GEORGETTE’S LMR Exam Questions And
Answers Verified 100% Correct
What to do if there is depakote toxicity? - ANSWER -D/C
depakote and check VPA level, LFTs, and ammonia
S/S of hepatotoxicity? - ANSWER -RUQ pain, reddish brown
urine, jaundice, fatigue, and elevated LFTs
Normal AST? - ANSWER -5-40
Normal ALT? - ANSWER -5-35
Kava kava can cause? - ANSWER -Liver damage and heavy
sedation
Kava kava is c/i with? - ANSWER -Benzos or sedatives
Mood stabilizer most associated with SJS? - ANSWER -
Lamictal
Mood stabilizer with least weight gain? - ANSWER -Lamictal
,SGAs with least weight gain? - ANSWER -ziprasidone, abilify,
and latuda
Least sedating SGA? - ANSWER -Abilify
Routine labs with SGAs? - ANSWER -BMI, hip to waist ratio,
glucose, A1C, and lipid panel
Management of metabolic syndrome with SGAs? - ANSWER -
1. Nonpharm = exercise or nutritional counseling 2.
Pharm = switch to other SGA with lower chance of
metabolic syndrome
Carbamazepine can cause? - ANSWER -Agranulocytosis and
aplastic anemia
What should you screen for prior to starting Asians on
carbamazepine and why? - ANSWER -HLAB1502 Allele; risk
of SJS
When should you d/c carbamazepine if agranulocytosis is
suspected? - ANSWER -If ANC is < 1000 with or without s/s
of infection
Lithium range? - ANSWER -0.6 - 1.2
,What to do if lithium is 1.3 or 1.4? - ANSWER -Monitor
What to do if lithium is 1.5+? - ANSWER -D/C
Benefits of lithium? - ANSWER -Gold standard for mania,
neuroprotective, and antisuicidal effects
S/S of lithium toxicity? - ANSWER -Severe N/V, polydipsia,
polyuria, leukocytosis, palpitations, coarse tremor
What to do if lithium toxicity is suspected? - ANSWER -D/C
and check serum levels prior to checking VS
Kidney disease and drugs that reduce renal clearance can
raise lithium levels. What are these drugs? - ANSWER -
NSAIDs, ace inhibitors for heart failure (-pril), and thiazides
(HCTZ)
What demonstrates understanding of education on lithium? -
ANSWER -Taking extra water with patient when they go
hiking
, NMS s/s? - ANSWER -Extreme muscle rigidity, mutism,
elevated CPK (muscle contraction and destruction),
myoglobinuria (breakdown of muscle cells, rhabdomyolysis),
increased WBCs, and increased LFTs
Treatment of NMS and MOAs? - ANSWER -D/C med,
bromocriptine (D2 agonist), and dantrolene (muscle relaxant)
Serotonin syndrome s/s? - ANSWER -Hyperreflexia and
myoclonic jerks
Serotonin syndrome causes? - ANSWER -SSRIs, SNRIs,
MAOIs, -triptans (for migraines like sumatriptan/imitrex)
Treatment for serotonin syndrome? - ANSWER -D/C med and
administer cyproheptadine
Wash out from SSRI to MAOI or vice-versa? - ANSWER -14
days
Wash out from Prozac to MAOI? - ANSWER -5-6 weeks
Drug choice for patient that is depressed and also has
cancer? - ANSWER -Celexa or lexapro d/t fewer drug to drug
interactions
Answers Verified 100% Correct
What to do if there is depakote toxicity? - ANSWER -D/C
depakote and check VPA level, LFTs, and ammonia
S/S of hepatotoxicity? - ANSWER -RUQ pain, reddish brown
urine, jaundice, fatigue, and elevated LFTs
Normal AST? - ANSWER -5-40
Normal ALT? - ANSWER -5-35
Kava kava can cause? - ANSWER -Liver damage and heavy
sedation
Kava kava is c/i with? - ANSWER -Benzos or sedatives
Mood stabilizer most associated with SJS? - ANSWER -
Lamictal
Mood stabilizer with least weight gain? - ANSWER -Lamictal
,SGAs with least weight gain? - ANSWER -ziprasidone, abilify,
and latuda
Least sedating SGA? - ANSWER -Abilify
Routine labs with SGAs? - ANSWER -BMI, hip to waist ratio,
glucose, A1C, and lipid panel
Management of metabolic syndrome with SGAs? - ANSWER -
1. Nonpharm = exercise or nutritional counseling 2.
Pharm = switch to other SGA with lower chance of
metabolic syndrome
Carbamazepine can cause? - ANSWER -Agranulocytosis and
aplastic anemia
What should you screen for prior to starting Asians on
carbamazepine and why? - ANSWER -HLAB1502 Allele; risk
of SJS
When should you d/c carbamazepine if agranulocytosis is
suspected? - ANSWER -If ANC is < 1000 with or without s/s
of infection
Lithium range? - ANSWER -0.6 - 1.2
,What to do if lithium is 1.3 or 1.4? - ANSWER -Monitor
What to do if lithium is 1.5+? - ANSWER -D/C
Benefits of lithium? - ANSWER -Gold standard for mania,
neuroprotective, and antisuicidal effects
S/S of lithium toxicity? - ANSWER -Severe N/V, polydipsia,
polyuria, leukocytosis, palpitations, coarse tremor
What to do if lithium toxicity is suspected? - ANSWER -D/C
and check serum levels prior to checking VS
Kidney disease and drugs that reduce renal clearance can
raise lithium levels. What are these drugs? - ANSWER -
NSAIDs, ace inhibitors for heart failure (-pril), and thiazides
(HCTZ)
What demonstrates understanding of education on lithium? -
ANSWER -Taking extra water with patient when they go
hiking
, NMS s/s? - ANSWER -Extreme muscle rigidity, mutism,
elevated CPK (muscle contraction and destruction),
myoglobinuria (breakdown of muscle cells, rhabdomyolysis),
increased WBCs, and increased LFTs
Treatment of NMS and MOAs? - ANSWER -D/C med,
bromocriptine (D2 agonist), and dantrolene (muscle relaxant)
Serotonin syndrome s/s? - ANSWER -Hyperreflexia and
myoclonic jerks
Serotonin syndrome causes? - ANSWER -SSRIs, SNRIs,
MAOIs, -triptans (for migraines like sumatriptan/imitrex)
Treatment for serotonin syndrome? - ANSWER -D/C med and
administer cyproheptadine
Wash out from SSRI to MAOI or vice-versa? - ANSWER -14
days
Wash out from Prozac to MAOI? - ANSWER -5-6 weeks
Drug choice for patient that is depressed and also has
cancer? - ANSWER -Celexa or lexapro d/t fewer drug to drug
interactions
