NR546 PSYCHOPHARMACOLOGY
FINAL EXAM REVIEW QUESTIONS AND
ANSWERS
1. Which dopamine pathway is primarily responsible for the development of extrapyramidal
symptoms (EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway controls motor movements. Chronic
blockade of D2 receptors in this pathway leads to EPS and tardive dyskinesia.
2. A patient on Clozapine presents with an absolute neutrophil count (ANC) of 800/mm³.
What is the appropriate clinical action?
A. Continue treatment but monitor daily
B. Switch to Risperidone immediately
,C. Reduce the dose by 50%
D. Interrupt treatment and consult hematology
Answer: D
Conceptual Explanation: An ANC below 1000/mm³ is classified as severe
neutropenia/agranulocytosis, requiring immediate interruption of Clozapine and
hematological consultation.
3. Which mechanism of action distinguishes Aripiprazole from older second-generation
antipsychotics like Olanzapine?
A. D2 receptor antagonism
B. Muscarinic M1 receptor agonism
C. 5-HT2A receptor antagonism
D. D2 receptor partial agonism
Answer: D
Conceptual Explanation: Aripiprazole acts as a D2 partial agonist, meaning it stabilizes
dopamine activity rather than completely blocking it.
4. The therapeutic reference range for Lithium in the maintenance phase of Bipolar Disorder
is generally considered to be:
A. 0.2 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
, C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: C
Conceptual Explanation: The standard maintenance range for Lithium is 0.6 to 1.2
mEq/L. Levels above 1.5 mEq/L indicate toxicity.
5. Which antidepressant is most likely to cause a hypertensive crisis if taken with foods high
in tyramine?
A. Sertraline
B. Phenelzine
C. Venlafaxine
D. Bupropion
Answer: B
Conceptual Explanation: Phenelzine is an MAOI. Inhibition of MAO-A prevents the
breakdown of tyramine, leading to excessive norepinephrine release and hypertension.
6. A patient experiences severe ‘electrical shock’ sensations and dizziness after stopping their
medication abruptly. Which drug is most likely responsible?
A. Paroxetine
B. Fluoxetine
C. Bupropion
FINAL EXAM REVIEW QUESTIONS AND
ANSWERS
1. Which dopamine pathway is primarily responsible for the development of extrapyramidal
symptoms (EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway controls motor movements. Chronic
blockade of D2 receptors in this pathway leads to EPS and tardive dyskinesia.
2. A patient on Clozapine presents with an absolute neutrophil count (ANC) of 800/mm³.
What is the appropriate clinical action?
A. Continue treatment but monitor daily
B. Switch to Risperidone immediately
,C. Reduce the dose by 50%
D. Interrupt treatment and consult hematology
Answer: D
Conceptual Explanation: An ANC below 1000/mm³ is classified as severe
neutropenia/agranulocytosis, requiring immediate interruption of Clozapine and
hematological consultation.
3. Which mechanism of action distinguishes Aripiprazole from older second-generation
antipsychotics like Olanzapine?
A. D2 receptor antagonism
B. Muscarinic M1 receptor agonism
C. 5-HT2A receptor antagonism
D. D2 receptor partial agonism
Answer: D
Conceptual Explanation: Aripiprazole acts as a D2 partial agonist, meaning it stabilizes
dopamine activity rather than completely blocking it.
4. The therapeutic reference range for Lithium in the maintenance phase of Bipolar Disorder
is generally considered to be:
A. 0.2 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
, C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: C
Conceptual Explanation: The standard maintenance range for Lithium is 0.6 to 1.2
mEq/L. Levels above 1.5 mEq/L indicate toxicity.
5. Which antidepressant is most likely to cause a hypertensive crisis if taken with foods high
in tyramine?
A. Sertraline
B. Phenelzine
C. Venlafaxine
D. Bupropion
Answer: B
Conceptual Explanation: Phenelzine is an MAOI. Inhibition of MAO-A prevents the
breakdown of tyramine, leading to excessive norepinephrine release and hypertension.
6. A patient experiences severe ‘electrical shock’ sensations and dizziness after stopping their
medication abruptly. Which drug is most likely responsible?
A. Paroxetine
B. Fluoxetine
C. Bupropion
