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Exam (elaborations)

GEORGETTE REVIEW. QUESTIONS WITH ANSWERS

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  • Course
  • GEORGETTE
  • Institution
  • GEORGETTE

GEORGETTE REVIEW. QUESTIONS WITH ANSWERS

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  • November 4, 2024
  • 27
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • GEORGETTE
  • GEORGETTE
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GEEKA
GEORGETTE REVIEW. QUESTIONS WITH ANSWERS

Native americans - answers- ethnic group w/ the highest rate of si in the us

If cultural question - answers- make an accommodation for them even if against policy

Respect also important

Contextualize their situation/clarify the meaning of their illness in their culture

If it's a cultural syndrome, it's not mental illness--provide supportive psychotherapy

Education w/ cultural consideration - answers- teach education based on cultural.

If multiple cultures present during education- provide multicultural ethonospecific
assessment parameters

Answering tips - answers- if part of quesiton wrong, whole question wrong.

If 3 of the same and one different usually answer is the one that's different

Answering tips - answers- priority is airway, breathing, circulation.

What do you do first?
Reduce calorie, exercise..if not

Then switch to lurasidone, abilify, or geodon

First psychotic episodes? - answers- atypicals...especially im injections because fastest
mode of action

Zyprexa, invega, abilify or geodon

Normal tsh - answers- 0.5 - 5.0

Hyperthyroid - answers- anxiety, irritable, heat intolerance, tachy, mood swings, wt loss,
increased appetite

Hypothyroid - answers- cold intolerance, lethargy, wt gain, decreased lbido

Steven johnson (lamictal, lamotrigine) - answers- fever
Rash
Burning eyes/mucosa
Ha

,Lamictal - answers- mood stabilizer that causes the least amount of wt gain

Carbamazepine (tegretol) - answers- also can cause sjs or rash

Especially in asians

Must screen for hlab-1502 allele first for all asains (if positive, means at increased risk
for sjs, don't give)

Which meds cause agranulocytosis - answers- tegretol and clozaril

Dc if anc <1000 whether or not signs of infection

Monitor for signs of infection which indicate granulocytosis- fever, sore throat, fatigue,
chills.

Valproic acid (depakote) - answers- can cause:
-spina bifida
-hepatotoxicity (ruq pain, reddish-brown urine- check lfts)

Signs of hepatotoxicity (depakote) level >150 - answers- confusion
Disorientation
Lethargy
Respiratory depression

Priority- d/c depakote
Get lfts, ammonia levels --high ammonia causes confusion

50-125, toxicity occurs if >150

Pregnancy test - answers- hcg human chorionic gonadotropin

Always check before placing on mood stabilizer for women childbearing age (12-51)

Kava kava - answers- herbal supplement
Taken for insomnia, anxiety

Most important is to check lfts

Also drug drug interaction w/ kava and benzos

Which meds can effect liver? - answers- bzn
Tca
Depakote

Lithium level - answers- 0.6-1.2

, If reaches 1.5- discontinue lithum...

If 1.3 or 1.4---monitor for toxicity, but once reaches 1.5- immediately d/c

Which drugs increase lithium levels - answers- they reduce renal clearance:

Nsaids
Hydrochlorothiazide
Ace inhibitors

Also- dehydration/hyponatremia can increase lithium. Make sure they stay hydrated.

Treatment of nms - answers- d/c med

Bromocriptine (parlodel)- d2 agonist

Or

Dantrolene- muscle relaxant (muscle rigidity)

Serotonin syndrome - answers- d/c med

Cyproheptadine

Then maslows heirchy-- safety, needs, culture

Then assessment before intervention if needed.

Don't choose to delegate, always chose to collaborate/do it yourself

3 antipscyhotics that are least likely to cause wt gain - answers- lurasidone, abilify, and
ziprasidone (geodon)

Abilify least sedating

Pt develops metabolic syndrome: - answers- elevated a1c, lipid, glucose, hip to waist
ratio, bmi

When switching antidepressenats - answers- wait 14 days when ssri -> maoi

Wait 5-6 wks from fluoxetine to maoi

Wait 2 wks if switching from maoi -> fluoxetine.

Due to fluoxetine (prozac) having longer halflife.

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