NU664 ADVANCED
PSYCHOPHARMACOLOGY FINAL
EXAM QUESTIONS AND ANSWERS
1. Which neurotransmitter pathway is primarily associated with the positive symptoms of
schizophrenia and is the target of D2 receptor antagonism?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The mesolimbic pathway involves the projection of dopamine
from the ventral tegmental area to the nucleus accumbens. Hyperactivity in this pathway is
linked to positive symptoms like hallucinations; blocking D2 receptors here reduces these
symptoms.
2. Aripiprazole is unique among antipsychotics due to which mechanism of action?
A. Full D2 receptor antagonism
,B. Potent H1 receptor antagonism
C. Partial D2 receptor agonism
D. Selective serotonin reuptake inhibition
Answer: C
Conceptual Explanation: Aripiprazole acts as a D2 partial agonist, meaning it stabilizes
dopamine activity by acting as an antagonist in high-dopamine environments and an
agonist in low-dopamine environments.
3. Which laboratory value is the most critical to monitor for a patient prescribed Clozapine?
A. Serum creatinine
B. Thyroid Stimulating Hormone (TSH)
C. Absolute Neutrophil Count (ANC)
D. Liver Function Tests (LFTs)
Answer: C
Conceptual Explanation: Clozapine carries a Risk Evaluation and Mitigation Strategy
(REMS) requirement for monitoring the Absolute Neutrophil Count (ANC) due to the risk of
life-threatening agranulocytosis.
4. What is the primary mechanism of action of Mirtazapine?
A. Monoamine oxidase inhibition
B. Selective serotonin reuptake inhibition
, C. Alpha-2 adrenergic antagonism
D. N-methyl-D-aspartate (NMDA) antagonism
Answer: C
Conceptual Explanation: Mirtazapine is a Noradrenergic and Specific Serotonergic
Antidepressant (NaSSA) that works by blocking presynaptic alpha-2 autoreceptors and
heteroreceptors, increasing the release of norepinephrine and serotonin.
5. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Sertraline
B. Bupropion
C. Fluoxetine
D. Escitalopram
Answer: B
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly at high
doses or in patients with electrolyte imbalances common in bulimia or anorexia nervosa.
6. Which mood stabilizer is most associated with the risk of Stevens-Johnson Syndrome (SJS)?
A. Lithium
B. Valproate
C. Gabapentin
PSYCHOPHARMACOLOGY FINAL
EXAM QUESTIONS AND ANSWERS
1. Which neurotransmitter pathway is primarily associated with the positive symptoms of
schizophrenia and is the target of D2 receptor antagonism?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The mesolimbic pathway involves the projection of dopamine
from the ventral tegmental area to the nucleus accumbens. Hyperactivity in this pathway is
linked to positive symptoms like hallucinations; blocking D2 receptors here reduces these
symptoms.
2. Aripiprazole is unique among antipsychotics due to which mechanism of action?
A. Full D2 receptor antagonism
,B. Potent H1 receptor antagonism
C. Partial D2 receptor agonism
D. Selective serotonin reuptake inhibition
Answer: C
Conceptual Explanation: Aripiprazole acts as a D2 partial agonist, meaning it stabilizes
dopamine activity by acting as an antagonist in high-dopamine environments and an
agonist in low-dopamine environments.
3. Which laboratory value is the most critical to monitor for a patient prescribed Clozapine?
A. Serum creatinine
B. Thyroid Stimulating Hormone (TSH)
C. Absolute Neutrophil Count (ANC)
D. Liver Function Tests (LFTs)
Answer: C
Conceptual Explanation: Clozapine carries a Risk Evaluation and Mitigation Strategy
(REMS) requirement for monitoring the Absolute Neutrophil Count (ANC) due to the risk of
life-threatening agranulocytosis.
4. What is the primary mechanism of action of Mirtazapine?
A. Monoamine oxidase inhibition
B. Selective serotonin reuptake inhibition
, C. Alpha-2 adrenergic antagonism
D. N-methyl-D-aspartate (NMDA) antagonism
Answer: C
Conceptual Explanation: Mirtazapine is a Noradrenergic and Specific Serotonergic
Antidepressant (NaSSA) that works by blocking presynaptic alpha-2 autoreceptors and
heteroreceptors, increasing the release of norepinephrine and serotonin.
5. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Sertraline
B. Bupropion
C. Fluoxetine
D. Escitalopram
Answer: B
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly at high
doses or in patients with electrolyte imbalances common in bulimia or anorexia nervosa.
6. Which mood stabilizer is most associated with the risk of Stevens-Johnson Syndrome (SJS)?
A. Lithium
B. Valproate
C. Gabapentin
