Georgette's - LMR final/ 529 Qs with Certified
Solutions.
What is the normal range for TSH? - Answer: 0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism - Answer: Decreased TSH
Increased T4 and T3
What are labs in Hypothyroidism? - Answer: Increased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism? - Answer: Heat intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
Page 1 of 68
,What are 4 primary symptoms of Hypothyroidism? - Answer: Cold intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder? - Answer: Depression
Hyperthyroidism mimics symptoms of what psychiatric disorder? - Answer: Mania
Valproic acid produces what teratogenic effect? - Answer: Spina bifida (neural tube defect)
What is the primary organ where valproic acid is toxic? - Answer: Liver (hepatoxicity)
What are 4 signs of hepatoxicity? - Answer: Abdominal pain in the RUQ
Reddish-brown urine
Yellowing of the skin/sclera
Fatigue
What is the therapeutic range for valproic acid? - Answer: 50-125 mcg/ml
What is a toxic level of valproic acid? - Answer: >150 mcg/ml
What are 4 signs of valproic acid toxicity? - Answer: Disorientation
Lethargy
Respiratory depression
Nausea/vomiting
A patient on depakote complains of abdominal pain in the RUQ and reddish-brown urine. What
do you suspect? What do you do? - Answer: Suspect: hepatotoxicity
Page 2 of 68
,Interventions:
-hold med
-draw LFT's (priority)
-VPA/DVP level
With suspected toxicity with valproic acid, what steps/labs should be drawn? - Answer: D/C
drug
Check drug level
Obtain LFTs
Obtain ammonia level
A pregnant patient is taking accutane, zyprexa, and abilify. What medication needs to be
discontinued? - Answer: Accutane
Accutane is used for acne and is contraindicated in pregnancy as it can cause birth defects
What herbal supplement is used for anxiety, stress, and insomnia? - Answer: Kava Kava
What is a major side effect of Kava Kava? - Answer: Liver damage
What drugs should be avoided with Kava Kava? - Answer: Alprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
What are 5 symptoms of Stephen's Johnson Syndrome (SJS)? - Answer: Key symptoms:
-Fever
-Burning of mouth/eyes
Additional symptoms:
Page 3 of 68
, Body aches
Severe red rash
Peeling skin
Facial and tongue swelling
Which mood stabilizer causes the least weight gain? - Answer: Lamotrigine (Lamictal)
Which 3 SGAs cause the least weight gain? - Answer: Lurasidone (Latuda)
Aripiprazole (Abilify)
Ziprasidone (Geodon)
Which SGA is the least sedating? - Answer: Aripiprazole (Abilify)
Your patient is taking Kava Kava and you need to add an antipsychotic to manage their
schizophrenia. Which medication do you add? - Answer: Aripiprazole (least sedating)
What are 2 hallmark symptoms of delirium? - Answer: Acute onset
Altered LOC
impaired cognition
inattention
How are agitation and psychotic symptoms treated in delirium? - Answer: Low-dose Haldol
Ensure you check QTc first as Haldol can cause QTc prolongation
Your 16 year old patient complains of feeling "funny" after inhaling Acetone (nail polish
remover). What is your action? - Answer: Obtain a UDS
They may be abusing other substances
Page 4 of 68
Solutions.
What is the normal range for TSH? - Answer: 0.5 - 5.0 mu/L
What are lab values in Hyperthyroidism - Answer: Decreased TSH
Increased T4 and T3
What are labs in Hypothyroidism? - Answer: Increased TSH
Decreased T4 and T3
What are 5 primary symptoms of Hyperthyroidism? - Answer: Heat intolerance
Agitation, Anxiety, Irritability
Tachycardia
Mood swings
Weight loss
Page 1 of 68
,What are 4 primary symptoms of Hypothyroidism? - Answer: Cold intolerance
Lethargy
Weight gain
Decreased libido
Hypothyroidism mimics symptoms of what psychiatric disorder? - Answer: Depression
Hyperthyroidism mimics symptoms of what psychiatric disorder? - Answer: Mania
Valproic acid produces what teratogenic effect? - Answer: Spina bifida (neural tube defect)
What is the primary organ where valproic acid is toxic? - Answer: Liver (hepatoxicity)
What are 4 signs of hepatoxicity? - Answer: Abdominal pain in the RUQ
Reddish-brown urine
Yellowing of the skin/sclera
Fatigue
What is the therapeutic range for valproic acid? - Answer: 50-125 mcg/ml
What is a toxic level of valproic acid? - Answer: >150 mcg/ml
What are 4 signs of valproic acid toxicity? - Answer: Disorientation
Lethargy
Respiratory depression
Nausea/vomiting
A patient on depakote complains of abdominal pain in the RUQ and reddish-brown urine. What
do you suspect? What do you do? - Answer: Suspect: hepatotoxicity
Page 2 of 68
,Interventions:
-hold med
-draw LFT's (priority)
-VPA/DVP level
With suspected toxicity with valproic acid, what steps/labs should be drawn? - Answer: D/C
drug
Check drug level
Obtain LFTs
Obtain ammonia level
A pregnant patient is taking accutane, zyprexa, and abilify. What medication needs to be
discontinued? - Answer: Accutane
Accutane is used for acne and is contraindicated in pregnancy as it can cause birth defects
What herbal supplement is used for anxiety, stress, and insomnia? - Answer: Kava Kava
What is a major side effect of Kava Kava? - Answer: Liver damage
What drugs should be avoided with Kava Kava? - Answer: Alprazolam
CNS depressants (e.g., phenobarbital, zolpidem)
What are 5 symptoms of Stephen's Johnson Syndrome (SJS)? - Answer: Key symptoms:
-Fever
-Burning of mouth/eyes
Additional symptoms:
Page 3 of 68
, Body aches
Severe red rash
Peeling skin
Facial and tongue swelling
Which mood stabilizer causes the least weight gain? - Answer: Lamotrigine (Lamictal)
Which 3 SGAs cause the least weight gain? - Answer: Lurasidone (Latuda)
Aripiprazole (Abilify)
Ziprasidone (Geodon)
Which SGA is the least sedating? - Answer: Aripiprazole (Abilify)
Your patient is taking Kava Kava and you need to add an antipsychotic to manage their
schizophrenia. Which medication do you add? - Answer: Aripiprazole (least sedating)
What are 2 hallmark symptoms of delirium? - Answer: Acute onset
Altered LOC
impaired cognition
inattention
How are agitation and psychotic symptoms treated in delirium? - Answer: Low-dose Haldol
Ensure you check QTc first as Haldol can cause QTc prolongation
Your 16 year old patient complains of feeling "funny" after inhaling Acetone (nail polish
remover). What is your action? - Answer: Obtain a UDS
They may be abusing other substances
Page 4 of 68
