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Georgettes LMR EXAM STUDY GUIDE With Complete Solutions
When questions ask for a priority action...think about... - ANSWER✅✅ABC, airway breathing, circulation Maslows hierarchy If undecided on an answer due to high similarities, choose: - ANSWER✅✅the umbrella answer What is the most common side effect of olanzapine/zyprexa - ANSWER✅✅metabolic syndrome what is the difference between typical and atypical antipsychotics - ANSWER✅✅Atypical 5HT2A specific 1st psychotic break... two actions to take - ANSWER✅✅UDS and r/o sub Consider IM Geodon or Invega Three AP with least weight gain - ANSWER✅✅Latuda, Abilify, Geodon Always encourage interprofessional collaboration - ANSWER✅✅between therapists/pcps/SW/RN, the ENTIRE team TSH High, then....t3/t4 - ANSWER✅✅T3, T4 low TSH low, then...t3/t4 - ANSWER✅✅T3, T4 high cold/hot sensitivity with t3/t4 relationship - ANSWER✅✅T3/T4 low, hypothyroid, cold, slow T3/T4 high, hyperthyroid, hot, flushed, tachy 1 / 4
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What birth defect can be caused by depakote? - ANSWER✅✅Spina bifida What organ does depakote cause toxicity? and what sx would you expect to see? labs to run? -
ANSWER✅✅Hepatotoxicity: RUQ pain, reddish brown urine-
Do LFTs kava kava is used to treat - ANSWER✅✅anxiety and insomnia Rash and fever associated with tegretol, suspect - ANSWER✅✅ What allele is HLAB 1502 associated? - ANSWER✅✅Asians. They CANNOT have tegretol. Test all asians for this allele.what rare and dangerous side effects are associated with tegretol - ANSWER✅✅Aplastic anemia Agranulocytosis-DC at ANC less than 1000 Sx's of agranulocytosis - ANSWER✅✅unusual bleeding or bruising, mouth sores, infections, fever, sore throat, fatigue if starting a woman on lithium what test should be done? why? - ANSWER✅✅HCG--risk of ebstein anomaly adverse s/e of lamictal/lamotrigine - ANSWER✅✅SJS labs to checke BEFORE starting on lithium - ANSWER✅✅BUN CRE urine protein What does protein in urine indicate - ANSWER✅✅kidney impairment; 4+ protein in urine=you cannot start on lithium 2 / 4
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best choice med for decreasing si in bipolar disorder. - ANSWER✅✅lithium best choice med for si in schizophrenia - ANSWER✅✅clozaril best choice med for SI in borderline - ANSWER✅✅lithium What medications will INCREASE Li levels - ANSWER✅✅NSAIDS ACE's Thiazides/HCTZ Besides medications, what else can cause increased Li levels - ANSWER✅✅dehydration hyponatremia lithium s/e inc N/V, which will effect electrolytes, and dehydration status what type of tremors will you see with lithium toxicity? - ANSWER✅✅course tremors lithium can cause what other comorbidities? - ANSWER✅✅hypothyroidism maculopapular rash leukocytosis twave inversion what is a defining characteristic of NMS vs SS - ANSWER✅✅muscle rigidity Sx's/labs associated with NMS - ANSWER✅✅Inc CPK, WBC, LFT Rhabdomyolosis myoglobinuria Can lead to mutism 3 / 4
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myoglobinuria/rhabdo can cause cherry colored urine Treatment for NMS and what each does - ANSWER✅✅DC the offending agent bromocriptin-D2 agonis
dantrolene: muscle relaxant
Make sure if ? is asking for agonist or relaxant Sx of SS - ANSWER✅✅HYPERREFLEXIA myoclonic jerks treatment for SS - ANSWER✅✅ciproheptadine how to best PREVENT SS - ANSWER✅✅follow proper transition protocols SSRI to MAOI=14 days Prozac to MAOI=5-6 weeks Triptans can also cause SS due to serotonin increase with use Why are SSRIs considered the safest for use in depression - ANSWER✅✅safest for OD depressed patient presents with fatigue and low energy, consider: - ANSWER✅✅NDRI wellbutrin sexual s/e with ssri? try... - ANSWER✅✅wellbutrin due to lower risk of sexual s/e What medication must be avoided if client has seizure history or eating disorder? why? - ANSWER✅✅wellbutrin due to decreasing the seizure threshold
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