ADVANCED PSYCHOPHARMACOLOGY
EXAM 3 MASTERY QUESTIONS AND
ANSWERS
1. Which dopamine pathway is primarily responsible for the development of positive
symptoms in schizophrenia when overactive?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway, projecting from the ventral tegmental
area to the nucleus accumbens, is associated with reward and positive symptoms like
hallucinations when dopamine is excessive.
2. A patient taking Risperidone develops galactorrhea. Which dopaminergic pathway is
involved in this side effect?
A. Tuberoinfundibular
,B. Mesocortical
C. Mesolimbic
D. Nigrostriatal
Answer: A
Conceptual Explanation: The tuberoinfundibular pathway controls prolactin secretion;
D2 blockade here leads to increased prolactin levels, causing galactorrhea and
gynecomastia.
3. Which antidepressant is contraindicated in patients with a history of seizures or bulimia
nervosa due to a lowered seizure threshold?
A. Sertraline
B. Bupropion
C. Mirtazapine
D. Fluoxetine
Answer: B
Conceptual Explanation: Bupropion is known to lower the seizure threshold, particularly
in patients with eating disorders or pre-existing seizure conditions.
4. What is the mechanism of action of Aripiprazole that distinguishes it from Haloperidol?
A. Full D2 antagonism
B. Alpha-1 adrenergic antagonism
, C. Partial D2 agonism
D. Muscarinic M1 agonism
Answer: C
Conceptual Explanation: Aripiprazole is a D2 partial agonist, meaning it stabilizes
dopamine levels by acting as an antagonist in high-dopamine environments and an agonist
in low-dopamine environments.
5. A patient on Lithium presents with coarse tremors, ataxia, and confusion. The plasma level
is 2.2 mEq/L. What is the priority intervention?
A. Increase fluid intake and continue dose
B. Switch to Valproic Acid immediately
C. Administer Vitamin B6
D. Hold the dose and prepare for possible hemodialysis
Answer: D
Conceptual Explanation: Lithium levels above 1.5 mEq/L are toxic; levels above 2.0 often
require aggressive management, including holding the med and potentially hemodialysis if
severe symptoms are present.
6. Which mood stabilizer is most strongly associated with the rare but life-threatening
Stevens-Johnson Syndrome (SJS)?
A. Lamotrigine
EXAM 3 MASTERY QUESTIONS AND
ANSWERS
1. Which dopamine pathway is primarily responsible for the development of positive
symptoms in schizophrenia when overactive?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway, projecting from the ventral tegmental
area to the nucleus accumbens, is associated with reward and positive symptoms like
hallucinations when dopamine is excessive.
2. A patient taking Risperidone develops galactorrhea. Which dopaminergic pathway is
involved in this side effect?
A. Tuberoinfundibular
,B. Mesocortical
C. Mesolimbic
D. Nigrostriatal
Answer: A
Conceptual Explanation: The tuberoinfundibular pathway controls prolactin secretion;
D2 blockade here leads to increased prolactin levels, causing galactorrhea and
gynecomastia.
3. Which antidepressant is contraindicated in patients with a history of seizures or bulimia
nervosa due to a lowered seizure threshold?
A. Sertraline
B. Bupropion
C. Mirtazapine
D. Fluoxetine
Answer: B
Conceptual Explanation: Bupropion is known to lower the seizure threshold, particularly
in patients with eating disorders or pre-existing seizure conditions.
4. What is the mechanism of action of Aripiprazole that distinguishes it from Haloperidol?
A. Full D2 antagonism
B. Alpha-1 adrenergic antagonism
, C. Partial D2 agonism
D. Muscarinic M1 agonism
Answer: C
Conceptual Explanation: Aripiprazole is a D2 partial agonist, meaning it stabilizes
dopamine levels by acting as an antagonist in high-dopamine environments and an agonist
in low-dopamine environments.
5. A patient on Lithium presents with coarse tremors, ataxia, and confusion. The plasma level
is 2.2 mEq/L. What is the priority intervention?
A. Increase fluid intake and continue dose
B. Switch to Valproic Acid immediately
C. Administer Vitamin B6
D. Hold the dose and prepare for possible hemodialysis
Answer: D
Conceptual Explanation: Lithium levels above 1.5 mEq/L are toxic; levels above 2.0 often
require aggressive management, including holding the med and potentially hemodialysis if
severe symptoms are present.
6. Which mood stabilizer is most strongly associated with the rare but life-threatening
Stevens-Johnson Syndrome (SJS)?
A. Lamotrigine
