NR 546 MIDTERM EXAM REVIEW -
ADVANCED PSYCHOPHARMACOLOGY
QUESTIONS WITH CORRECT ANSWERS
(LATEST ), (A+ GUARANTEE).
1. Which dopaminergic pathway is responsible for the ‘positive’ symptoms of schizophrenia,
such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: Overactivity in the mesolimbic dopamine pathway is associated
with positive symptoms of schizophrenia. The mesocortical pathway is associated with
negative symptoms, nigrostriatal with motor movement, and tuberoinfundibular with
prolactin regulation.
2. A patient taking Clozapine must have regular blood monitoring for which life-threatening
condition?
A. Thrombocytopenia
,B. Hepatic failure
C. Nephrotoxicity
D. Agranulocytosis
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis (a
dangerous drop in absolute neutrophil count), requiring regular ANC monitoring through
the Clozapine REMS program.
3. Which of the following describes the mechanism of action of Lithium in the treatment of
Bipolar Disorder?
A. Selective inhibition of serotonin reuptake
B. Modulation of second messenger systems like the phosphoinositol cycle
C. Direct blockade of D2 receptors in the striatum
D. Potentiation of GABA-A receptor chloride channels
Answer: B
Conceptual Explanation: Lithium’s exact mechanism is complex but involves modulating
second messenger systems, inhibiting inositol monophosphatase, and affecting glycogen
synthase kinase-3 (GSK-3).
, 4. A patient presents with hyperreflexia, clonus, tremors, and diaphoresis after starting a new
antidepressant while already taking an MAOI. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome (NMS)
B. Anticholinergic Toxicity
C. Serotonin Syndrome
D. Hypertensive Crisis
Answer: C
Conceptual Explanation: Serotonin syndrome is characterized by neuromuscular
excitability (clonus, hyperreflexia), autonomic instability, and mental status changes, often
occurring when two serotonergic agents are combined.
5. What is the primary pharmacological reason for a tyramine-restricted diet when taking
Phenelzine (Nardil)?
A. To prevent excessive weight gain
B. To prevent gastrointestinal upset
C. To reduce the risk of serotonin syndrome
D. To avoid hypertensive crisis due to catecholamine release
Answer: D
ADVANCED PSYCHOPHARMACOLOGY
QUESTIONS WITH CORRECT ANSWERS
(LATEST ), (A+ GUARANTEE).
1. Which dopaminergic pathway is responsible for the ‘positive’ symptoms of schizophrenia,
such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: Overactivity in the mesolimbic dopamine pathway is associated
with positive symptoms of schizophrenia. The mesocortical pathway is associated with
negative symptoms, nigrostriatal with motor movement, and tuberoinfundibular with
prolactin regulation.
2. A patient taking Clozapine must have regular blood monitoring for which life-threatening
condition?
A. Thrombocytopenia
,B. Hepatic failure
C. Nephrotoxicity
D. Agranulocytosis
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis (a
dangerous drop in absolute neutrophil count), requiring regular ANC monitoring through
the Clozapine REMS program.
3. Which of the following describes the mechanism of action of Lithium in the treatment of
Bipolar Disorder?
A. Selective inhibition of serotonin reuptake
B. Modulation of second messenger systems like the phosphoinositol cycle
C. Direct blockade of D2 receptors in the striatum
D. Potentiation of GABA-A receptor chloride channels
Answer: B
Conceptual Explanation: Lithium’s exact mechanism is complex but involves modulating
second messenger systems, inhibiting inositol monophosphatase, and affecting glycogen
synthase kinase-3 (GSK-3).
, 4. A patient presents with hyperreflexia, clonus, tremors, and diaphoresis after starting a new
antidepressant while already taking an MAOI. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome (NMS)
B. Anticholinergic Toxicity
C. Serotonin Syndrome
D. Hypertensive Crisis
Answer: C
Conceptual Explanation: Serotonin syndrome is characterized by neuromuscular
excitability (clonus, hyperreflexia), autonomic instability, and mental status changes, often
occurring when two serotonergic agents are combined.
5. What is the primary pharmacological reason for a tyramine-restricted diet when taking
Phenelzine (Nardil)?
A. To prevent excessive weight gain
B. To prevent gastrointestinal upset
C. To reduce the risk of serotonin syndrome
D. To avoid hypertensive crisis due to catecholamine release
Answer: D
