NR 546 MIDTERM EXAM –
PSYCHOPHARMACOLOGY QUESTIONS
WITH CORRECT ANSWERS (LATEST
), (A+ GUARANTEE).
1. A patient taking Fluoxetine (Prozac) for Depression begins to experience shivering,
diaphoresis, hyperreflexia, and agitation. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome
B. Anticholinergic Toxicity
C. Serotonin Syndrome
D. SSRI Discontinuation Syndrome
Answer: C
Conceptual Explanation: Serotonin Syndrome is characterized by a triad of mental status
changes, autonomic hyperactivity, and neuromuscular abnormalities (like hyperreflexia
and clonus). Neuroleptic Malignant Syndrome is associated with dopamine antagonists and
usually involves lead-pipe rigidity.
2. Which CYP450 enzyme is primarily responsible for the metabolism of about 25% of all
drugs, including many antidepressants and antipsychotics, despite making up a small
percentage of total liver enzymes?
A. CYP3A4
,B. CYP1A2
C. CYP2C19
D. CYP2D6
Answer: D
Conceptual Explanation: CYP2D6 is a major metabolic pathway for psychotropic
medications. While CYP3A4 handles more overall drugs, CYP2D6 is highly significant in
psychiatry due to genetic polymorphisms leading to poor or ultra-rapid metabolism.
3. A patient is started on Clozapine (Clozaril). Which laboratory value must be monitored
weekly for the first six months to assess for agranulocytosis?
A. Serum Creatinine
B. Alanine Aminotransferase (ALT)
C. Platelet Count
D. Thyroid Stimulating Hormone (TSH)
E. Absolute Neutrophil Count (ANC)
Answer: E
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. The
Absolute Neutrophil Count (ANC) must be tracked via the Risk Evaluation and Mitigation
Strategy (REMS) program to ensure the patient’s immune system is not dangerously
compromised.
, 4. Which dopamine pathway is associated with the positive symptoms of schizophrenia, such
as hallucinations and delusions?
A. Nigrostriatal pathway
B. Mesolimbic pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: The Mesolimbic pathway, running from the ventral tegmental
area to the nucleus accumbens, is hypothesized to be overactive in schizophrenia, leading
to positive symptoms.
5. Which medication acts as a selective alpha-2 adrenergic antagonist, thereby increasing the
release of both serotonin and norepinephrine?
A. Venlafaxine
B. Bupropion
C. Mirtazapine
D. Duloxetine
Answer: C
PSYCHOPHARMACOLOGY QUESTIONS
WITH CORRECT ANSWERS (LATEST
), (A+ GUARANTEE).
1. A patient taking Fluoxetine (Prozac) for Depression begins to experience shivering,
diaphoresis, hyperreflexia, and agitation. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome
B. Anticholinergic Toxicity
C. Serotonin Syndrome
D. SSRI Discontinuation Syndrome
Answer: C
Conceptual Explanation: Serotonin Syndrome is characterized by a triad of mental status
changes, autonomic hyperactivity, and neuromuscular abnormalities (like hyperreflexia
and clonus). Neuroleptic Malignant Syndrome is associated with dopamine antagonists and
usually involves lead-pipe rigidity.
2. Which CYP450 enzyme is primarily responsible for the metabolism of about 25% of all
drugs, including many antidepressants and antipsychotics, despite making up a small
percentage of total liver enzymes?
A. CYP3A4
,B. CYP1A2
C. CYP2C19
D. CYP2D6
Answer: D
Conceptual Explanation: CYP2D6 is a major metabolic pathway for psychotropic
medications. While CYP3A4 handles more overall drugs, CYP2D6 is highly significant in
psychiatry due to genetic polymorphisms leading to poor or ultra-rapid metabolism.
3. A patient is started on Clozapine (Clozaril). Which laboratory value must be monitored
weekly for the first six months to assess for agranulocytosis?
A. Serum Creatinine
B. Alanine Aminotransferase (ALT)
C. Platelet Count
D. Thyroid Stimulating Hormone (TSH)
E. Absolute Neutrophil Count (ANC)
Answer: E
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. The
Absolute Neutrophil Count (ANC) must be tracked via the Risk Evaluation and Mitigation
Strategy (REMS) program to ensure the patient’s immune system is not dangerously
compromised.
, 4. Which dopamine pathway is associated with the positive symptoms of schizophrenia, such
as hallucinations and delusions?
A. Nigrostriatal pathway
B. Mesolimbic pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: The Mesolimbic pathway, running from the ventral tegmental
area to the nucleus accumbens, is hypothesized to be overactive in schizophrenia, leading
to positive symptoms.
5. Which medication acts as a selective alpha-2 adrenergic antagonist, thereby increasing the
release of both serotonin and norepinephrine?
A. Venlafaxine
B. Bupropion
C. Mirtazapine
D. Duloxetine
Answer: C
