NU 578 ADVANCED
PSYCHOPHARMACOLOGY FINAL
EXAM PREP QUESTIONS & ANSWERS
100% GUARANTEE PASS | UNIVERSITY
OF SOUTH ALABAMA
1. A patient with treatment-resistant schizophrenia is started on Clozapine. Which of the
following laboratory parameters must be monitored strictly according to the REMS program?
A. Platelet count
B. Serum Creatinine
C. Liver Function Tests (LFTs)
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. The
Clozapine REMS program requires regular monitoring of the Absolute Neutrophil Count
(ANC) to mitigate the risk of severe neutropenia.
2. Which cytochrome P450 enzyme is primarily responsible for the metabolism of
approximately 25% of all psychotropic medications, including many antidepressants and
antipsychotics?
A. CYP3A4
,B. CYP1A2
C. CYP2C19
D. CYP2D6
Answer: D
Conceptual Explanation: CYP2D6 is a major metabolic pathway for many psychotropic
drugs. Genetic polymorphisms in this enzyme can lead to poor, intermediate, extensive, or
ultra-rapid metabolism.
3. A patient taking Phenelzine (an MAOI) consumes aged cheese and red wine. They present
to the emergency department with a severe headache and blood pressure of 210/120 mmHg.
What is the mechanism of this reaction?
A. Tyramine-induced release of norepinephrine
B. Inhibition of norepinephrine reuptake
C. Excessive serotonin accumulation
D. Dopamine receptor hypersensitivity
Answer: A
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine in the gut. High levels
of tyramine act as a pressor agent, triggering the release of stored norepinephrine, leading
to a hypertensive crisis.
, 4. Which mood stabilizer is most associated with a risk of Stevens-Johnson Syndrome (SJS),
particularly in patients of Asian descent with the HLA-B*1502 allele?
A. Lithium
B. Carbamazepine
C. Valproate
D. Topiramate
Answer: B
Conceptual Explanation: Carbamazepine is strongly associated with SJS/TEN. Genetic
testing for the HLA-B*1502 allele is recommended for patients of Asian ancestry before
initiation.
5. A 28-year-old female patient with Bipolar I Disorder is planning to become pregnant.
Which medication carries the highest risk for neural tube defects (Ebstein’s anomaly
excluded)?
A. Lithium
B. Lamotrigine
C. Valproate
D. Quetiapine
Answer: C
PSYCHOPHARMACOLOGY FINAL
EXAM PREP QUESTIONS & ANSWERS
100% GUARANTEE PASS | UNIVERSITY
OF SOUTH ALABAMA
1. A patient with treatment-resistant schizophrenia is started on Clozapine. Which of the
following laboratory parameters must be monitored strictly according to the REMS program?
A. Platelet count
B. Serum Creatinine
C. Liver Function Tests (LFTs)
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. The
Clozapine REMS program requires regular monitoring of the Absolute Neutrophil Count
(ANC) to mitigate the risk of severe neutropenia.
2. Which cytochrome P450 enzyme is primarily responsible for the metabolism of
approximately 25% of all psychotropic medications, including many antidepressants and
antipsychotics?
A. CYP3A4
,B. CYP1A2
C. CYP2C19
D. CYP2D6
Answer: D
Conceptual Explanation: CYP2D6 is a major metabolic pathway for many psychotropic
drugs. Genetic polymorphisms in this enzyme can lead to poor, intermediate, extensive, or
ultra-rapid metabolism.
3. A patient taking Phenelzine (an MAOI) consumes aged cheese and red wine. They present
to the emergency department with a severe headache and blood pressure of 210/120 mmHg.
What is the mechanism of this reaction?
A. Tyramine-induced release of norepinephrine
B. Inhibition of norepinephrine reuptake
C. Excessive serotonin accumulation
D. Dopamine receptor hypersensitivity
Answer: A
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine in the gut. High levels
of tyramine act as a pressor agent, triggering the release of stored norepinephrine, leading
to a hypertensive crisis.
, 4. Which mood stabilizer is most associated with a risk of Stevens-Johnson Syndrome (SJS),
particularly in patients of Asian descent with the HLA-B*1502 allele?
A. Lithium
B. Carbamazepine
C. Valproate
D. Topiramate
Answer: B
Conceptual Explanation: Carbamazepine is strongly associated with SJS/TEN. Genetic
testing for the HLA-B*1502 allele is recommended for patients of Asian ancestry before
initiation.
5. A 28-year-old female patient with Bipolar I Disorder is planning to become pregnant.
Which medication carries the highest risk for neural tube defects (Ebstein’s anomaly
excluded)?
A. Lithium
B. Lamotrigine
C. Valproate
D. Quetiapine
Answer: C
