NSG 552 ADVANCED
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. Which neurotransmitter’s signal transduction pathway primarily involves the recruitment
of a G-protein-coupled receptor leading to the activation of adenylyl cyclase?
A. Glutamate via NMDA receptors
B. GABA via GABA-A receptors
C. Glycine via Gly-R receptors
D. Norepinephrine via Beta-1 adrenergic receptors
Answer: D
Conceptual Explanation: Norepinephrine binding to Beta-1 receptors activates Gs
proteins, which then stimulate adenylyl cyclase to produce cAMP. NMDA, GABA-A, and Gly-
R are ionotropic receptors.
2. Which dopamine pathway is hypothesized to be responsible for the negative and cognitive
symptoms seen in schizophrenia?
A. Mesolimbic pathway
,B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The mesocortical pathway, particularly projections to the
prefrontal cortex, is associated with negative symptoms and cognitive dysfunction when
dopamine activity is deficient.
3. What is the clinical significance of a drug acting as a ‘partial agonist’ at a neurotransmitter
receptor?
A. It acts as a ‘net’ agonist in low-signal environments and a ‘net’ antagonist in high-signal
environments.
B. It always blocks the effect of the endogenous neurotransmitter.
C. It binds to an allosteric site to enhance the efficacy of the primary ligand.
D. It causes irreversible down-regulation of the receptor.
Answer: A
Conceptual Explanation: Partial agonists act as rheostats; they provide more signal than
an antagonist but less than a full agonist, stabilizing neurotransmission regardless of the
baseline level.
, 4. Which CYP450 enzyme is significantly inhibited by the antidepressant Fluoxetine,
potentially leading to increased levels of TCAs?
A. CYP2D6
B. CYP1A2
C. CYP2E1
D. CYP3A4
Answer: A
Conceptual Explanation: Fluoxetine and Paroxetine are potent inhibitors of CYP2D6,
which is responsible for the metabolism of many tricyclic antidepressants and
antipsychotics.
5. What is the primary mechanism of action of Valproate in the treatment of Bipolar
Disorder?
A. Selective serotonin reuptake inhibition
B. Inhibition of voltage-gated sodium channels and enhancement of GABAergic
neurotransmission
C. Antagonism of NMDA glutamate receptors
D. Dopamine D2 receptor blockade
Answer: B
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. Which neurotransmitter’s signal transduction pathway primarily involves the recruitment
of a G-protein-coupled receptor leading to the activation of adenylyl cyclase?
A. Glutamate via NMDA receptors
B. GABA via GABA-A receptors
C. Glycine via Gly-R receptors
D. Norepinephrine via Beta-1 adrenergic receptors
Answer: D
Conceptual Explanation: Norepinephrine binding to Beta-1 receptors activates Gs
proteins, which then stimulate adenylyl cyclase to produce cAMP. NMDA, GABA-A, and Gly-
R are ionotropic receptors.
2. Which dopamine pathway is hypothesized to be responsible for the negative and cognitive
symptoms seen in schizophrenia?
A. Mesolimbic pathway
,B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The mesocortical pathway, particularly projections to the
prefrontal cortex, is associated with negative symptoms and cognitive dysfunction when
dopamine activity is deficient.
3. What is the clinical significance of a drug acting as a ‘partial agonist’ at a neurotransmitter
receptor?
A. It acts as a ‘net’ agonist in low-signal environments and a ‘net’ antagonist in high-signal
environments.
B. It always blocks the effect of the endogenous neurotransmitter.
C. It binds to an allosteric site to enhance the efficacy of the primary ligand.
D. It causes irreversible down-regulation of the receptor.
Answer: A
Conceptual Explanation: Partial agonists act as rheostats; they provide more signal than
an antagonist but less than a full agonist, stabilizing neurotransmission regardless of the
baseline level.
, 4. Which CYP450 enzyme is significantly inhibited by the antidepressant Fluoxetine,
potentially leading to increased levels of TCAs?
A. CYP2D6
B. CYP1A2
C. CYP2E1
D. CYP3A4
Answer: A
Conceptual Explanation: Fluoxetine and Paroxetine are potent inhibitors of CYP2D6,
which is responsible for the metabolism of many tricyclic antidepressants and
antipsychotics.
5. What is the primary mechanism of action of Valproate in the treatment of Bipolar
Disorder?
A. Selective serotonin reuptake inhibition
B. Inhibition of voltage-gated sodium channels and enhancement of GABAergic
neurotransmission
C. Antagonism of NMDA glutamate receptors
D. Dopamine D2 receptor blockade
Answer: B
