava Kava liver damage What are 5 symptoms of Stephen's Johnson Syndrome? Fever -Key sx to suspect SJS; high yield (HY) burning of mouth/eyes -HY