NR546 PSYCHOPHARMACOLOGY
MIDTERM EXAM QUESTIONS AND
ANSWERS
1. Which dopamine pathway is primarily responsible for the positive symptoms of
schizophrenia and is the target for most antipsychotic medications?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: Hyperactivity in the mesolimbic pathway is associated with
positive symptoms like hallucinations and delusions. Blocking D2 receptors here reduces
these symptoms.
2. A patient is prescribed Clozapine. Which laboratory value is most critical to monitor due to
the risk of agranulocytosis?
A. Liver Function Tests (LFTs)
B. Serum Creatinine
,C. Absolute Neutrophil Count (ANC)
D. Thyroid Stimulating Hormone (TSH)
Answer: C
Conceptual Explanation: Clozapine carries a Black Box Warning for agranulocytosis;
therefore, the Absolute Neutrophil Count (ANC) must be monitored regularly via the REMS
program.
3. Which antidepressant is known for its dual mechanism as a Norepinephrine and Dopamine
Reuptake Inhibitor (NDRI) and should be avoided in patients with seizure disorders?
A. Bupropion
B. Venlafaxine
C. Fluoxetine
D. Duloxetine
Answer: A
Conceptual Explanation: Bupropion is an NDRI that lowers the seizure threshold,
especially in patients with eating disorders or known seizure history.
4. In the treatment of Bipolar Disorder, which medication is associated with a rare but life-
threatening risk of Stevens-Johnson Syndrome (SJS)?
A. Lamotrigine
B. Valproate
, C. Quetiapine
D. Lithium
Answer: A
Conceptual Explanation: Lamotrigine must be titrated slowly to minimize the risk of
serious rashes, including Stevens-Johnson Syndrome.
5. Which cytochrome P450 enzyme is significantly induced by cigarette smoking, potentially
requiring higher doses of Olanzapine or Clozapine?
A. CYP1A2
B. CYP3A4
C. CYP2D6
D. CYP2C19
Answer: A
Conceptual Explanation: Cigarette smoke contains polycyclic aromatic hydrocarbons that
induce CYP1A2, leading to faster metabolism of drugs like Clozapine and Olanzapine.
6. Which of the following describes the mechanism of action of Buspirone?
A. GABA-A positive allosteric modulator
B. 5-HT1A partial agonist
C. Alpha-2 adrenergic antagonist
MIDTERM EXAM QUESTIONS AND
ANSWERS
1. Which dopamine pathway is primarily responsible for the positive symptoms of
schizophrenia and is the target for most antipsychotic medications?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: Hyperactivity in the mesolimbic pathway is associated with
positive symptoms like hallucinations and delusions. Blocking D2 receptors here reduces
these symptoms.
2. A patient is prescribed Clozapine. Which laboratory value is most critical to monitor due to
the risk of agranulocytosis?
A. Liver Function Tests (LFTs)
B. Serum Creatinine
,C. Absolute Neutrophil Count (ANC)
D. Thyroid Stimulating Hormone (TSH)
Answer: C
Conceptual Explanation: Clozapine carries a Black Box Warning for agranulocytosis;
therefore, the Absolute Neutrophil Count (ANC) must be monitored regularly via the REMS
program.
3. Which antidepressant is known for its dual mechanism as a Norepinephrine and Dopamine
Reuptake Inhibitor (NDRI) and should be avoided in patients with seizure disorders?
A. Bupropion
B. Venlafaxine
C. Fluoxetine
D. Duloxetine
Answer: A
Conceptual Explanation: Bupropion is an NDRI that lowers the seizure threshold,
especially in patients with eating disorders or known seizure history.
4. In the treatment of Bipolar Disorder, which medication is associated with a rare but life-
threatening risk of Stevens-Johnson Syndrome (SJS)?
A. Lamotrigine
B. Valproate
, C. Quetiapine
D. Lithium
Answer: A
Conceptual Explanation: Lamotrigine must be titrated slowly to minimize the risk of
serious rashes, including Stevens-Johnson Syndrome.
5. Which cytochrome P450 enzyme is significantly induced by cigarette smoking, potentially
requiring higher doses of Olanzapine or Clozapine?
A. CYP1A2
B. CYP3A4
C. CYP2D6
D. CYP2C19
Answer: A
Conceptual Explanation: Cigarette smoke contains polycyclic aromatic hydrocarbons that
induce CYP1A2, leading to faster metabolism of drugs like Clozapine and Olanzapine.
6. Which of the following describes the mechanism of action of Buspirone?
A. GABA-A positive allosteric modulator
B. 5-HT1A partial agonist
C. Alpha-2 adrenergic antagonist
