PMHNP-BC exam with correct answers

PMHNP-BC exam with correct answers Risk of Schizophrenia in monozygotic twins is? - Answer ️️ -46-50% Family hx risk of schizophrenia - Answer ️️ -10x risk with 1st degree relative brain changes in schizophrenia - Answer ️️ -increase in ventricular volume (enlarged cerebral ventricles) Hippocampus volume decrease, 4% smaller Decreased electrical activity in frontal lobes Decrease glutamate and GABA release. Decreased total brain volume functional neuroimaging findings of schizophrenia - Answer ️️ -Abnormal function of frontal cortical regions Including for solo lateral prefrontal and anterior cingulate cortices Maximum dose of Celexa - Answer ️️ -40mg/day as higher doses can cause abnormal electrical activity of the heart. Some experts still prescribe higher What class of medication is bupropion - Answer ️️ -NDRI boosts norepinephrine, noradrenaline, and dopamine neurotransmitters What hematologic change is associated with lithium? - Answer ️️ -Leukocytosis. Lithium raises WBC counts. Monitor CBC GABA in terms of anxiety disorders - Answer ️️ -Most abundant inhibitory neurotransmitter. Decreasing GABA would increase anxiety. Benzos are used to bind with GABA to potentiate the anxiolytic effects of GABA What to avoid while on Disulfiram - Answer ️️ -Anything containing alcohol (vinegar, mouthwash, aftershave, cough medicine). Avoid for 2 weeks after discontinuing disulfiram. Lab effected by disulfiram that requires monitoring - Answer ️️ -Disulfiram can elevate liver function tests A medication that can induce mania - Answer ️️ -Corticosteroids What finding would be associated with an acoustic neuroma? - Answer ️️ -Unilateral ringing in the ear (tinnitus) may be the first symptom of an acoustic neuroma. What delay is expected in a 4 year old with Asperger's? - Answer ️️ -Delay in social skills development. Unlike autistic disorder, no significant delays in language, cognitive development, or age appropriate self help skills are observed. Primary clinical features of Asperger's - Answer ️️ -Qualitative social impairment Markedly abnormal nonverbal communicative gestures Failure to develop peer relationships Lack of social or emotional reciprocity Impaired ability to express pleasure in other persons' happiness. Chlorpromazine (Thorazine) and clozapine cause what troublesome side effect due to their alpha 1-adrenergic blockade? - Answer ️️ -Orthostatic hypotension. Manage by raising dose of chlorpromazine and clozapine slowly. What medication is strictly prohibited when the patient is on an MAOI such as selegiline due to the risk of hypertensive crisis and death? - Answer ️️ -Meperidine (Demerol) Dopamine pathways in relation to clinical symptoms of schizophrenia - Answer ️️ -Negative symptoms are related to DA deficit in the cerebral cortex; positive symptoms are related to DA excess in the nucleus accumbens and mesolimbic system. Facial characteristics of child with fetal alcohol syndrome - Answer ️️ -Small head Short eyelid opening Flat midface Smooth philtrum Underdeveloped jaw Thin upper lip Short nose (Can also have inner epicanthal folds, short palpebral fissure) Physical features of prayer willi syndrome - Answer ️️ -Obesity Small stature Small hands and feet Hypotonia Hypogonadism Physical features of von recklinghausen's disease - Answer ️️ -Café au lait spots Neurofibromas In what condition is the use of bupropion contraindicated? - Answer ️️ -Bulimia. Do not use bupropion in past or present eating disorders due to increased risk of seizures. Predominant risk factor of antisocial personality disorder? - Answer ️️ -Genetic predisposition of first-degree family member. Antisocial personality disorder is 5X more common among first-degree relative of men with the disorder than the general population. Risk of inhibition of platelet aggregation (risk of bleeding from SSRIs, NSAIDS, ASA) is an example of this - Answer ️️ -Pharmacodynamics Rare but serious side effect of trazodone (Desyrel) - Answer ️️ -Priapism arcus senilis (gray opaque band in the cornea) prior to age 40 is associated with what disorder? - Answer ️️ -Hyperlipidemia Asians are poor metabolizers of which enzyme? (Will have exaggerated response to diazepam) - Answer ️️ -CYP 2C19 Side effects of oxcarbazepine (Trileptal) - Answer ️️ -Excessive urination and thirst (can be distinguished from possible DM II if blood sugar is up but HGBA1C is normal. Dopamine antagonism in the tuberoinfundibular pathway can cause what side effect? (Antipsychotic drugs) - Answer ️️ -Galactorrhea Which part of the brain modulates pain and can help explain how transcranial magnetic stimulation can help decrease pain? - Answer ️️ -Prefrontal cort