NR 546 FINAL EXAM GUIDE:
ADVANCED PSYCHOPHARMACOLOGY
QUESTIONS AND ANSWERS
1. Which dopamine pathway is associated with the positive symptoms of schizophrenia and is
the primary target for antipsychotic efficacy?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway involves the projection from the
ventral tegmental area to the nucleus accumbens; hyperactivity here is linked to
hallucinations and delusions.
2. A patient taking Clozapine presents with a sudden onset of high fever, muscle rigidity, and
autonomic instability. What is the most likely diagnosis?
A. Serotonin Syndrome
,B. Agranulocytosis
C. Neuroleptic Malignant Syndrome (NMS)
D. Anticholinergic Toxicity
Answer: C
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by lead-pipe rigidity, hyperthermia, and autonomic dysfunction.
3. Which antidepressant is strictly contraindicated in patients with a history of seizures or
eating disorders?
A. Fluoxetine
B. Venlafaxine
C. Mirtazapine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion lowers the seizure threshold, especially in patients
with electrolyte imbalances common in bulimia or anorexia.
4. In the treatment of Bipolar Disorder, which medication requires monitoring of the HLA-
B*1502 allele in patients of Asian descent?
A. Lithium
B. Valproate
, C. Lamotrigine
D. Carbamazepine
Answer: D
Conceptual Explanation: The HLA-B*1502 allele significantly increases the risk of
Stevens-Johnson Syndrome (SJS) when taking Carbamazepine.
5. What is the primary mechanism of action of Buspirone?
A. GABA-A positive allosteric modulator
B. D2 receptor antagonist
C. Selective serotonin reuptake inhibitor
D. 5-HT1A partial agonist
Answer: D
Conceptual Explanation: Buspirone acts as a partial agonist at the 5-HT1A receptor,
helping to reduce anxiety without the sedative effects of benzodiazepines.
6. A patient has been on Lithium for 5 years. Which lab values are most critical to monitor for
long-term safety?
A. Liver function tests (LFTs)
B. Serum creatinine and TSH
C. Complete Blood Count (CBC)
ADVANCED PSYCHOPHARMACOLOGY
QUESTIONS AND ANSWERS
1. Which dopamine pathway is associated with the positive symptoms of schizophrenia and is
the primary target for antipsychotic efficacy?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway involves the projection from the
ventral tegmental area to the nucleus accumbens; hyperactivity here is linked to
hallucinations and delusions.
2. A patient taking Clozapine presents with a sudden onset of high fever, muscle rigidity, and
autonomic instability. What is the most likely diagnosis?
A. Serotonin Syndrome
,B. Agranulocytosis
C. Neuroleptic Malignant Syndrome (NMS)
D. Anticholinergic Toxicity
Answer: C
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by lead-pipe rigidity, hyperthermia, and autonomic dysfunction.
3. Which antidepressant is strictly contraindicated in patients with a history of seizures or
eating disorders?
A. Fluoxetine
B. Venlafaxine
C. Mirtazapine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion lowers the seizure threshold, especially in patients
with electrolyte imbalances common in bulimia or anorexia.
4. In the treatment of Bipolar Disorder, which medication requires monitoring of the HLA-
B*1502 allele in patients of Asian descent?
A. Lithium
B. Valproate
, C. Lamotrigine
D. Carbamazepine
Answer: D
Conceptual Explanation: The HLA-B*1502 allele significantly increases the risk of
Stevens-Johnson Syndrome (SJS) when taking Carbamazepine.
5. What is the primary mechanism of action of Buspirone?
A. GABA-A positive allosteric modulator
B. D2 receptor antagonist
C. Selective serotonin reuptake inhibitor
D. 5-HT1A partial agonist
Answer: D
Conceptual Explanation: Buspirone acts as a partial agonist at the 5-HT1A receptor,
helping to reduce anxiety without the sedative effects of benzodiazepines.
6. A patient has been on Lithium for 5 years. Which lab values are most critical to monitor for
long-term safety?
A. Liver function tests (LFTs)
B. Serum creatinine and TSH
C. Complete Blood Count (CBC)
