Whether you're days from testing or deep in the trenches of your clinical prep, this episode delivers three case-based psychopharm scenarios designed to sharpen your diagnostic edge and reinforce high-risk, high-yield content for the PMHNP board exam. These aren’t fluff. These are the cases you’ll wish you studied harder—until now.

We break down three real-world dilemmas disguised as board-style questions. From the sneaky presentation of a health-anxious patient with no symptoms to the estrogen-lamotrigine interaction that could tank your mood stabilizer’s effect, to the exact number of days you must wait before initiating an MAOI after stopping an SSRI—this episode gets straight to the clinical meat.

If you’ve ever felt unsure about the difference between illness anxiety disorder and somatic symptom disorder, or you’re fuzzy on UGT1A4 and why it matters, or if serotonin syndrome is still a little too theoretical—you need this episode.

• The underrecognized red flags of illness anxiety disorder, and how one word in a patient’s narrative can change the entire diagnosis.
• The board-critical difference between a patient having symptoms vs. fearing they’ll get them.
• A deep dive into lamotrigine’s metabolic vulnerability—and how estrogen triggers an enzyme that might be sabotaging your treatment plan.
• The exact washout protocol required when transitioning from SSRIs to MAOIs—and the potentially deadly reason why you never fudge the math.
• Why UGT1A4 matters: the phase II liver enzyme you didn’t realize could blow up your lamotrigine levels.

• 💡 Case-based learning that mirrors real ANCC PMHNP exam structure
• 📊 Realistic distractors and rationales that test your diagnostic discrimination
• 🧠 Deep integration of pharmacology and psychiatric reasoning
• 🚫 Zero spoilers—answers are discussed in-episode only
• 🧬 Tightly woven clinical pearls you’ll carry into practice
• 💥 Mini “board bombs” that will either detonate your recall—or cement it

• Psych NP board review
• Illness anxiety vs somatic symptom disorder
• Lamotrigine and estrogen interaction
• UGT1A4 lamotrigine metabolism
• Bipolar depression treatment interactions
• MAOI washout protocol
• Switching from SSRI to phenelzine
• Serotonin syndrome prevention
• High-yield psychopharmacology
• PMHNP clinical pearls podcast
• ANCC PMHNP exam prep
• Psych NP case studies podcast
• Psychiatric differential diagnosis
• SSRI MAOI contraindications

Want the full breakdown of serotonin syndrome cases, drug-switching cheat sheets, and exclusive flashcard packs for everything from UGT enzymes to tricky anxiety presentations? Join us on Patreon for extended content, board prep vaults, and one-on-one Q&A.

• Lamotrigine
• Paxil (paroxetine)
• Phenelzine (Nardil)
• Estrogen-containing oral contraceptives

This episode isn’t about cramming. It’s about clinically understanding the why behind every answer—and becoming the kind of psych NP who doesn’t just pass boards… but owns the room.

🎧 Listen now and sharpen your diagnostic sword.

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Pearls and Prep

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