NR 546 PSYCHOPHARMACOLOGY
MIDTERM EXAM 1 PRACTICE
QUESTIONS AND ANSWERS (LATEST),
(A+ GUARANTEE). JUST RELEASED
1. A patient is prescribed a medication that acts as a potent inhibitor of the CYP2D6 enzyme.
Which of the following antidepressants would likely have its plasma concentration
significantly increased if co-administered?
A. Paroxetine
B. Venlafaxine
C. Desvenlafaxine
D. Sertraline
Answer: A
Conceptual Explanation: Paroxetine is both a substrate and a potent inhibitor of CYP2D6.
While many SSRIs interact with CYP450, Paroxetine’s metabolism is heavily dependent on
2D6, and its inhibition can lead to significantly increased levels of other 2D6 substrates or
itself via auto-inhibition.
2. Which dopamine pathway is primarily responsible for the negative symptoms and
cognitive impairment seen in patients with schizophrenia?
A. Mesolimbic pathway
,B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The mesocortical pathway, particularly projections to the
prefrontal cortex, is associated with negative symptoms (apathy, withdrawal) and
cognitive deficits when dopamine activity is deficient.
3. A 28-year-old female patient with a history of bulimia nervosa is seeking treatment for
Major Depressive Disorder. Which medication is strictly contraindicated due to an increased
risk of seizures?
A. Fluoxetine
B. Duloxetine
C. Mirtazapine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion is contraindicated in patients with seizure disorders
or a history of anorexia/bulimia nervosa due to a lowered seizure threshold observed in
these populations.
, 4. Which of the following describes the ‘steady state’ of a drug in the plasma?
A. When the drug has been in the system for exactly 24 hours
B. When the drug reaches its maximum therapeutic effect
C. When the amount of drug administered equals the amount of drug eliminated within a
dosing interval
D. When the drug is no longer detectable in the bloodstream
Answer: C
Conceptual Explanation: Steady state occurs when the rate of drug administration equals
the rate of drug elimination, typically reached after 4 to 5 half-lives.
5. A patient taking a Monoamine Oxidase Inhibitor (MAOI) consumes a large amount of aged
cheese and wine. What physiological reaction is most likely to occur?
A. Serotonin syndrome
B. Anticholinergic toxicity
C. Neuroleptic malignant syndrome
D. Hypertensive crisis
Answer: D
Conceptual Explanation: Tyramine in aged foods is normally broken down by MAO-A in
the gut. MAOIs block this, leading to a surge in norepinephrine and a potentially fatal
hypertensive crisis.
MIDTERM EXAM 1 PRACTICE
QUESTIONS AND ANSWERS (LATEST),
(A+ GUARANTEE). JUST RELEASED
1. A patient is prescribed a medication that acts as a potent inhibitor of the CYP2D6 enzyme.
Which of the following antidepressants would likely have its plasma concentration
significantly increased if co-administered?
A. Paroxetine
B. Venlafaxine
C. Desvenlafaxine
D. Sertraline
Answer: A
Conceptual Explanation: Paroxetine is both a substrate and a potent inhibitor of CYP2D6.
While many SSRIs interact with CYP450, Paroxetine’s metabolism is heavily dependent on
2D6, and its inhibition can lead to significantly increased levels of other 2D6 substrates or
itself via auto-inhibition.
2. Which dopamine pathway is primarily responsible for the negative symptoms and
cognitive impairment seen in patients with schizophrenia?
A. Mesolimbic pathway
,B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The mesocortical pathway, particularly projections to the
prefrontal cortex, is associated with negative symptoms (apathy, withdrawal) and
cognitive deficits when dopamine activity is deficient.
3. A 28-year-old female patient with a history of bulimia nervosa is seeking treatment for
Major Depressive Disorder. Which medication is strictly contraindicated due to an increased
risk of seizures?
A. Fluoxetine
B. Duloxetine
C. Mirtazapine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion is contraindicated in patients with seizure disorders
or a history of anorexia/bulimia nervosa due to a lowered seizure threshold observed in
these populations.
, 4. Which of the following describes the ‘steady state’ of a drug in the plasma?
A. When the drug has been in the system for exactly 24 hours
B. When the drug reaches its maximum therapeutic effect
C. When the amount of drug administered equals the amount of drug eliminated within a
dosing interval
D. When the drug is no longer detectable in the bloodstream
Answer: C
Conceptual Explanation: Steady state occurs when the rate of drug administration equals
the rate of drug elimination, typically reached after 4 to 5 half-lives.
5. A patient taking a Monoamine Oxidase Inhibitor (MAOI) consumes a large amount of aged
cheese and wine. What physiological reaction is most likely to occur?
A. Serotonin syndrome
B. Anticholinergic toxicity
C. Neuroleptic malignant syndrome
D. Hypertensive crisis
Answer: D
Conceptual Explanation: Tyramine in aged foods is normally broken down by MAO-A in
the gut. MAOIs block this, leading to a surge in norepinephrine and a potentially fatal
hypertensive crisis.
