PASS! PMHNP Certification Exam Study
Questions and Answers.
Pain and bloating after eating is caused by... -
\delayed gastric emptying
Medications that cause delayed gastric emptying? -
\PPIs; ranitidine, famotidine, omeprazole
What instructions should you give your patient if they are prescribed antacids/PPIs and
psychotropics? -
\Give medications at least 2 hours apart b/c antacids/PPIs decrease absorption of
psychotropics
Normal BMI range -
\18.5-25
Criteria for admission for ED bx: -
\BMI <15; 25% total body weight loss in 3 months; severe dehydration, infection,
bradycardia, hypothermia, hematemesis, hypokalemia
What neurotransmitters are implicated in ADHD? -
\DA, NE, 5HT - DNS
What brain structures are involved in ADHD? -
\Reticular activating system, basal ganglia, frontal cortex - RBF
Abnormalities in this part of the brain cause inattentive ADHD: -
\Prefrontal cortex
Amphetamines are FDA approved for children beginning at _ years old -
\3
Methamphetamines are FDA approved for children beginning at _ years old -
\6
Alpha agonists clonidine and guanfacine are FDA approved to treat ADHD in patients
ages ___ -
\6-17
Strattera is FDA approved to treat ADHD in patients ages ___ -
\6 and up (including adults)
,Adults diagnosed with both ADHD and depression would benefit from being prescribed:
-
\Wellbutrin
Conduct disorder can be diagnosed in: -
\Both children and adults
Conduct disorder diagnostic criteria: -
\Violating rights of others or societal norms; aggression towards people/animals;
destruction of property; no remorse
Treatment for conduct disorder: -
\Targets aggression and mood; SGA, mood stabilizer, SSRI, alpha agonists
ODD diagnostic criteria: -
\Argumentative, defiant for at least 6 months and with 4 sx
Treatment of ODD: -
\Focused on family therapy, child management skills, teaching parents
reinforcement/boundaries/problem solving
DMDD diagnostic criteria: -
\Childhood depressive d/o between ages 6-17; chronic dysregulated mood, frequent
tantrums, severe irritability; typically DMDD rather than bipolar d/o in children
Neurotransmitters implicated in ASD: -
\Glutamate, GABA, 5HT - GGS
Echolalia -
\Meaningless repetition of words; often seen in ASD
Broken mirror theory -
\Dysfunction of the mirror neuron system results in poor social interaction and cognition
in ASD patients
Parallel play is developmentally appropriate at which ages? -
\1-3 years old
Parallel play continuing beyond the age of 3 years old may be indicative of... -
\ASD dx d/t social deficits
M-CHAT -
\Modified Checklist for Autism in Toddlers; ASD scale
ADOS-G -
\Autism Diagnostic Observation Schedule - Generic; ASD scale
,ASQ -
\Ages and Stages Questionnaire; development and social/emotional screening
Pharmacological treatment of ASD: -
\Stimulants (increase DA to help with impulsivity, hyperactivity, inattention;
Antipsychotics (target aggressive bx, tantrums, self-injury, stereotyped bx)
Nightmares in children can be the result of: -
\Genetic factors; assess family patterns of nightmares
Features of children diagnosed with Fragile X -
\LARGE features: large head, elongated face, hyperextensible joints, abnormally large
testes, short stature
Features of children diagnosed with fetal alcohol syndrome -
\small features: small head, small eye opening, low nasal bridge, flat midface, smooth
philtrum, thin upper lip
Clock drawing test assesses function of which brain lobe? -
\Parietal
What does the clock drawing test assess for? -
\Executive/cognitive fx, impairments associated w/ damage to right parietal lobe,
constructional apraxia (inability to draw or assemble objects)
Important labs to draw for patients presenting with dementia? -
\B12, folic acid
Dementia presents with mental decline that is ___ -
\Chronic; if acute sx, consider other dx
Symptoms of subcortical dementia: -
\Motor sx, lack of coordination, tremors, depression, irritability, apathy
Example of subcortical dementia diagnosis -
\Huntington's disease
Symptoms of cortical dementia: -
\Language and memory impairments (aphasia and amnesia)
Example of cortical dementia diagnosis: -
\Alzheimer's
Presentation of dementia d/t HIV disease -
\Subcortical effects; motor abnormalities, bx abnormalities, cognitive decline
, Presentation of dementia with Lewy bodies -
\Visual hallucinations, Parkinsonian sx
Presentation of frontal lobe dementia (e.g. Pick's disease) -
\Personality/bx changes, language changes, inappropriate social bx, aggression
Presentation of Huntington's disease -
\Subcortical dementia; motor abnormalities, psychomotor slowing; high incidence of
depression, psychosis; begins ages 30-45; affects males and females equally
What is the most effective test to determine if someone will develop Huntington's
disease? -
\Direct genetic test (no risk)
What is the likelihood a child of a parent with Huntington's will develop it? -
\50% chance
Dementia etiology -
\Cerebral atrophy, enlarged ventricles; decreased Ach and NE; genetic loading
What neurotransmitters are implicated in dementia, and how? -
\Decreased Ach and NE
What is the first line treatment for psychosis and agitation in dementia? -
\SGAs - but try nonpharmacological therapies first
What is delirium? -
\ACUTE disturbance of LOC, cognition, attention
What pharmacological treatment do you use for delirium-induced agitation or
psychosis? -
\Low dose haldol
What pharmacological treatment do you use for alcohol-induced delirium? -
\BNZ
Anytime a patient presents with delirium, what labs should you order? -
\UA with culture and specificity d/t infx being a potential cause for delirium, esp in older
adults
What is pseudodementia? -
\Cognitive sx r/t depression in older adults
Dementia vs. pseudodementia -
\Dementia: premorbid hx of slowly declining cognition
Questions and Answers.
Pain and bloating after eating is caused by... -
\delayed gastric emptying
Medications that cause delayed gastric emptying? -
\PPIs; ranitidine, famotidine, omeprazole
What instructions should you give your patient if they are prescribed antacids/PPIs and
psychotropics? -
\Give medications at least 2 hours apart b/c antacids/PPIs decrease absorption of
psychotropics
Normal BMI range -
\18.5-25
Criteria for admission for ED bx: -
\BMI <15; 25% total body weight loss in 3 months; severe dehydration, infection,
bradycardia, hypothermia, hematemesis, hypokalemia
What neurotransmitters are implicated in ADHD? -
\DA, NE, 5HT - DNS
What brain structures are involved in ADHD? -
\Reticular activating system, basal ganglia, frontal cortex - RBF
Abnormalities in this part of the brain cause inattentive ADHD: -
\Prefrontal cortex
Amphetamines are FDA approved for children beginning at _ years old -
\3
Methamphetamines are FDA approved for children beginning at _ years old -
\6
Alpha agonists clonidine and guanfacine are FDA approved to treat ADHD in patients
ages ___ -
\6-17
Strattera is FDA approved to treat ADHD in patients ages ___ -
\6 and up (including adults)
,Adults diagnosed with both ADHD and depression would benefit from being prescribed:
-
\Wellbutrin
Conduct disorder can be diagnosed in: -
\Both children and adults
Conduct disorder diagnostic criteria: -
\Violating rights of others or societal norms; aggression towards people/animals;
destruction of property; no remorse
Treatment for conduct disorder: -
\Targets aggression and mood; SGA, mood stabilizer, SSRI, alpha agonists
ODD diagnostic criteria: -
\Argumentative, defiant for at least 6 months and with 4 sx
Treatment of ODD: -
\Focused on family therapy, child management skills, teaching parents
reinforcement/boundaries/problem solving
DMDD diagnostic criteria: -
\Childhood depressive d/o between ages 6-17; chronic dysregulated mood, frequent
tantrums, severe irritability; typically DMDD rather than bipolar d/o in children
Neurotransmitters implicated in ASD: -
\Glutamate, GABA, 5HT - GGS
Echolalia -
\Meaningless repetition of words; often seen in ASD
Broken mirror theory -
\Dysfunction of the mirror neuron system results in poor social interaction and cognition
in ASD patients
Parallel play is developmentally appropriate at which ages? -
\1-3 years old
Parallel play continuing beyond the age of 3 years old may be indicative of... -
\ASD dx d/t social deficits
M-CHAT -
\Modified Checklist for Autism in Toddlers; ASD scale
ADOS-G -
\Autism Diagnostic Observation Schedule - Generic; ASD scale
,ASQ -
\Ages and Stages Questionnaire; development and social/emotional screening
Pharmacological treatment of ASD: -
\Stimulants (increase DA to help with impulsivity, hyperactivity, inattention;
Antipsychotics (target aggressive bx, tantrums, self-injury, stereotyped bx)
Nightmares in children can be the result of: -
\Genetic factors; assess family patterns of nightmares
Features of children diagnosed with Fragile X -
\LARGE features: large head, elongated face, hyperextensible joints, abnormally large
testes, short stature
Features of children diagnosed with fetal alcohol syndrome -
\small features: small head, small eye opening, low nasal bridge, flat midface, smooth
philtrum, thin upper lip
Clock drawing test assesses function of which brain lobe? -
\Parietal
What does the clock drawing test assess for? -
\Executive/cognitive fx, impairments associated w/ damage to right parietal lobe,
constructional apraxia (inability to draw or assemble objects)
Important labs to draw for patients presenting with dementia? -
\B12, folic acid
Dementia presents with mental decline that is ___ -
\Chronic; if acute sx, consider other dx
Symptoms of subcortical dementia: -
\Motor sx, lack of coordination, tremors, depression, irritability, apathy
Example of subcortical dementia diagnosis -
\Huntington's disease
Symptoms of cortical dementia: -
\Language and memory impairments (aphasia and amnesia)
Example of cortical dementia diagnosis: -
\Alzheimer's
Presentation of dementia d/t HIV disease -
\Subcortical effects; motor abnormalities, bx abnormalities, cognitive decline
, Presentation of dementia with Lewy bodies -
\Visual hallucinations, Parkinsonian sx
Presentation of frontal lobe dementia (e.g. Pick's disease) -
\Personality/bx changes, language changes, inappropriate social bx, aggression
Presentation of Huntington's disease -
\Subcortical dementia; motor abnormalities, psychomotor slowing; high incidence of
depression, psychosis; begins ages 30-45; affects males and females equally
What is the most effective test to determine if someone will develop Huntington's
disease? -
\Direct genetic test (no risk)
What is the likelihood a child of a parent with Huntington's will develop it? -
\50% chance
Dementia etiology -
\Cerebral atrophy, enlarged ventricles; decreased Ach and NE; genetic loading
What neurotransmitters are implicated in dementia, and how? -
\Decreased Ach and NE
What is the first line treatment for psychosis and agitation in dementia? -
\SGAs - but try nonpharmacological therapies first
What is delirium? -
\ACUTE disturbance of LOC, cognition, attention
What pharmacological treatment do you use for delirium-induced agitation or
psychosis? -
\Low dose haldol
What pharmacological treatment do you use for alcohol-induced delirium? -
\BNZ
Anytime a patient presents with delirium, what labs should you order? -
\UA with culture and specificity d/t infx being a potential cause for delirium, esp in older
adults
What is pseudodementia? -
\Cognitive sx r/t depression in older adults
Dementia vs. pseudodementia -
\Dementia: premorbid hx of slowly declining cognition
