NU 643 Exam 3 V3 | NU 643 Advanced
Psychopharmacology | Actual Q&A with Rationale
(NU643 Exam 3) | Regis University
1. A 24-year-old male is diagnosed with Schizophrenia and exhibits significant auditory
hallucinations and delusions. Which dopamine pathway is hypothesized to be overactive,
leading to these positive symptoms?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Correct Answer: B
Explanation: The mesolimbic pathway projects from the ventral tegmental area to the
nucleus accumbens. Excessive dopamine activity in this pathway is strongly associated
with the positive symptoms of schizophrenia, such as hallucinations and delusions.
Conventional and atypical antipsychotics target this pathway by blocking D2 receptors to
reduce these symptoms.
2. A patient taking Risperidone reports breast tenderness and galactorrhea. Blockade of
dopamine in which pathway is responsible for these side effects?
A. Nigrostriatal pathway
B. Mesocortical pathway
,C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Correct Answer: C
Explanation: The tuberoinfundibular pathway regulates prolactin secretion by the
pituitary gland. Under normal conditions, dopamine inhibits prolactin release; however,
when D2 receptors in this pathway are blocked, prolactin levels rise. This results in clinical
symptoms like galactorrhea, amenorrhea, and gynecomastia.
3. Which dopamine pathway is associated with the negative and cognitive symptoms of
schizophrenia when dopamine levels are insufficient?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesocortical pathway
Correct Answer: D
Explanation: The mesocortical pathway projects to the prefrontal cortex and is involved in
executive function and emotional regulation. A deficiency of dopamine in this area is
thought to contribute to negative symptoms like apathy and cognitive deficits. Many
atypical antipsychotics aim to improve these symptoms by modulating serotonin-
dopamine interactions.
, 4. A patient initiated on Haloperidol develops severe muscle rigidity, high fever, and
autonomic instability. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
C. Acute Dystonia
D. Tardive Dyskinesia
Correct Answer: B
Explanation: Neuroleptic Malignant Syndrome is a rare but life-threatening reaction to
dopamine antagonists. It is characterized by the ‘lead pipe’ muscle rigidity, hyperthermia,
and mental status changes. Immediate discontinuation of the offending agent and
supportive care are critical for patient survival.
5. When starting a patient on Clozapine, what is the mandatory laboratory monitoring
requirement due to the risk of agranulocytosis?
A. Liver Function Tests (LFTs)
B. Absolute Neutrophil Count (ANC)
C. Serum Creatinine
D. Thyroid Stimulating Hormone (TSH)
Correct Answer: B
Psychopharmacology | Actual Q&A with Rationale
(NU643 Exam 3) | Regis University
1. A 24-year-old male is diagnosed with Schizophrenia and exhibits significant auditory
hallucinations and delusions. Which dopamine pathway is hypothesized to be overactive,
leading to these positive symptoms?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Correct Answer: B
Explanation: The mesolimbic pathway projects from the ventral tegmental area to the
nucleus accumbens. Excessive dopamine activity in this pathway is strongly associated
with the positive symptoms of schizophrenia, such as hallucinations and delusions.
Conventional and atypical antipsychotics target this pathway by blocking D2 receptors to
reduce these symptoms.
2. A patient taking Risperidone reports breast tenderness and galactorrhea. Blockade of
dopamine in which pathway is responsible for these side effects?
A. Nigrostriatal pathway
B. Mesocortical pathway
,C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Correct Answer: C
Explanation: The tuberoinfundibular pathway regulates prolactin secretion by the
pituitary gland. Under normal conditions, dopamine inhibits prolactin release; however,
when D2 receptors in this pathway are blocked, prolactin levels rise. This results in clinical
symptoms like galactorrhea, amenorrhea, and gynecomastia.
3. Which dopamine pathway is associated with the negative and cognitive symptoms of
schizophrenia when dopamine levels are insufficient?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesocortical pathway
Correct Answer: D
Explanation: The mesocortical pathway projects to the prefrontal cortex and is involved in
executive function and emotional regulation. A deficiency of dopamine in this area is
thought to contribute to negative symptoms like apathy and cognitive deficits. Many
atypical antipsychotics aim to improve these symptoms by modulating serotonin-
dopamine interactions.
, 4. A patient initiated on Haloperidol develops severe muscle rigidity, high fever, and
autonomic instability. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
C. Acute Dystonia
D. Tardive Dyskinesia
Correct Answer: B
Explanation: Neuroleptic Malignant Syndrome is a rare but life-threatening reaction to
dopamine antagonists. It is characterized by the ‘lead pipe’ muscle rigidity, hyperthermia,
and mental status changes. Immediate discontinuation of the offending agent and
supportive care are critical for patient survival.
5. When starting a patient on Clozapine, what is the mandatory laboratory monitoring
requirement due to the risk of agranulocytosis?
A. Liver Function Tests (LFTs)
B. Absolute Neutrophil Count (ANC)
C. Serum Creatinine
D. Thyroid Stimulating Hormone (TSH)
Correct Answer: B
