Georgette's LMR Quiz Questions & Answers 2023/2024, Quizzes of Sport Studies

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Georgette's LMR Quiz Questions & Answers

2023/

1. There is a medication class that is contraindicated when a patient has tics. What is that class of medication?: Stimulants --often used for ADHD
2. What action do you take if a patient reports being a victim of abuse.: Safety first! Provide patient with an environment of safety and reassure them of their safety in the clinic/hospital.
3. If you work inpatient, what do you do before discharging a patient who says they have been abused?: Make sure the patient will be safe.
4. If you work inpatient, is a safety contract sufficient to determine that you are releasing a patient into a safe home?: No. A safety contract is not enough. The NP has to confirm that the patient is going to be safe for themselves or their environment is safe.
5. Inpatient--for safety, where should the NP interview the patient and why?: Safety is more important than privacy. In an office with a door open or partially open. The day room would be a breach of confidentiality and a closed door or in their room would give the patient access to harming the NP.
6. If a child comes into the office with their parents and say they have been abused, what action does the NP take?: interview the child separately from the parents THEN report to CPS
7. If a child comes into an appointment without their parents and plays with a toy in a sexual way, what action does the NP take?: This makes the NP suspect abuse so initial action is to immediately report to CPS.
8. What is the cornerstone of building a therapeutic alliance with adolescents?: Confidentiality with the explanation that confidentiality must be broken if they are a danger to self or others
9. Do we interview adolescents with their parents in the room?: No because the adolescent may have info that they want kept confidential from their parents.
10. If an adolescent comes in with their parents, do you keep the parents and adolescent together or separate theme?: Separate them and speak to adolescent alone because the adolescent has a right to confidentiality.

11. Which ethnic group has the highest incidence of suicide and suicide attempts ?: Native American
12. Native Americans believe in their healing stick. If a staff member tries to take it away, what should the NP do?: Educate the staff member in cultural competency and sensitivity.
13. If a patient wants a traditional healer to accompany them to an appointment, what does the NP have to do ?: Get consent from the patient and allow the traditional healer to attend as well. With permission from the patient, you can include the healer in the care plan as follow up.
14. Which labs should be taken before treating for depression or mania?: TSH
15. What is the normal range of TSH?: 0.5-5.0 mu/L
16. Symptoms of hypothyroidism mimic which mental illness?: Depression
17. Symptoms of hyperthyroidism mimic which mental illness?: Mania 18. If TSH is low i.e. 0.4 or lower, what is happening to T4 an T3 and what condition does patient have?: T4 and T3 will be high and patient will have hyperthyroidism
18. If TSH is high e.g. 7.0, what is happening to T4 an T3 and what condition does patient have?: T4 and T3 will be low and patient will have hypothyroidism.
19. What are the symptoms of hyperthyroidism that can mimic mania? And what are other symptoms?: agitation, anxiety, irritability, mood swings, weight loss. Other symptoms are heat intolerance and tachycardia
20. What are symptoms of hypothyroidism that mimic depression? And what are other symptoms?: lethargy, weight gain, decreased libido. And, cold intolerance
21. What is the Black Box warning for Depakote?: Pancreatitis
22. What are physical side effects/ dangers of Depakote (Divalproex)--for patient or fetus: Spina bifida in fetuses Hepatotoxicity
23. If a patient taking depakote has signs of hepatotoxicity what would those signs and symptoms be ?: Abdominal pain in upper right quadrant of abdomen Reddish brown urine

Yellowing of the skin and whites of eyes Fatigue

25. If patient taking depakote has signs of hepatotoxicity, what should the NP do?: A liver function test --check AST and ALT levels 26. Signs of valproic acid toxicity?: Disorientation lethargy Respiratory depression Nausea/vomiting
26. What action do we take at signs of valproic acid (Divalproex/Depakote) toxicity?: Dc medication and check depakote levels, do a LFT and check ammonia levels
27. What are the signs and symptoms of pancreatitis: upper adbominal pain abdominal pain that radiates to patient's back tenderness when touching the abdomen fever rapid pulse nausea vomiting oily stools
28. What in mental illness is Kava (or Kava Kava) used for ?: Kava Calms anxiety stress insomnia
29. What is the major side effect of Kava? What do we monitor?: Liver damage We monitor patient for RUQ pain and do LFTs
30. Kava is contraindicated with which meds/med classes?: Xanax (Alprazolam) CNS depressants/ sedative medications Benzos (CLonazepam/Klonopin), (Lorazepam/ Ativan), phenobarbital (Donnatal) Zolpidem (Ambien)

32. Lamictal and weight: Lamictal is the mood stabilizer that causes the least weight gain
33. Lamictal and rash: Can cause Stevens Johnson
34. What are the symptoms of Stevens Johnson syndrome?: Body aches, red rash, peeling skin, facial and tongue swelling
35. Which antipsychotics cause the least weight gain?: ZAL Ziprasodone (Geodon) Aripriprazole (Abilify) Lurasidone (Latuda)
36. For patients taking antipsychotics that have caused weight gain, what routine labs do we check?: bmi hip-to-waist ratio glucose lipid panel
37. Non-pharm treatment of antipsychotic induced weight gain (AIWG)--1st line: Exercise and nutritional counseling This is first line treatment
38. Pharm intervention for Antipsychotic Induced Weight Gain: Switch to antipsychotic with lower potential for weight gain: ZAL
39. Black Box Warning for Carbamazepine: agranulocytosis, aplastic anemia, Stevens --Johnson syndrome
40. symptoms of Aplastic anemia: pallor fatigue HA fever nosebleeds bleeding gums skin rash SOB
41. If prescribing Carbamazepine for an Asian patient, what gene do you screen for ?: HLA-B* 1502 allele is highly associated with Carbamazepine- induced Stevens-Johnson syndrome
42. ANC level that indicates NP should DC clozapine or Carbamazepine?: An ANC less than 1000 mm3 whether patient is showing signs of infection or not.

43. What are signs of infection for which we should monitor patients on Clozapine or Carbamazepine to DC it?: Sudden fever Chills sore throat weakness
44. Lithium and neuroprotection: Lithium is neuroprotective treatment of choice for bipolar disorder-- can protect nerve cells from damage. 45. What is the therapeutic range of Lithium: 0.6-1.2 mEq/L
45. At what Lithium level does lithium toxicity occur?: 1.5 mEq/L or higher
46. Lithium is the gold standard for treating what?: Mania
47. Lithium and suicide.: Lithium is the only mood stabilizer with evidence of anti-suicidal effects in bipolar
48. What is the therapeutic range of depakote?: 50-125 micrograms (ug/ml)
49. What is the toxic range of depakote(valproic acid)?: 150 microgrms (ug/ml)
50. Necessary labs for Lithium: TSH Serum creatinine BUN Urinalysis HCG for females age 12-
51. Signs of lithium toxicity: In mild lithium toxicity, symptoms include WATCAD--Weakness, Ataxia, Tremor, Concentration poorness and Diarrhea. weakness, worsening tremor, mild ataxia, poor concentration and diarrhea. With worsening toxicity, vomiting, the development of a gross tremor, slurred speech, confusion and lethargy emerge
52. When to DC Lithium: serum level of 1.3 or 1.4 and signs of Lithium toxicity. with or without symptoms if 1.5 serum level --toxicity level If creatinine or BUN are high because Lithium is processed through kidney
53. Preventative tests when prescribing antipsychotics to women: Take HCG test/ aka pregnancy test before placing any woman on antipsychotic -for females of age 12-51.
54. If patient has 4+ protein in urine while on lithium what do we do ?: Monitor closely for lithium toxicity

56. What are side effects of Lithium?: hypothyroidism, ebstein anomaly, and nephrogenic diabetes insipidus, fine hand tremors, Maculopapular rash, GI upset(Diarrhea, vomiting, cramps, anorexia), polyuria, polydispsia, T-wave inversions, Leukocytosis (increased WBCs)
57. What do we do in cases of Lithium toxicity?: DC Li and check serum Li levels 58. What are some factors that can increase Lithium levels?: Kidney disease or drugs that reduce renal clearance NSAIDS(ibuprofen, Indocin) Thiazides (hydrochlorothiazide) ACE inhibitors Medications used for cardiac failure (lisinopril) Dehydration Hyponatremia (low sodium levels)
58. What causes Neuroleptic Malignant Syndrome (NMS)?: Antipsychotics
59. What are the symptoms of Neuroleptic Malignant syndrome (NMS)?: Extreme musclular rigidity Mutism Elevated CPK (happens due to muscle contraction and destruction) Myoglobinuria Elevated WBCs(leukocytosis) Elevated LFTs
60. What is the treatment for NMS?: DC the antipsychotic and treat with: There are two with different MOAs: Bromocriptine (Parlodel) which is a Dopamine (2) agonist Dantrolene which is a Muscle Relaxant
61. What are the signs of both NMS and serotonin syndrome?: Hyperthermia Tachycardia Diaphoresis Altered level of consciousness
62. What are the signs of Serotonin Syndrome?: Hyperreflexia Myoclonic jerks
63. What causes serotonin syndrome?: SSRIs/SNRIs/TCAs/MAOIs

65. How do we treat Serotonin Syndrome?: DC the offending agent and treat with Cyproheptadine
66. When switching from an SSRI to an MAOI, how long wait before starting the MAOI?: wait 14 days
67. When switching from fluoxetine (Prozac) to MAOIs how long to wait before starting the MAOI?: 5-6 weeks
68. When switching from an MAOI to Prozac how long wait until start Prozac?: wait 2 weeks
69. Why the wait times for switching from between SSRIs and MAOIs?: need a washout period of 5 half-lives between cessation of previous drug and introduction of new drug. This is the time it takes for the medication to degenerate out of the system
70. Due to risk of Serotonin Syndrome, which combination of meds to we avoid?: Combinations of SSRIs and SNRIs or TCAs or MAOIs or St. John's Wort
71. If we see "regenerate" in answers related to serotonin, what do you do ?: eliminate. "Regenrate" is wrong answer
72. Why are SSRIs the 1st line antidepressants used in depression: because they are safer in cases of overdose
73. Serotonin Syndrome and triptans?: Triptans can cause serotonin syndrome so no triptans (for migraines) or sumatriptan (imitrex)
74. Which antidepressant to do we give a patient who is depressed and has cancer?: Citalopram or escitalopram because lower incidence of drug-drug interaction.
75. Which antidepressant to do we give a patient who is depressed and has neuropathic pain?: SNRI or TCA An SNRI is safer

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76 What do we prescribe for patients in chronic neuropathic pain?: Alpha 2 Delta Ligands= Gabapentin and Pregabalin (Lyrica)

77. antidepressants and sexual dysfunction: SSRIs/SNRIs can cause sexual dysfunction
78. Important info about Wellbutrin: NDRIs do not cause sexual dysfunction = Wellbutrin Patient depressed +Low energy +fatigue give Wellbutrin Wellbutrin contraindicated in hx of seizures or eating d/o = Wellbutrin increase seizure risk
79. Black Box Warning on all depressants and responsibiltity of NP: increase thoughts of self-harm in adolescents. assess for frequency and severity of these thoughts at every visit.
80. Alcohol and depression: If patient is depressed, assess alcohol intake because some patients use alcohol to self-medicate and this can become a barrier to treatment
81. Prozac and Insomnia: Prozac can cause insomnia; encourage pt to take Prozac in the morning
82. Mental illnesses that cause thoughts of self-harm: Depression bipolar alcohol abuse eating disorder schizophrenia
83. mental illness most often associated with Homicidal ideation: Antisocial personality disorder
84. Placebo rate, children, antidepressants: few experimental studies exist that investigate the placebo effect of antidepressants in children and adolescent (When compared to adults, children with depression have a reduced placebo representation in studies but a higher placebo rate).
85. positive symptoms of schizophrenia: •Hallucination, Delusion, Loose association •Ideas of reference (paranoia/ paranoid delusions) •Agitated and bizarre behavior
86. Negative symptoms of schizophrenia: •Avolition - Asociality (Hygiene, Work) •Anhedonia - Asociality (Interest, Relationship) •Blunted affect

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•Paucity of thought 87 age of onset of schizophrenia: 18-25 males 25-35 in females

88. What is going on in brain of a schizophrenic that we see in an MRI/PET scan?: Ventricular enlargement Everything else is decreasing in size --Different lobes --Different parts of limbic system --Cerebral blood flow
89. What are the parts of the brain in which abnormalities or changes/deficits cause agression, impulsitivity, and abstract thinking problems in schizophrenia?: prefrontal cortex amygdala basal ganglia hippocampus limbic regions
90. Medications for which schizophrenics have a low tolerability so they are not as neuroprotective for schizophrenics as they are for others: Alpha 2 adrenergic receptor agonist (guanfacine and clonidine)
91. Why should we not give stimulants to schizophrenics?: Because stimulants can potentiate dopamine release
92. Non-pharm management of schizophrenia: manualized group therapy and assertive community treatment (ACT)
93. What is ACT?: ACT is a form of rehabilitation post-hospitalization
94. If a schizophrenic has a long-term history of non-adherence what may they need for in home care?: Referral to case management team so a nurse can go to their home and administer their medication. And, referral to aerobic exercise program
95. What level of care is social skills training for a schizophrenic?: Tertiary
96. How does exercise help schizophrenics?: Improve cognition Improve quality of life Improve long term health
97. A schizophrenic is taking oral Haldol and is at high risk of relapse (multiple hospitalizations), what should we do about administering medication: switch to intramuscular Haldol

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98. Dosing for switching from oral Haldol to Haldol Decanoate: 20 X the total daily oral doses=Decanoate dose--example: 5 mg PO BID LAI--20 X 10 mg = 200 mg 99 What is the dose limit of LAI Haldol that can be given in one week?: 100 mg If they need 200 mg then give 100 mg on day one and come back in 5-7 days for another 100 mg; same for 300 mg= 100 mg day one 5-7 days for second 100 mg and 5-7 days for third 100 mg
99. What is a delusion?: Firm belief maintained despite evidence to the contrary. 101. If doing a MSE of preschooler(3-5y/o), what is the most important approach to: listen and observe cues—depends on clinical observation
100. Components of a Mental Status Exam--what do you assess with thought process assessment?: Assess the organization of the patient's thoughts and ideas.
101. Components of a Mental Status Exam--what do you assess with thought content assessment?: Refers to the themes that occupy the patient's thoughts and perceptual disturbances. Ex: Suicidal ideations homicidal ideations SI or HI plan visual hallucinations auditory hallucinations
102. Mental status exam--when evaluating thought process or thought content, what are we evaluating? Are we evaluating organization of speech?: We are evaluting thoughts and ideas NO, we are not evaluating organization of speech
103. The Folstein Mini Mental Status Examination is used with which population and for what ?: Adults--to assess cognitive decline
104. What are some important components of the mini-mental status examination: Concentration/attention/ calculation--examples: count backward from 100 by 7s Orientation: Year, season, date, day, month, country, town, hospital, floor

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Registration/ability to learn new material: say names of three unrelated objects clearly and slolwy, ask patient to repeat immediately Recall (memory): Ask patient if they can recall the three object words previously

Study online at https://quizlet.com/_bvkg asked to remember 5 minutes after introducing the object words Fund of knowledge: Who is president/govenor

107. What is the purpose of the Clock drawing test ?: Very quick way to screen for possible dementia-- takes 1-2 minutes to complete
108. If there are impairments on the CDT (Clock Drawing Test), which part of the brain may be damaged?: right parietal lobe i.e. the right hemisphere of the brains
109. What makes an antipsychotic atypical?: Atypical antipsychotics have both dopamine and 5HT2A receptor antagonism Lower chance of EPS syndromes
110. Which type of antipsychotic for first psychotic episode?: Atypical antipsychotic that can be administered IM like Invegga, Geodon or Abilify.
111. Dopamine Pathway: Mesocortical pathway relationship between dopamine and schizophrenic symptoms: Meso--not major depression but meso depression + other negative symptoms decreased dopamine in the mesocortical pathway is thought to be responsible for negative and depressive symptoms of schizophrenia
112. Nigrostriatal pathway of brain controls what ?: Nigrostriatal pathway mediates motor movements Dopamine blockade in this pathway can lead to increase acetylcholine levels-- increase salivation, teary eyes, diarrhea
113. Dopamine Pathway: Nigrostriatal pathway relationship between dopamine and EPS: Blockade of dopamine receptors in the nigrostriatal pathways can lead to EPs e.g. acute dystonia, parkinsonism, and akathisia Long standing D2 blockade in the nigrostriatal pathway can lead to Tardive Dyskinesia.
114. Neurotransmitters and EPS: Increased acetylcholine and decreased dopamine can cause EPS'
115. EPS and metoclopramide: Metoclopramide (Reglan) can cause EPS like Tardive dyskinesia and parkinsonism
116. How do you treat EPS except Tardive Dyskinesia?: Benztropine

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117. How do we treat Tardive Dyskinesia?: stop/decrease meds, switch to new anti psych that doesn't cause tardive dyskinesia (possibly clozapine)
118. Dopamine Pathway: Tuberoinfundibular pathway relationship between dopamine and physical symptoms: Blockade of D2 receptors in this pathway can lead to increased prolactin levels leading to hyperprolactinemia which clinically manifests as amenorrhea, galactorrhea (Risperidone), sexual dysfunction, and gynecomastia. Long term hyperprolactinemia can be associated with osteoporosis.
119. Normal prolactin levels: Men--less than 20 ng/ml Women -- less than 25 ng/ml
120. impact of Cytocrome P450 enzyme CYP1A2 inducers on drugs metabolized on the pathway: decrease serum levels of drugs that are substrates of CYP1A2 enzymes which causes subtherapeutic drug levels
121. impact of Cytocrome P450 enzyme CYP1A2 inhibitors on drugs metabolized on the pathway: Increase serum levels possibly causing toxic levels of drug 122. Olanzapine (Zyprexa) and Clozapine are both metabolized on which enzyme?: Cytochrome P450 Enzyme CYP1A
122. If a patient on olanzapine or clozapine stops smoking what do we do with the dose: Decrease the dose because smoking is an inducer and it is no longer decreasing the serum levels of the drug.
123. Which are more worrisome? Inhibitors or Inducers?: Inhibitors because they can cause toxic levels of a drug in the body.
124. Is Tegretol(carbamazapine) an Inducer or Inhibitor ?: Inducer
125. Are clarithromycin and erithromycin inducers or inhibitors?: Inhibitors
126. If a patient is taking tegretol (carbamazapine) and clarithromycin, tegretol an inducer and clarithromycin an inhibitor, what should an NP do?: Decrease the tegretol (carbamazapine) to avoid the inhibitors causing a toxic level of tegretol in the blood
127. Medications that cause mania: Steroids Disulfram (Antabuse) Isoniazid(INH) Antidepressants in persons with bipolar
128. Medications that cause depression: Steroids Beta blockeres

Study online at https://quizlet.com/_bvkg Interferon Isotretinoin (Accutane) Some retroviral drugs Antineoplastic drugs benzodiazepines progesterone

130. Steroids and psychosis: Steroids can cause psychosis
131. Are flonase and prednisone steroids?: Yes
132. When taking medications that cause mania and depression, how do you dose the antidepresant or antipsychotic?: Increase the dose. 133. Neurotransmitters involved in addiction: Dopamine and GABA
133. What causes pain in anorexics after eating?: Delayed gastric emptying
134. medications that can delay gastric emptying: Ranitidine--Antihistamine and Antacid Famotidine--Antihistamine and Antacid Omeprazole--proton pump inhibitor
135. If a med decreases the absorption of psychotropic medications, what is the best way to take it?: Take 2 hours apart
136. Some medications that decrease absorption of psychotropics?: Antacids PPIs like Protonix, Omeprazole
137. If a patient aged 65+ is given SSRIs, for what should we monitor them?: monitor for increased anxiety
138. What is a paradoxical effect of a medication?: when medication causes opposite effect for which is was prescribed. Avoid giving in the future
139. Heart issues and Geodon and Citalopram: Geodon and Citalopram can cause QT prolongation
140. What is the maximum recommended dosage per day for Citalopram?: 40 mg for those 65+-- 20 mg
141. What is the greatest risk factor for bipolar: multigenerational bipolar 143. If a person's first bipolar episode is after the age of 45, what is the likely cause?: A medical condition like a stroke
142. What are the symptoms of Mania?: Distractability Insomnia Grandiosity Flight of ideas

Study online at https://quizlet.com/_bvkg Agitation/Activity increase Sexual indiscretions (or other pleasurable activity) Talkativeness DIG FAST

145. What is apoptosis: programmed cell death
146. Primary symptoms of Borderline Personality Disorder: self-harming behavior recurrent suicidal behavior
147. What is the only treatment for Borderline Personality Disorder?: DBT-- decreases suicidality in Borderlines
148. Who created DBT?: Marsha Linehan
149. What is the diagnostic process for borderline: use their journals/diaries to help diagnose borderlines
150. Medication for a pateint with borderline presenting with irritability, anger and self-harming behavior: Lithium
151. Specific Medication for a patient with borderline presenting with depressed mood, emotional lability, interpersonal problems, rejection sensitivity, aggresion, hostility: Depakote
152. What is conversion disorder?: a mental condition--usually begining suddenly after a stressful experience-- in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation Treatment is therapy
153. What is an adjustment disorder?: An unhealthy or excessive response to an event or change within 3 months of it happening
154. What are symptoms of adjustment disorder: with depressed mood -- feelings of sadness, decreased interest, sleep disturbance, appetite changes with mixed disturbance of emotion and conduct -- A child has a mix of symptoms from anxiety, depression and conduct dysfunction--possible peer conflict, verbal altercations, insomnia, frequent crying
155. Differentiation between Adjustment disorder and MDD: Adjustment disorder has a specific cause.

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156. How do we treat Oppositional Defiant Disorder?: Family therapy with emphasis on child management skills; teaching parents about positive reinforcement and boundary settings. Child and parent problem-solving skills training
157. In ODD therapy, if no parenting skills are developed, what can ODD turn into: Conduct Disorder
158. What are key symptoms of conduct disorder: Aggression toward people or animals and property. Lack of remorse for ill deeds done
159. Pharmacological treatment for conduct disorder: Targets mood and aggression--treat with antipsychotics, mood stabilizers, SSRIs and alpha agonists (Clonidine and guanfacine)
160. Diagnosing Tourette Syndrome: At least 2 motor tics and at least 1 vocal tic have been present, not necessarily at the same time--for more than a year Tics are not caused by using a subtance or other medical condition
161. When children have motor tics are they rare and permanent ?: No. Children's tics are common and often temporary
162. Primary neurotransmitter involved in Tourette Syndrome: Dopamine, Norepinephrine, serotonin (DNS) Hyperactivity of Dopaminergic systems in brain can lead to Tourette's
163. Pharmacological treatment of Tourette Syndrome: Clonidine (Catapres or Kapvay) or Guanfacine (Intuniv)
164. What is acute stress disorder?: Psychiatric diagnosis that may occur in patients within 4 weeks after a traumatic event Features include anxiety, insomnia, re-experiencing, avoidance behaviors--basically PTSD symptoms but duration of symptoms is less than a month. (PTSD has to last at least one month) 165. What are hallmark symptoms of PTSD?: Intrusive re- experiencing Increased arousal (hyperarousal) Avoidance of stimuli associated with trauma
165. Pharmacological management of PTSD: SSRIs, TCAs, Prazosin for nightmares

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167. Non-Pharmacological management of PTSD: EMDR (preferred over CBT) CBT
168. What are the phases of EMDR?: Desensitization phase Installation phase body scan phase
169. Which parts of the brain are affected in ADHD?: Frontal cortex Basal ganglia Abnormalities in prefrontal cortex--inattentive Abnormalities of reticular activating system
170. ADHD -- age amphetamines are approved for: children age 3 to adult 171. Heart and ADHD meds: Assess cardiac hx before beginning stimulants. There can be elevated heart rate and BP; increase risk of heart attack and stroke
171. ADHD -- age methylphenidate are approved for: children age 6 to adult
172. ADHD-- what does the dorsolateral prefrontal cortex control?: Executive function Cognitive process such as planning, working memory Problem solving How to direct and maintain attention to a task
173. Signs of stimulant abuse: Insomnia Tremors Increased BP Heart palpitations
174. ADHD--If patient starts having symptoms again during the day, what does that indicate; what should be done?: Medication has been cleared by the body; consider an extended release dose.
175. If parent is anxious or scared of child starting stimulants what should be done?: address their anxiety—give them some support before continuing with psychoedcation
176. What is OCD?: Presence of anxiety-provoking obsessions (recurrent and persistent thoughts, impulses, or images) or compulsions (for example motor tics) that function to reduce the person's subjective anxiety level
177. Which autoimmune illness should be considered with sudden onset OCD symptoms in children?: PANDAS--Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.
178. Differentiate OCD from Tourettes: Tourettes= tics only

Study online at https://quizlet.com/_bvkg OCD = intrusive/ persistent thoughts and tics

180. Factitious disorder: Condition in which a person presents with physical or mental illness symptoms that are induced.
181. Malingering: symptoms are faked for secodary gain such as avoiding work or prison
182. factitious disorder imposed on another: a condition in which one person induces illness symptoms in someone else
183. Reactive Attachment Disorder: product of severely dysfunctional early relationships between principle caregiver and child ---- results when caregiver disregards child's physical/emotional needs--> behavioral/interpersonal problems later in life (fearful/inhibited/withdrawn/apathetic/shows no emotion towards caregivers/ disruptive/disorganized)
184. GAD (general anxiety disorder): excessive worry for at least 6 months 185. Panic Attack: surge of intense fear or discomfort that reaches a peak within minutes as well as a sense of impending doom
185. Panic Disorder: diagnosis given when patient experiences recurrent panic attacks without apparent triggers
186. SSRIs for treatment of panic disorder: fluoxetine Paroxetine Sertraline Venlafaxine

Study online at https://quizlet.com/_bvkg 188 Definition and Symptoms of DMDD (disruptive mood dysregulation disorder): Childhood (<18) depressive disorder that includes Chronic dysregulated mood ("moody") Frequent intense temper outburts/temper tantrums Severe irritability Anger

189. Treatment for panic attacks: Betablocker like propranolol.
190. Contraindications for propranolol: Can cause bronchospasms so contraindicated in patients using bronchodilators like albuterol
191. Anorexia Nervosa symptoms: Low BMI (<15) Amenorrhea Emaciation Bradycardia Hypotension
192. Action if Anorexic with BMI less than 15?: Refer for hospitalization. If parent refuses, report to CPS
193. BMI of bulimia nervosa: Usually in normal range
194. What is the non-pharm treatment for Oppositional Defiant Disorder?: 1. Family therapy, with emphasis on child management skills;
195. teaching parents about positive reinforcement and boundary settings
196. Child and parent problem-solving training
197. If no parenting skills are developed what can ODD develop into?: CD- conduct disorder
198. What are the primary symptoms of Conduct disorder: Aggression towards human and animals and lack of remorse
199. What is the pharm treatment for conduct disorder?: Meds that target mood and aggression:
200. antipsychotics
201. mood stabilizers
202. SSRIs
203. alpha agonists (Clonidine and guanfacine)
204. What are the defining symptoms of Tourette Syndrome/Disorder: 1. At least 2 motor tics and at least 1 vocal tic
205. Tics are not caused by a substance or other medical conditions

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199. What is the expected permanence of children's motor tics?: They are fairly common and can be temporary.
200. What are the primary neurotransmitters involved in tourette's syndrome?- : DNS= Dopamine, Norepinephrine, Serotonin Hyperactivity of Dopaminergic systems in the brain can lead to Tourette's
201. What is the primary pharm treatment for Tourette's: Clonidine (Catapres, Kapvay) Guanfacine (Intuniv)
202. What are secondary pharm treatments for Tourette's ?: Atypical Antipsychotic Haldol, Pimozide, Aripiprazole
203. DSM-5 of Acute Stress Disorder: Acute stress disorder occurs within 4 weeks of traumatic event. Features include anxiety, insomnia, poor concentration, intense fear or helpless- ness, re-experiencing the event and avoidance behaviors-It presents as PTSD but the onset of symptoms is less than PTSD
204. What is the minimum length of time that PTSD has to last?: One month
205. Hallmark symptoms of PTSD: Intrusive re-experiencing Increased arousal Avoidance of stimuli associated with the trumatic event
206. What is the pharm management of PTSD?: Prazosin for nightmares SSRIs TCAs
207. What is primary important non-pharm treatment for PTSD?: EMDR
208. What are the different Non-pharm treatments for PTSD?: EMDR CBT
209. What are the parts of the brain involved in ADHD?: BAFaP Basal ganglia Abnormalities in reticular activating system Frontal cortex abnormalities in the Prefrontal cortex--inattentive type
210. Cardiology and ADHD stimulant: Assess cardiac history before placing patient on stimulants as they can cause elevated heart rate and bP and increase risk of Heart attack and stroke

Study online at https://quizlet.com/_bvkg96 If history or family hx of cardiac issues, get an ECG before starting.

211. What are the ages for amphetamines?: 3 and up
212. what are the ages for methylphenidate?: Ages 6 and older
213. What are the ages for Alpha agonist or alpha 2 adrenergic receptors agonist?: Age 6 and up
214. What are the ages for Strattera?: Ages 6 and up 215 Which aspect of ADHD does the Dorsolateral prefrontal cortex control?: Executive function
215. Signs of Stimulant Abuse: Insomnia tremors increased blood pressure and HR Heart palpitations
216. If a patient is having ADHD symptoms during the day after having taken their stiumlant, what does that indicate and what should we do?: Indicates the medication has been cleared by the body We should consider an extended release
217. What to do if parent is really anxious or scared about Medication for their kid?: Address their anxiety--support them then continue with psychoeducation 219. Differentiate OCD from Tourettes: OCD--intrusive/persistent thoughts and tics Tourettes: Tics only
218. Symptoms of OCD: presence of anxiety provoking obsessions--recurrent and persistent thoughts, impulses, or images or compulsions for example motor tics that funtion to reduce the person's subjective anxiety level
219. What does PANDAS stand for and which mental illness' acute onset may be an indication of having PANDAS?: Should be considered in all children with sudden onset OCD symptoms Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections
220. Malingering: Deliberate faking of a physical or psychological disorder motivated by secondary gain.
221. factitious disorder: Condition in which a person does things to make themselves sick when they are not organically sick

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224. Reactive Attachment Disorder: in children, a pattern of inhibited, withdrawn, apathetic behavior toward adult caregivers and show no emotion towards caregivers. The product of a severely dysfuntional early relationship between the principal caregiver and the child
225. GAD: General Anxiety Disorder: excessive worry for at least 6 months

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226 Panic Attack: Abrupt surge of intense fear of discomfort that reaches a peak within minutes; a variety of psychological and physical symptoms including a sense of impending doom

227. Panic Disorder: Patient experiences recurrent unexpected panic attacks
228. Treatment for Panic disorder: Fluoxetine Paroxetine sertraline SNRI--venlafaxine Beta Blocker--this manages the elevated BP that occurs with a panic attack Can also give benzos which aren't as safe
229. Beta blockers can cause bronchospasms so they are contraindicated with: bronchodilators like albuterol
230. DMDD--Disruptive mood dysregulation disorder: Childhood depressive and mood disorder--diagnosis age 6-17 Chronic dysregulated mood Frequent intense temper outbursts/ temper tantrums
231. Hallmark symptoms of Anorexia Nervosa: Low BMI (15 or less than 15) Amenorrhea Emaciation Bradycardia Hypotension
232. BMI for Bulimia Nervosa: BMI usually in normal range
233. if a patient has an irritable, depressed, labile mood, what is the first thing we should do ?: Administer the mood questionnaire
234. When should we assess for nightmare disorder?: if pt reports a nightmare and parents or other family members have nightmares
235. Which neurotransmitters are affected in autism?: Glutamate, GABA, Serotonin
236. What are the symptoms of autism?: Persistent deficits in social communication and social interaction No response when called by name

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Nonverbal communication Little or no eye contact often like to line up, stack, or organize objects and toys in long, tidy rows 237 Broken mirror theory of autism: Claims that dysfunction of the mirror neuron system may be the cause of poor social interaction and cognition

238. If delirium is caused by ETOH or substance abuse what treatment can we give patient?: Benzos
239. What are often the causes of delirium in older people and what should we test them for?: Infections We should do a urinalysis with culture and sensitivity
240. Dementia and which vitamins levels should be checked: Progressive mental decline; personality changes occur, irritability Check Vit B12 and Folic Acid levels
241. Differentiating between depression and dementia: with depression it is acute onset of memory problems like happening over 5 months. Also, in combination with memory issues, they have depression issues. "I do not know" responses are commonly depression. In dementia, patient often confabulates answers--will not say "I do not know" Dementia memory decline happens over time i.e. over 12 months or longer
242. Pseudodementia: Primary diagnosis is depression acute onset of memory problems like happening over 5 months
243. Which parts of the brain are involved in Dementia: subcortical--motor symptoms: lack of coordination, tremors, ataxia, dystonia Cortical: Language (aphasia) and memory impairments
244. Early signs of HIV dementia: Cognitive decline motor abnormalities behavioral abnormalities
245. Lewy Body Disease symptom of importance for the test: Presents with recurrent visual hallucinations
246. Pick's disease: AKA frontotemporal dementia/frontal lobe dementia Personality, behavioral, and language changes (slurred) in early stage
247. What meds treat HIV dementia?: Antiretrovirals

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248. if patient has history of high risk behavior and HIV dementia symptoms, what should we do?: give them an HIV test
249. Pharm treatment of psychosis and agitation in dementia?: atypical antipsychotics
250. What does the amygdala control?: aggression fear anxiety emotions
251. What does the Hippocampus control?: emotions stress learning memory
252. What does dopamine produced in the substantia nigra regulate?: motor movements
253. If you are taking care of a terminal infant what do you do with the parents?: give infant to parents and allow them to grieve for their loss
254. How should we speak of and refer about grief to children: Normalize grief and loss in children—psychoeducation on grief responses; group therapy Grief responses vary so do not tell a patient or family how they should grieve 255. What is the most important factor in children's healing from grief?: an intact family so they can adapt easily
255. mood disorder neurotransmitters: DNS (dopamine, nor, serotonin+ GABA+ Glutamate )
256. What are most important risk factors for osteoporosis?: Smoking Caffeine Lack of weight bearing exercises Lack of dietary calcium and vitamin D