NR546 PSYCHOPHARMACOLOGY
FINAL EXAM PREP QUESTIONS AND
ANSWERS
1. Which dopamine pathway is associated with the positive symptoms of schizophrenia, such
as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway involves the projection of dopamine
from the ventral tegmental area to the nucleus accumbens; overactivity here is linked to
positive symptoms.
2. A patient on Clozapine reports a sudden onset of high fever and a severe sore throat. What
is the most critical lab to evaluate?
A. Absolute Neutrophil Count (ANC)
,B. Serum glucose levels
C. Liver function tests
D. Thyroid Stimulating Hormone (TSH)
Answer: A
Conceptual Explanation: Clozapine carries a risk of agranulocytosis; clinical signs of
infection like fever or sore throat require immediate ANC monitoring to ensure it hasn’t
dropped below safe levels.
3. A patient taking Phenelzine (an MAOI) presents with a severe headache, palpitations, and
blood pressure of 210/120. Which substance likely caused this?
A. Tyramine-rich foods like aged cheese
B. Leafy greens like spinach
C. Over-the-counter Ibuprofen
D. Grapefruit juice
Answer: A
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine; high levels of
tyramine cause a massive release of norepinephrine, leading to a hypertensive crisis.
4. What is the primary mechanism of action of the antidepressant Bupropion?
A. Dopamine and Norepinephrine reuptake inhibition (DNRI)
B. Alpha-2 adrenergic antagonism
, C. Selective serotonin reuptake inhibition
D. Monoamine oxidase inhibition
Answer: A
Conceptual Explanation: Bupropion is a DNRI, which distinguishes it from SSRIs and
SNRIs and accounts for its lack of sexual side effects and its utility in smoking cessation.
5. Which mood stabilizer is most strongly associated with the risk of Stevens-Johnson
Syndrome (SJS), requiring a slow titration?
A. Lithium
B. Valproate
C. Lamotrigine
D. Topiramate
Answer: C
Conceptual Explanation: Lamotrigine must be titrated slowly to reduce the risk of life-
threatening rashes like SJS, particularly when combined with inhibitors like valproate.
6. Excessive blockade of dopamine in the Nigrostriatal pathway by typical antipsychotics
leads to which side effect?
A. Hyperprolactinemia
B. Metabolic syndrome
C. Worsening of negative symptoms
FINAL EXAM PREP QUESTIONS AND
ANSWERS
1. Which dopamine pathway is associated with the positive symptoms of schizophrenia, such
as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway involves the projection of dopamine
from the ventral tegmental area to the nucleus accumbens; overactivity here is linked to
positive symptoms.
2. A patient on Clozapine reports a sudden onset of high fever and a severe sore throat. What
is the most critical lab to evaluate?
A. Absolute Neutrophil Count (ANC)
,B. Serum glucose levels
C. Liver function tests
D. Thyroid Stimulating Hormone (TSH)
Answer: A
Conceptual Explanation: Clozapine carries a risk of agranulocytosis; clinical signs of
infection like fever or sore throat require immediate ANC monitoring to ensure it hasn’t
dropped below safe levels.
3. A patient taking Phenelzine (an MAOI) presents with a severe headache, palpitations, and
blood pressure of 210/120. Which substance likely caused this?
A. Tyramine-rich foods like aged cheese
B. Leafy greens like spinach
C. Over-the-counter Ibuprofen
D. Grapefruit juice
Answer: A
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine; high levels of
tyramine cause a massive release of norepinephrine, leading to a hypertensive crisis.
4. What is the primary mechanism of action of the antidepressant Bupropion?
A. Dopamine and Norepinephrine reuptake inhibition (DNRI)
B. Alpha-2 adrenergic antagonism
, C. Selective serotonin reuptake inhibition
D. Monoamine oxidase inhibition
Answer: A
Conceptual Explanation: Bupropion is a DNRI, which distinguishes it from SSRIs and
SNRIs and accounts for its lack of sexual side effects and its utility in smoking cessation.
5. Which mood stabilizer is most strongly associated with the risk of Stevens-Johnson
Syndrome (SJS), requiring a slow titration?
A. Lithium
B. Valproate
C. Lamotrigine
D. Topiramate
Answer: C
Conceptual Explanation: Lamotrigine must be titrated slowly to reduce the risk of life-
threatening rashes like SJS, particularly when combined with inhibitors like valproate.
6. Excessive blockade of dopamine in the Nigrostriatal pathway by typical antipsychotics
leads to which side effect?
A. Hyperprolactinemia
B. Metabolic syndrome
C. Worsening of negative symptoms
