Final Comprehensive Exam Review 2025
Neurology & Psychiatry
1. What is the mechanism of action of Levodopa/Carbidopa in Parkinson’s disease?
→ Levodopa converts to dopamine in the brain; Carbidopa prevents peripheral
breakdown of Levodopa, enhancing CNS availability.
2. When should pharmacologic treatment be initiated in patients with Parkinson’s
disease?
→ When symptoms begin interfering with daily functioning or quality of life.
3. What patient education should be provided when prescribing Levodopa?
→ Take on an empty stomach; avoid high-protein meals; may cause nausea, dizziness,
and dyskinesias.
4. What are the goals of pharmacotherapy in Alzheimer’s disease?
→ Slow progression of cognitive decline, improve/maintain function, and manage
behavioral symptoms.
5. Which medications are first-line in managing mild to moderate Alzheimer’s disease?
→ Cholinesterase inhibitors: Donepezil, Rivastigmine, Galantamine.
6. What are key side effects of medications used to treat alcohol use disorder?
→ Naltrexone: Nausea, hepatotoxicity; Acamprosate: Diarrhea; Disulfiram: Flushing,
nausea with alcohol.
7. Which medications are commonly used in alcohol use disorder, and how are they
chosen based on comorbidities?
, → Naltrexone (avoid in liver disease), Acamprosate (avoid in renal disease), Disulfiram
(only for highly motivated patients).
8. What are common side effects associated with stimulant medications for ADHD?
→ Decreased appetite, insomnia, increased BP/HR, irritability, and potential for misuse.
9. How does insomnia treatment differ between short-term and chronic management?
→ Short-term: Z-drugs (e.g., Zolpidem); chronic: focus on CBT-I and sleep hygiene.
10. What are the first-line pharmacologic options for managing insomnia?
→ Non-benzodiazepine hypnotics (Zolpidem), Melatonin agonists (Ramelteon).
11. What is the recommended order of treatment lines for major depressive disorder?
→ 1st: SSRIs; 2nd: SNRIs, Bupropion; 3rd: TCAs, MAOIs, augmentation strategies.
12. Which antidepressants are preferred in patients who experience sexual side effects
from SSRIs?
→ Bupropion and Mirtazapine.
13. What medications are contraindicated in depression with comorbid bipolar
disorder?
→ SSRIs or SNRIs as monotherapy (may induce mania); mood stabilizers should be co-
prescribed.
Cardiology
14. What ECG changes are expected with Class I and Class III antiarrhythmic drugs?
→ Class I: Widened QRS; Class III: Prolonged QT interval.
Neurology & Psychiatry
1. What is the mechanism of action of Levodopa/Carbidopa in Parkinson’s disease?
→ Levodopa converts to dopamine in the brain; Carbidopa prevents peripheral
breakdown of Levodopa, enhancing CNS availability.
2. When should pharmacologic treatment be initiated in patients with Parkinson’s
disease?
→ When symptoms begin interfering with daily functioning or quality of life.
3. What patient education should be provided when prescribing Levodopa?
→ Take on an empty stomach; avoid high-protein meals; may cause nausea, dizziness,
and dyskinesias.
4. What are the goals of pharmacotherapy in Alzheimer’s disease?
→ Slow progression of cognitive decline, improve/maintain function, and manage
behavioral symptoms.
5. Which medications are first-line in managing mild to moderate Alzheimer’s disease?
→ Cholinesterase inhibitors: Donepezil, Rivastigmine, Galantamine.
6. What are key side effects of medications used to treat alcohol use disorder?
→ Naltrexone: Nausea, hepatotoxicity; Acamprosate: Diarrhea; Disulfiram: Flushing,
nausea with alcohol.
7. Which medications are commonly used in alcohol use disorder, and how are they
chosen based on comorbidities?
, → Naltrexone (avoid in liver disease), Acamprosate (avoid in renal disease), Disulfiram
(only for highly motivated patients).
8. What are common side effects associated with stimulant medications for ADHD?
→ Decreased appetite, insomnia, increased BP/HR, irritability, and potential for misuse.
9. How does insomnia treatment differ between short-term and chronic management?
→ Short-term: Z-drugs (e.g., Zolpidem); chronic: focus on CBT-I and sleep hygiene.
10. What are the first-line pharmacologic options for managing insomnia?
→ Non-benzodiazepine hypnotics (Zolpidem), Melatonin agonists (Ramelteon).
11. What is the recommended order of treatment lines for major depressive disorder?
→ 1st: SSRIs; 2nd: SNRIs, Bupropion; 3rd: TCAs, MAOIs, augmentation strategies.
12. Which antidepressants are preferred in patients who experience sexual side effects
from SSRIs?
→ Bupropion and Mirtazapine.
13. What medications are contraindicated in depression with comorbid bipolar
disorder?
→ SSRIs or SNRIs as monotherapy (may induce mania); mood stabilizers should be co-
prescribed.
Cardiology
14. What ECG changes are expected with Class I and Class III antiarrhythmic drugs?
→ Class I: Widened QRS; Class III: Prolonged QT interval.
