A 36-year-old male presents to your office with rapid speech, elevated mood, increased energy, poor sleep, and increased appetite. You consult a psychiatrist who recommends initiating medication treatment with lithium. The psychiatrist asks you to perform some baseline tests before starting the medication.
All of the following tests should be done to appropriately monitor the patient taking lithium, except:
Correct Answer C:
Liver enzymes should be monitored in individuals who are taking valproic acid or carbamazepine, but not lithium, which is excreted primarily through the kidney.
A. Lithium may cause EKG changes such as flattening or inversion of T waves or, more seriously, sinus node dysfunction.
B. Elevation of white blood count is possible while taking lithium.
D. Hypothyroidism secondary to lithium can be detected by elevation of TSH.
E. Renal function should be monitored every 3 months
A 60-year-old female patient comes in with a complaint of multiple episodes of abnormally elevated energy levels and sudden mood changes in one week, followed by one or more depressive episodes, the next week. According to this description, the most likely diagnosis is bipolar disorder and she is started on lithium.
Which of the following could be caused by this medication?
Treatment with lithium may cause:
Which is not a part of normal grief reaction after the death of a loved one?
Correct Answer B:
A normal reaction to loss, grief is unique in its impact, course and meaning to each of us. While every change brings about a loss, experiencing the loss of a partner, a parent or sibling, or a lifelong friend, with whom we share history, often has special meaning to us and hits us even harder.
A patient who is evaluated 1 week after the death of her father describes many memories of her father and says that she is tearful occasionally and having some trouble falling asleep. She returned to work 4 days after her father's death.
Proper treatment for this patient should consist of which of the following?
Correct Answer E:
The treatment of a normal grief reaction involves conservative, supportive treatment. Most of the support that people receive after a loss comes from friends and family. Doctors and nurses may also be a source of support. For people who experience difficulty in coping with their loss, grief counseling or grief therapy may be necessary.
Grief counseling helps mourners with normal grief reactions work through the tasks of grieving. Grief counseling can be provided by professionally trained people, or in self-help groups where bereaved people help other bereaved people. All of these services may be available in individual or group settings.
The goals of grief counseling include: Helping the bereaved to accept the loss by helping him or her to talk about the loss. Helping the bereaved to identify and express feelings related to the loss (for example, anger, guilt, anxiety, helplessness, and sadness). Helping the bereaved to separate emotionally from the person who died and to begin new relationships.
Which is true regarding suicide in adolescents?
Males commit suicide successfully at a greater rate than females. But females attempt suicide more.
Most suicides occur in the spring. The month of May has been noted for its high rate of suicide. The speculation is that during the winter and early spring when people are depressed. Lack of daylight correlates with depression and suicide.
Poverty and low income, with concomitantly fewer options and opportunities, correlate with suicide.
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