NR546 PSYCHOPHARMACOLOGY
ADVANCED PRACTICE QUESTIONS
AND ANSWERS
1. Which dopaminergic pathway is primarily associated with the development of
extrapyramidal symptoms (EPS) and tardive dyskinesia when D2 receptors are blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway controls motor function and
movement. Chronic blockade of D2 receptors in this pathway leads to EPS and tardive
dyskinesia.
2. A patient taking Clozapine presents with a fever, sore throat, and lethargy. Which lab test
is the highest priority?
A. Complete blood count with differential
,B. Liver function tests
C. Serum Clozapine level
D. Fastng blood glucose
Answer: A
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A CBC
with ANC is required to monitor for life-threatening neutropenia.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Bupropion
B. Sertraline
C. Duloxetine
D. Mirtazapine
Answer: A
Conceptual Explanation: Bupropion lowers the seizure threshold and is contraindicated
in patients with seizure disorders or bulimia/anorexia due to electrolyte-induced seizure
risks.
4. What is the mechanism of action of Memantine in the treatment of Alzheimer’s disease?
A. Reversible acetylcholinesterase inhibitor
B. Dopamine agonist
, C. NMDA receptor antagonist
D. 5HT2A antagonist
Answer: C
Conceptual Explanation: Memantine is an uncompetitive NMDA receptor antagonist that
regulates glutamate activity to prevent neurotoxicity in Alzheimer’s disease.
5. Serotonin syndrome is most distinctively characterized by which physical exam finding
compared to Neuroleptic Malignant Syndrome (NMS)?
A. Hyperthermia
B. Muscle rigidity
C. Hyperreflexia and myoclonus
D. Autonomic instability
Answer: C
Conceptual Explanation: While both cause hyperthermia and autonomic instability,
Serotonin Syndrome typically features hyperreflexia and myoclonus, whereas NMS
features ‘lead-pipe’ rigidity and hyporeflexia.
6. Which cytochrome P450 enzyme is significantly induced by cigarette smoking, potentially
lowering levels of Olanzapine and Clozapine?
A. CYP1A2
B. CYP3A4
ADVANCED PRACTICE QUESTIONS
AND ANSWERS
1. Which dopaminergic pathway is primarily associated with the development of
extrapyramidal symptoms (EPS) and tardive dyskinesia when D2 receptors are blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway controls motor function and
movement. Chronic blockade of D2 receptors in this pathway leads to EPS and tardive
dyskinesia.
2. A patient taking Clozapine presents with a fever, sore throat, and lethargy. Which lab test
is the highest priority?
A. Complete blood count with differential
,B. Liver function tests
C. Serum Clozapine level
D. Fastng blood glucose
Answer: A
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A CBC
with ANC is required to monitor for life-threatening neutropenia.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Bupropion
B. Sertraline
C. Duloxetine
D. Mirtazapine
Answer: A
Conceptual Explanation: Bupropion lowers the seizure threshold and is contraindicated
in patients with seizure disorders or bulimia/anorexia due to electrolyte-induced seizure
risks.
4. What is the mechanism of action of Memantine in the treatment of Alzheimer’s disease?
A. Reversible acetylcholinesterase inhibitor
B. Dopamine agonist
, C. NMDA receptor antagonist
D. 5HT2A antagonist
Answer: C
Conceptual Explanation: Memantine is an uncompetitive NMDA receptor antagonist that
regulates glutamate activity to prevent neurotoxicity in Alzheimer’s disease.
5. Serotonin syndrome is most distinctively characterized by which physical exam finding
compared to Neuroleptic Malignant Syndrome (NMS)?
A. Hyperthermia
B. Muscle rigidity
C. Hyperreflexia and myoclonus
D. Autonomic instability
Answer: C
Conceptual Explanation: While both cause hyperthermia and autonomic instability,
Serotonin Syndrome typically features hyperreflexia and myoclonus, whereas NMS
features ‘lead-pipe’ rigidity and hyporeflexia.
6. Which cytochrome P450 enzyme is significantly induced by cigarette smoking, potentially
lowering levels of Olanzapine and Clozapine?
A. CYP1A2
B. CYP3A4
