NR 546 PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM PREP
QUESTIONS & ANSWERS
(CHAMBERLAIN) 100% GUARANTEE
PASS
1. Which dopamine pathway is responsible for the development of hyperprolactinemia when
blocked by typical antipsychotics?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: C
Conceptual Explanation: Dopamine in the tuberoinfundibular pathway normally inhibits
prolactin release. Blocking D2 receptors here results in increased prolactin levels.
2. A patient stabilized on Clozapine begins smoking a pack of cigarettes a day. What is the
most likely pharmacological consequence?
A. Clozapine levels will increase due to CYP1A2 inhibition.
B. Smoking has no effect on Clozapine metabolism.
,C. Clozapine levels will decrease due to CYP2D6 induction.
D. Clozapine levels will decrease due to CYP1A2 induction.
Answer: D
Conceptual Explanation: Polycyclic aromatic hydrocarbons in cigarette smoke induce the
CYP1A2 enzyme, which metabolizes clozapine, leading to decreased serum levels of the
drug.
3. Which of the following is a primary mechanism of action for Second-Generation
Antipsychotics (SGAs) that distinguishes them from First-Generation Antipsychotics (FGAs)?
A. Potent D2 receptor antagonism only
B. Norepinephrine reuptake inhibition
C. GABA-A receptor modulation
D. 5HT2A receptor antagonism
Answer: D
Conceptual Explanation: SGAs are defined by their high 5HT2A to D2 receptor binding
ratio. Antagonism at 5HT2A receptors increases dopamine release in certain pathways,
reducing EPS risk.
4. Lithium toxicity can be precipitated by the concurrent use of which class of medications?
A. NSAIDs
B. Loop diuretics
, C. Acetaminophen
D. Calcium channel blockers
Answer: A
Conceptual Explanation: NSAIDs (except aspirin/sulindac) decrease renal blood flow and
prostaglandin synthesis, leading to reduced lithium clearance and increased toxicity risk.
5. What is the black box warning associated with Lamotrigine?
A. Agranulocytosis
B. Hepatotoxicity
C. Stevens-Johnson Syndrome (SJS)
D. Pancreatitis
Answer: C
Conceptual Explanation: Lamotrigine carries a black box warning for serious rashes,
including SJS and Toxic Epidermal Necrolysis, usually occurring within the first 2-8 weeks
of treatment.
6. A patient presents with high fever, muscle rigidity (‘lead pipe’), and autonomic instability
after starting Haloperidol. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Anticholinergic Crisis
C. Acute Dystonia
COMPREHENSIVE EXAM PREP
QUESTIONS & ANSWERS
(CHAMBERLAIN) 100% GUARANTEE
PASS
1. Which dopamine pathway is responsible for the development of hyperprolactinemia when
blocked by typical antipsychotics?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: C
Conceptual Explanation: Dopamine in the tuberoinfundibular pathway normally inhibits
prolactin release. Blocking D2 receptors here results in increased prolactin levels.
2. A patient stabilized on Clozapine begins smoking a pack of cigarettes a day. What is the
most likely pharmacological consequence?
A. Clozapine levels will increase due to CYP1A2 inhibition.
B. Smoking has no effect on Clozapine metabolism.
,C. Clozapine levels will decrease due to CYP2D6 induction.
D. Clozapine levels will decrease due to CYP1A2 induction.
Answer: D
Conceptual Explanation: Polycyclic aromatic hydrocarbons in cigarette smoke induce the
CYP1A2 enzyme, which metabolizes clozapine, leading to decreased serum levels of the
drug.
3. Which of the following is a primary mechanism of action for Second-Generation
Antipsychotics (SGAs) that distinguishes them from First-Generation Antipsychotics (FGAs)?
A. Potent D2 receptor antagonism only
B. Norepinephrine reuptake inhibition
C. GABA-A receptor modulation
D. 5HT2A receptor antagonism
Answer: D
Conceptual Explanation: SGAs are defined by their high 5HT2A to D2 receptor binding
ratio. Antagonism at 5HT2A receptors increases dopamine release in certain pathways,
reducing EPS risk.
4. Lithium toxicity can be precipitated by the concurrent use of which class of medications?
A. NSAIDs
B. Loop diuretics
, C. Acetaminophen
D. Calcium channel blockers
Answer: A
Conceptual Explanation: NSAIDs (except aspirin/sulindac) decrease renal blood flow and
prostaglandin synthesis, leading to reduced lithium clearance and increased toxicity risk.
5. What is the black box warning associated with Lamotrigine?
A. Agranulocytosis
B. Hepatotoxicity
C. Stevens-Johnson Syndrome (SJS)
D. Pancreatitis
Answer: C
Conceptual Explanation: Lamotrigine carries a black box warning for serious rashes,
including SJS and Toxic Epidermal Necrolysis, usually occurring within the first 2-8 weeks
of treatment.
6. A patient presents with high fever, muscle rigidity (‘lead pipe’), and autonomic instability
after starting Haloperidol. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Anticholinergic Crisis
C. Acute Dystonia
