NAPLEX PRACTICE QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS 2024

What is the range for acute manic episode treatment with lithium? - 0.8-1.2 mEq/L higher than maintenance treatment Which medication may potentially interact with and raise lithium levels? A. metoprolol B. lisinopril C. Tenormin D. APAP - lisinopril affects the kidneys!! Which is a side effect of lithium that commonly occurs in patients taking long term? A. ataxia B. constipation C. hypothyroidism D. neuropathy - C. hypothyroidism sometimes, diabetes insipidius which of following is true regarding MAO inhibitors for depression? A. potential for severe side effects of hypertensive crisis precipitated by certain foods B. considered 1st line C. good choice because few drug interactions - A. tyramine -containing foods can precipitate Serotonin syndrome and hypertensive crises Which of the following agents may be considered 1st line for treatment of major depression? A. Buspar B. lithium C. fluoxetine (Prozac) D. Doxepin (Silenor) - C fluoxetine SSRIs and SNRIs are first line for depression. Silenor = insomnia What is an advantage of using bupropion for tx of MDD? A. action is specific to serotonin unlike SSRIs B. fairly sedating so can also treat insomnia C. free from effect of lowering seizure threshold D. free from sexual side effects unlike many SSRIs - free from sexual side effects unlike many SSRIs **can lower seizure threshold another benefit: wellbutrin approved for smoking cessation Which of the following are counseling points for patient switching from SSRI --> SNRI for depression? A. same SE as SSRIs, except maybe more HTN B. should be stopped abruptly if any side effects C. may require therapeutic drug monitoring - - Same SE as SSRIs - may include HTN - do not stop abruptly without talking to Dr. - no drug monitoring JS, age 56 takes tamoxifen for breast cancer remission. Starting SSRI for MDD. What is BEST initial choice? A. fluoxetine B. phenelzine C. Paxil D. Zoloft - D. Zoloft fluoxetine and paroxetine can lower tamoxifen levels in the blood. What are the goals of therapy for treating anxiety disorders? A. alleviate all symptoms B. improve functioning in society C. reduce anxious symptoms or prevent recurrence D. improve overall quality of mood and sleep - C. reduce symptoms and prevent recurrence Which of the following would be 1st line for 35yo patient newly diagnosed with anxiety (no other meds)? A. Celexa B. Olanzapine C. Buspirone D. Ativan - Celexa (SSRI are first line) What is the role of benzos in tx of anxiety? A. first line for newly diagnosed B. short term for initial period of SSRI C. PRN breakthrough for all pts being treated with meds D. tx of choice for patients with SUD - B. short term for initial period of SSRI