NR546 / NR 546 Actual Final Exam 2024 Prediction Questions (Correct Answers. Graded A)

NR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A)NR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) Which of the following is considered the pleasure center of the brain? A. Cortico-striatal-thalamic-cortical loop B. Mesolimbic dopamine pathway C. Mesocortical dopamine pathway D. None of the above B. Mesolimbic dopamine pathway A 35-year-old cigarette smoker would like to quit but is nervous because she typically craves a cigarette approximately every 2 hrs. The craving and withdrawal are due to: A. Desensitization of nicotinic receptors B. Resensitization of nicotinic receptors C. Desensitization of muscarinic receptors D. Resensitization of muscarinic receptors D. Resensitization of muscarinic receptors The reactive reward system signals the immediate prospect of pleasure or pain and triggers drug-seeking behavior. A. True B. False True What role does the amygdala play in substance abuse? A. Releases phasic bursts of dopamine to the nucleus accumbens when drugs of abuse are present B. Communicates to the ventral tegmental area when cues related to drugs of abuse are present C. Site of binding for most drugs of abuse D. A and B E. A, B, and C B. Communicates to the ventral tegmental area when cues related to drugs of abuse are present A 45-year-old patient has tried unsuccessfully to quit smoking several times over the past ten years. Nicotine's actions at which receptors are considered primarily responsible for its reinforcing effects? A. Alpha 4 beta 2 postsynaptic receptors in the ventral tegmental area B. Alpha 7 postsynaptic receptors in the prefrontal cortex C. A and B D. Neither A nor B A. Alpha 4 beta 2 postsynaptic receptors in the ventral tegmental area A 35-year-old cigarette smoker would like to quit but is nervous because she typically craves a cigarette approximately every 2 hrs. The craving and withdrawal are due to: A. Desensitization of nicotinic receptors B. Resensitization of nicotinic receptors C. Desensitization of muscarinic receptors D. Resensitization of muscarinic receptors B. Resensitization of nicotinic receptors B. Resensitization of nicotinic receptorsA 44-year-old patient has schizophrenia and comorbid alcohol abuse disorder. Alcohol has what effect on GABA and glutamate in the ventral tegmental area? A. Increases GABA and decreases glutamate B. Increases both GABA and glutamate C. Decreases GABA and increases glutamate D. Decreases both GABA and glutamate A. Increases GABA and decreases glutamateNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) A 26-year-old patient with ADHD has recently entered a drug rehabilitation center following arrest for possession of cocaine. The cocaine use in this patient may be an attempt at selfmedication for ADHD symptoms because it inhibits the dopamine transporter (but is not itself taken up into the neuron by the transporter). Thus, cocaine has the same action at the dopamine transporter as: A. Cocaine has the same actions at the dopamine transporter as amphetamine B. Cocaine has the same actions at the dopamine transporter as methylphenidate C. A and B B. Cocaine has the same actions at the dopamine transporter as methylphenidate Patrick is a 22-year-old male who recently experienced a psychotic-like episode after trying MDMA ("ecstasy") while at a party. A key binding site for hallucinogens is the: A. GABA-A receptor B. Cannabinoid 1 receptor C. Serotonin 2A receptor D. Serotonin 2C receptor C. Serotonin 2A receptor 29-year-old patient is morbidly obese and reports that he is "addicted to food". Hunger circuitry is connected to reward circuitry via dopaminergic projections from the hypothalamus to the nucleus accumbens. A. True B. False A. True Examples of neurotransmitters produced specifically as retrograde neurotransmitters (i.e., those that communicate from postsynaptic neuron to presynaptic neuron) include: A. GABA B. Galanin C. Histamine D. Nitric oxide D. Nitric oxide An example of volume neurotransmission is: A. Dopamine in the prefrontal cortex B. Dopamine in the striatum C. Norepinephrine in the prefrontal cortex D. Norepinephrine in the striatum A. Dopamine in the prefrontal cortDopamine in the prefrontal cortex In a G protein-linked signal transduction cascade, the second messenger can be synthesized:A. Intracellularly B. Extracellularly C. Either intra- or extracellularly A. Intracellularly Transport of monoamines requires energy, which is supplied by a: A. Calcium pump B. Potassium pump C. Sodium pump c. Sodium Pump 14. What is constitutive activity? A. Signal transduction when an agonist is bound to the receptor B. Signal transduction when an antagonist to the receptor C. Signal transudction when an inverse agonist is bound to the receptor D. Signal transduction when no agonist or inverse agonist is bound to theNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) recep D. Signal transduction when no agonist or inverse agonist is bound to the recep A partial agonist has what effect on neurotransmission?NR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) A. Net agonism when neurotransmission is deficient B. Net antagonism when neurotransmission is excessive C. A and B D. Neither A nor B C. A and B receptor with four transmembrane regions changes conformation as GABA binds. Which system is this process describing? A. Presynaptic transporter B. Ligand-gated ion channel C. Voltage-sensitive ion chann B. Ligandgated ion channel The known receptor sites for ligand-gated ion channels are: A. Inside the channel B. Outside the channel C. Both inside and outside the channel D. Ligand-gated ion channels do not have receptor sites C. Both inside and outside the channel receptor will stop responding to an agonist: A. When the agonist stops binding to it B. When the receptor becomes desensitized C. When the receptor becomes inactivated D. A and C E. A, B, and C E. A, B, and C Which of the following is true? A. Positive allosteric modulation is possible only in the presence of a neurotransmitter, while negative allosteric modulation is possible only in the absence of a neurotransmitter B. Negative allosteric modulation is possible only in the presence of a neurotransmitter, while positive allosteric modulation is possible only in the absence of a neurotransmitter C. Both positive and negative allosteric modulations are possible only in the absence of a neurotransmitter D. Both positive and negative allosteric modulations are possible only in the presence of a neurotransmitte When voltage-sensitive sodium channels are open and activated, the flow of sodium is: A. Into the neuron B. Out of the neuron A. Into the neuron The alpha 2 delta subunit of voltage-sensitive calcium channels is believed to help regulate opening and closing of the voltagesensitive calcium channel. A. A 22-year-old woman presents with schizophrenia characterized by the presence of positive, negative, cognitive, and affectivesymptoms. The symptom dimension of schizophrenia most effectively treated with antipsychotics is: A. Positive symptoms B. Negative symptoms C. Cognitive symptoms D. Affective symptoms A. Positive symptoms Symptoms of schizophrenia are hypothetically attributable to malfunctioning in the: A. Mesolimbic and nigrostriatal pathways B. Nigrostriatal and tuberoinfundibular pathways C. Tuberoinfundibular and mesocortical pathwaysNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) D. Mesocortical and mesolimbic pathwaysD. Mesocortical and mesolimbic pathwaysNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) The activation of N-methyl-d-aspartate (NMDA) receptors requires the presence of: A. Glutamate only . Glutamate and glycine C. Glutamate, glycine, and magnesium D. Glutamate and magnesium Glutamate and glycine A leading hypothesis of schizophrenia is: A. Hyperfunctioning NMDA receptors B. Hypofunctioning NMDA receptors B. Hypofunctioning NMDA receptors The activation of AMPA (alpha-amino-3-hydroxy-5- methyl-4-isoxazole- propionic acid) receptors requires the presence of: A. Glutamate only B. Glutamate and glycine C. Glutamate, glycine, and magnesium D. None of the above A. Glutamate only During cognitive challenges, individuals with schizophrenia demonstrate: A. Hypoactivation in the DLPFC B. Hyperactivation in the DLPFC C. Normal activation in the DLPFC D. A and B A. Hypoactivation in the DLPFC B. Hyperactivation in the DLPFC D. A and B Conventional antipsychotics may worsen negative symptoms, presumably through their actions in the: A. Mesolimbic pathway B. Mesolimbic and mesocortical pathways C. Mesolimbic, mesocortial, and nigrostrital pathways B. Mesolimbic and mesocortical pathways A 44-year-old male with schizophrenia has been taking an antipsychotic medication since initial diagnosis twelve years ago. He has recently begun experiencing difficulty with fluid movement of his arms as well as involuntary facial grimaces. Which of the following likely underlies these symptoms? A. Upregulation of serotonin 2A receptors B. Downregulation of serotonin 2A receptors C. Upregulation of dopamine 2 receptors D. Downregulation of dopamine 2 receptors C. Upregulation of dopamine 2 receptors38-year-old woman was diagnosed with schizophrenia approximately two years ago and after multiple trials of different medications has been maintained on haloperidol for the last several months with good response. Two weeks ago she began exhibiting mild motor symptoms representative of parkinsonism. Which of the following would be the most appropriate adjunct medication for this patient? A. Alpha 1 adrenergic agonist B. Cholinesterase inhibitor C. Histamine 1 antagonist D. Muscarinic 1 antagonist D. Muscarinic 1 antagonistNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) Which of the following has the secondary property of positive allosteric modulation at nicotinic receptors? A. Donepezil B. Rivastigmine C. Galantamine D. Memantine C. Galantamine A 25-year-old woman with longstanding anxiety is currently experiencing debilitating concerns that her children will be harmed whenever they are aware from her. Such worry is associated with activity in: A. Amygdala-centered circuits B. Cortico-striatal-thalamic-cortical circuits B. Corticostriatal- thalamic-cortical circuits A patient with generalized anxiety disorder is taking a benzodiazepine. What role do benzodiazepines play in GABA neurotransmission? A. Increase it via direct agonist actions B. Increase it via direct antagonist actions C. Increase it via negative allosteric modulation D. Increase it via positive allosteric modulation D. Increase it via positive allosteric modulation A patient with bipolar disorder responds to treatment with a mood stabilizing anticonvulsant agent. Which of the following has the strongest evidence of direct involvement in the mechanism of action of these agents? A. Voltage-sensitive calcium channels B. Voltage-sensitive potassium channels C. Voltage-sensitive sodium channels C. Voltage- sensitive sodium channels A 24-year-old woman has been taking lithium to treat her bipolar disorder for 6 years. Lithium's hypothesized mechanism of action is: A. Inhibition of second messenger enzymes B. Interaction with downstream signal transduction cascades C. Inhibition of voltage-sensitive sodium channels D. A and B E. B and C D. A and B A. Inhibition of second messenger enzymes B. Interaction with downstream signal transduction cascades; ~ ligand gated channel A 39-year-old patient with major depressive disorder presents toyour office after several months of trying various antidepressant drugs. It is suggested that he try augmenting his current regimen with L-methylfolate. Why might L-methylfolate hypothetically boost the therapeutic efficacy of antidepressants? A. It both increases synthesis and inhibits metabolism of monoamines B. It only increases synthesis of monoamines C. It only inhibits metabolism of monoamines A. It both increases synthesis and inhibits metabolism of monoamines A 25-year-old patient with first-episode major depressive disorder is being prescribed an antidepressant. The time course for therapeutic effects of antidepressants correlates with: A. Increase in presynaptic neurotransmission B. Increase in postsynaptic neurotransmission C. Changes in receptor sensitivity C. Changes in receptor sensitivityNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) The alpha 2 delta subunit of voltage-sensitive calcium channels is believed to help regulate opening and closing of the voltagesensitive calcium channel. A. When voltage-sensitive sodium channels are open and activated, the flow of sodium is: A. Into the neuron B. Out of the neuron A. Into the neuron What is the correct order and direction of ion flow into and out of a neuron experiencing an action potential? A. Na+ in, K+ out, Ca2+ in B. Ca2+ in, K+ out, Na+ in C. K+ in, Na+ in, Ca2+ in D. Na+ in, Ca2+ in, K+ out E. Ca2+ in, Na+ out, K+ out D. Na+ in, Ca2+ in, K+ out An excitatory signal is received at the dendrite of a pymidapyral glutamate neuron. When the signal is released from the incoming presynaptic dopaminergic axon, it is received as an inhibitory signal. However, this signal is not integrated properly with other incoming signals to that neuron. Which is the most likely site at which the error of integrating this signal with other incoming signals occurred? A. Dendritic membrane B. Soma C. Axonal Zone D. Presynaptic Zone B. Soma Soma is the site that integrates chemical encoding of signal transduction from all incoming signals; improper signal integration is most likely at this site. Which of the following are involved in regulating neurotransmission via excitation- secretion coupling? A. Voltage-Sensitive Sodium Channels B. Voltage-Sensitive Calcium Channels C. Both A and B D. Neither A nor BC. Both A and B Propagation of an action potential to the axon terminal is mediated by voltage-sensitive sodium channels. Influx of sodium through voltage- sensitive sodium channels at the axon terminal leads to opening of voltage- sensitive calcium channels, also at the axon terminal. Influx of calcium through the open voltage sensitive calcium channels leads to docking of synaptic vesicles and secretion of neurotransmitter into the synapse.What is epigenetics A. Acquired trait coded for by a change in DNA sequence B. Acquired trait not coded for by a change in DNA sequence C. Heritable trait coded for by a change in DNA sequence D. Heritable trait not coded for by a change in DNA sequence D. Heritable trait not coded for by a change in DNA sequence good example of epigenetics is cell differentiation Presynaptic reuptake transporters are a major method of inactivation forNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) which of the following?NR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) A. Serotonin B. Serotonin and GABA C. Serotonin, GABA and Histamine D. Serotonin, GABA, Histamine and Neuropeptides B. Serotonin and GABA Agonists cause ligand-gated ion channels to: A. open wider B. open for longer durations of time C. open more frequently D. A and B E. A and C c. open more frequently In a G protein-linked signal transduction cascade, the second messenger can be synthesized In the postsynaptic neuron In the synaptic cleft A and B Neither A nor BIn the postsynaptic neuron Neurogenesis has recently been discovered to occur in adults: A. Only in the dentate gyrus of the hippocampus B. In the dentate gyrus of the hippocampus and in the olfactory bulb C. In the dentate gyrus of the hippocampus, in the olfactory bulb, and in the lateral nucleus of the amygdala D. Throughout the brain E. Adult neurogenesis does not occur B. In the dentate gyrus of the hippocampus and in the olfactory bulb A neuron is infected with a toxin and causes a rather sudden inflammatory reaction. You detect a high concentration of cytokines in the surrounding area. Which process has taken place? A. Necrosis B. Synaptogenesis C. Excitotoxity D. Apoptosis E. Neurogenesis A. Necrosis Communication between human CNS neurons at synapses is: A. Chemical B. Electrical C. Neither A or B D. Both A and B A. Chemical A. ChemicalA serotonin molecule binds to a 5HT2A receptor causing electrical impulses to be sent down a GABA neuron's axon terminal, eventually releasing GABA to the GABA-A receptor of its postsynaptic neuron. Which type of neurotransmission does this describe? A. Classic Synaptic Neurotransmission B. Retrograde Neurotransmission C. Volume Neurotransmission D. Signal Cascade Transmission A. Classic Synaptic NeurotransmissionNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) A receptor with four transmembrane regions changes conformation as GABA binds. Which system is this process describing? A. Presynaptic transporter B. Ligand-gated ion channel C. Voltage-sensitive ion channel B. Ligand-gated ion channel Which of the following is the most likely impetus for upregulation of D2 receptors on a striatal dopamine neuron . A A bound receptor is taken out of circulation B. A new receptor is bound and put to use C. A D2 antagonist persistently binds to the receptor D. A D2 agonist persistently binds to the receptor C. A D2 antagonist persistently binds to the receptor The :direct role of transcription factors A. Cause neurotransmitter release B. Influence gene expression C. Synthesize enzymes D. Trigger signal transduction cascad B. Influence gene expression Protein of the CNS that stimulates cell proliferation, aids in cell survival and synaptic restructuring. It is also implicated in the neurotrophic hypothesis of depression A. Brain-derived neurotrophic factor (BDNF) B. Protein Kinase C. Prolactin A. Brain-derived neurotrophic factor (BDNF) (?)A. Brain-derived neurotrophic factor (BDNF) 1. Natural neurotransmitters are: a. Partial agonist b. Antagonist c. Agonist True or False: G-protein receptors are the most common targets of psychotropic drugs; their actions can lead to both therapeutic and side True or False: The cytochrome P450 enzyme system does not mediate how the body metabolizes antipsychotic drugs? false F Neurotransmitters can inhibit or excite neurons. , for example, is inhibitory effects? Twhereas i s excitatory. •Serotonin; dopamine •Glutamate; GABA •GABA; glutamate •None of the above is correct GABA; glutamate When depolarization occurs ; this allows the release of into the . •Sodium channels open; neurotransmitters; synaptic gap •Calcium channels open; dopamine; cell body •Calcium channels open; neurotransmitters; synaptic gapNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) •Potassium channels open; neurotransmitters; synaptic gap Calcium channels open; neurotransmitters; synaptic gap send signals away from neurons whereas receive signals from other neurons. • Axons; dendrites •Synapses; dendrites •Dendrites; axons • Axons; synapses Axons; dendrites Psychopharmacological agents act by? A. inhibiting enzymes B. Antagonizing receptors C. Stimulating Receptors D. All of the above D. All of the above The first messenger is the? A.Neurotransmitter B. Receptor C. G-protein D. Enzyme A.Neurotransmitter The glutamate neurotransmitter is and GABA is ? Excitatory and Inhibitory or Inhibitory and Excitatory Excitatory and Inhibitor Once a neurotransmitter acts upon a receptor, it? A. comes of f the receptor B. is destroyed by the enzyme C. is transported back D. All of the above D. All of the above NAM and PAM are? Either negative or positive depending on.. The Excitation Secretion Coupling process causes, VSSC and VSCC by? Sodium moves into the nerve, electrical charge then opens calcium channels Most Common action of antidepressants, has both therapeutic effects and causes side effectsG-protein Linked receptors Neurotransmitters act as? A. communication mediumsB. Gate Keepers C. Building blocks . Communication Mediums What are the targets for psych tropic drugs? A.Reuptake B. Ion channels C.Enzymes D.Neurotransm itt ers E. All of the Above E.All of the Above The Limbic SystemNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) includes? A. Hypothalamus B. Thalamus C. HippocampusB. NR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) D. Amygdala E. All of the Above E. All of the Above T or F? A partial agonist can both open and block activity 4. True A molecular and cellular hypothesis of depression (atrophy)? BDNF Prior to prescribing a psychotropic medication, the APN must order which labs? A. UDS B. Urine pregnancy C. CBC w/Diff D. All of the above All of the Above Frank, a 54yo male with Bipolar D/O, what is an approved medication that can be added to his mood stabilizer? Latuda Margaret is a 32 yo female who is afraid to take an antidepressant due to the side effect of weight gain. Which antidepressant is most associated with weight gain? Remeron The second messenger synthesizes what? Postsynaptic Neuron The direct role of the transcription factor is? Gene Expression A 38 yo presents with depression, anhedonia, decreased energy=Symptoms of Reduced Positive Affect. What neurotransmitters and Norepinephrine A 56 yo male with depression presents with an arrhythmia and possible cardiac arrest. He suffers from a seizure. Which medication did he likely OD (Elavil) TCA The presynaptic reuptake transporter? Serotonin and GABA Which of the following is considered the pleasure center of the brain? A. Cortico-striatal- thalamic-cortical loop B. Mesolimbic dopamine pathway C. pathwayD. None of the above B. Mesolimbic dopamine pathway The reactive reward system signals the immediate prospect of pleasure or pain and triggers drug-seeking behavior. A. TrueB. False A. True What role does the amygdala play in substance abuse? A. Releases phasic bursts of dopamine to the nucleus accumbens are involved? Dopamine on? AmitryptilineB . Alpha 4 beta 2 postsynaptic receptors in the when drugs of abuse are presentB. Communicates to the ventral tegmental area when cues related to drugs of abuse are present C. Site of binding for most drugs of abuse D. Communicates to the ventral tegmental area when cues related to drugs of abuse are present A 45-year-old patient has tried unsuccessfully to quit smoking several times over the past ten years. Nicotine's actions at which receptors are considered primarily responsible for its reinforcing effects? A. Alpha 4 beta 2 postsynaptic receptors in the ventral tegmental area B. Alpha 7 postsynaptic receptors in the prefrontal cortex C. A and B D. Neither A nor ventral tegmental area A 35-year-old cigarette smoker would like to quit but is nervous because sheNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) typically craves a cigarette approximately every 2 hrs. The craving and withdrawal are due to: A. Desensitization of nicotinic receptors B. Resensitization of nicotinic receptors C. Desensitization of muscarinic receptors D. Resensitization of muscarinic receptors B. Resensitization of nicotinic receptorsDecreases both GABA and glutamate A. to: C. Serotonin 2A antagonism NR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) A 44-year-old patient has schizophrenia and comorbid alcohol abuse disorder. Alcohol has what effect on GABA and glutamate in the ventral tegmental area? A. Increases GABA and decreases glutamate B. Increases both GABA and glutamate C. Decreases GABA and increases glutamate D. Increases GABA and decreases glutamate Patrick is a 22-year-old male who recently experienced a psychotic-like episode after trying MDMA ("ecstasy") while at a party. A key binding site for hallucinogens is the: A. GABA-A receptor B. Cannabinoid 1 receptor C. Serotonin 2A receptor D. Serotonin 2C receptor C. Serotonin 2A receptor A 21-year-old man with first-episode psychosis is prescribed an antipsychotic that has serotonin 2A antagonism. According to a leading hypothesis, blockade of serotonin 2A receptors in the cortex canultimately increase dopamine in the striatum through what initial mechanism? A. Decreased glutamate and thus increased GABA in the brainstemB. Decreased glutamate and thus decreased GABA in the brainstemC. Increased glutamate and thus decreased GABA in the brainstemD. Increased glutamate and thus increased GABA in the brainstem B. Decreased glutamate and thus decreased GABA in the brainstem The majority of atypical antipsychotics B. Have higher affinity for serotonin 2A receptors than for dopamine 2 receptors A 24-year-old schizophrenia patient with prominent cognitive symptoms and social impairment is being evaluated for treatment. Her care provider is considering initiating ziprasidone, quetiapine, or aripiprazole, all of which share the property of serotonin 1A agonism. This receptor binding property is expected to have clinical effects in schizophrenia most similar Dopamine 2 partial agonists cause receptor output that is less than that caused by dopamine but more than that caused by a conventional antipsychotic.A. TrueB. False A. True 9. A 34-year-old patient with bipolar disorder has been taking lithium with some success, but is now experiencing a depressive episode that is not responding to treatment. Her clinician isconsidering adding an atypical antipsychotic. What shared mechanism of some atypical antipsychotics may be partially responsible for antidepressant effects? C. Serotonin 1A partial agonism and serotonin 7 antagonism A 25-year-old patient who was diagnosed with ADHD at age 11 has previously been on immediaterelease methylphenidate and the methylphenidate patch. She is a heavy drinker and has a history of drug abuse. You decide to put her on 80 mg/day of atomoxetine, one of the non- stimulant medications effective in ADHD. Why does atomoxetine lack abuse potential? A. It decreases norepinephrine levels in the nucleus accumbens but not in the prefrontal cortex B. It increases dopamine levels in the prefrontal cortex but not in the nucleus accumbens C. It increases dopamine in the striatum and the anterior cingulate cortex D. It modulates serotonin levels in the raphe nucleus B. It increasesNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) dopamine levels in the prefrontal cortex but not in the nucleus accumbensNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) A 15-year-old patient with ADHD has a rare mutation in the gene for the dopamine transporter (DAT). In deciding which treatment to initiate for this patient's ADHD, you know it will be important to avoid treatments that depend on normally functioning DAT. Which of the following drugs are transported into neurons via the dopamine transporter? A. Atomoxetine B. Methylphenidate C. Amphetamine D. A and B E. None of the above C. Amphetamine Which of the following has the secondary property of positive allosteric modulation at nicotinic receptors? A. Donepezil B. Rivastigmine C. Galantamine D. Memantine C. Galantamine 34-year-old woman with posttraumatic stress disorder has been treated with exposure therapy, with partial success. Her clinician is considering an adjunct medication. The agent d-cycloserine could be efficacious for reducing symptoms in anxiety disorders because it has been shown to: A. Increase glutamate neurotransmission during fear conditioning B. Decrease glutamate neurotransmission during fear conditioning C. Increase glutamate neurotransmission during fear extinction D. Decrease glutamate neurotransmission during fear extinction C. Increase glutamate neurotransmission during fear extinction A patient with generalized anxiety disorder is taking a benzodiazepine. What role do benzodiazepines play in GABA neurotransmission? A. Increase it via direct agonist actions B. Increase it via direct antagonist actions C. Increase it via negative allosteric modulation D. Increase it via positive allosteric modulation D. Increase it via positive allosteric modulation A 45-year-old female presents with a hand-washing compulsion and an obsession with air fresheners. Based on these symptoms, which of the following is most likely to be true? A. She may have been born with the catechol-Omethyltransferase (COMT) Met genotype, leading to an increased risk of susceptibility to worry and anxiety disorders. B. She may have been born with the COMT Val genotype, leading to an increased risk of susceptibility to worry and anxiety disorders. A. She may have been born with the catechol-Omethyltransferase (COMT) Met genotype, leading to an increased risk of susceptibility to worry and anxiety disorde A 45-year-old female patient continues to maintain the reexperiencing of her fear of the opposite sex, which began one year ago when she was raped on her way to a parking garage. Which two brain regions are involved in the reciprocal relationship resulting in this symptom? A. Amygdala and hippocampus B. Basal forebrain and amygdalacalcium channels B. Indirect effects on NR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) C. Hippocampus and nucleus accumbens D. Hypothalamus and basal foreb . Amygdala and hippocampus A 35-year-old male Army veteran has been experiencing anxiety attacks during which he has difficulty breathing and increased heart rate. His symptom of difficulty breathing is hypothetically related to activation in the: A. Hippocampus B. Hypothalamus C. Parabrachial nucleus D. Periaqueductal gray C. Parabrachial nucleus A 22-year-old man exhibits a fear response in reaction to unexpectedly encountering a bear while hiking. The various expressions of fear are hypothetically regulated by circuitry centered around the: A. Amygdala B. Hippocampus C. Prefrontal cortex D. Thalamus A. Amygdala 24-year-old man was diagnosed with generalized anxiety disorder 2 years ago, and is now presenting with recurrent and spontaneous panic attacks. These anxiety disorders are hypothetically associated with: A. Unique circuitry for each disorder B. Overlapping circuitry but unique neurotransmitters for each disorder C. Overlapping circuity and neurotransmitters C. Overlapping circuity and neurotransmitters A 28-year-old woman presents with a depressive episode. She has previously been hospitalized and treated for a manic episode, but is not currently taking any medication.Which of the following have the best evidence of efficacy to treat bipolar depression? A. Lamotrigine, quetiapine B. Quetiapine, olanzapine monotherapy C. Olanzapine monotherapy, lithium D. Lithium, valproate E. Valproate, lamotrigine A. Lamotrigine, quetiapine A 32-year-old man with bipolar disorder has had a partial response to divalproex and is now being augmented with an atypical antipsychotic. The effects of atypical antipsychotics in nonpsychotic mania may be due to: A. Indirect effects on GABA release via D2 receptor antagonism B. Indirect effects on glutamate release via serotonin 2A antagonism C. Direct effects on voltage-sensitive sodium channels D. Direct effects on voltagesensitive glutamate release via serotonin 2A antagonism A patient with bipolar II disorder responds well to monotherapy with lamotrigine. Lamotrigine's unique therapeutic profile in bipolar depression compared to other anticonvulsants appears to be hypothetically linked to its: A. Activation of GABA release B. Inhibition of glutamate release B. Inhibition of glutamate release A patient with bipolar disorder responds to treatment with a mood stabilizing anticonvulsant agent. Which of the following has the strongest evidence of direct involvement in the mechanism of action of these agents? A. Voltage- sensitive calciumNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) channels B. Voltage-sensitive potassium channels C. Voltage- sensitive sodium channels C. Voltagesensitive sodium channels A 35-year-old patient with bipolar disorder is currently experiencing a depressive episode that involves suicidal ideation. Which of the following mood stabilizers has shown efficacy for the prevention of suicide? A. Lithium B. Carbamazepine C. Divalproex D. Lamotrigine A. Lithium A 24-year-old woman has been taking lithium to treat her bipolar disorder for 6 years. Lithium's hypothesized mechanism of action is: A. Inhibition of second messenger enzymes B. Interaction with downstream signal transduction cascades C. Inhibition of voltage-sensitive sodium channels D. A and B E. B and C D. A and B A 39-year-old patient with major depressive disorder presents to your office after several months of trying various antidepressant drugs. It is suggested that he try augmenting his current regimen with L-methylfolate. Why might L-methylfolate hypothetically boost the therapeutic efficacy of antidepressants? A. It both increases synthesis and inhibits metabolism of monoamines B. It only increases synthesis of monoamines C. It only inhibits metabolism of monoamines A. It both increases synthesis and inhibits metabolism of monoamines A clinician is considering options for a 45-year-old man with severe treatment-resistant depression who has exhibited only partial response to first-line and older generation antidepressants and who is unwilling to attempt electroconvulsive therapy or other stimulation therapy. One option, with extreme caution and under expert guidance, is to combine a monoamine oxidase inhibitor (MAOI) with a tricyclic antidepressant; however, which of the following should absolutely NOT be used in combination with an MAOI, even by an expert? A. Amitriptyline B. Clomipramine C. Nortriptyline D. Protriptyline B. Clomipramine Which of the following is the most potent property of trazodone? A. Serotonin reuptake inhibitionB. Serotonin 2C antagonism C. Serotonin 2A antagonism D. Histamine 1 antagonism C. Serotonin 2A antagonism A clinician has decided to adminster an alpha 2 antagonist to his patient. Alpha 2 antagonists have what effect on neurotransmission? A. Decrease norepinephrine and increase serotonin B. Decrease norepinephrine and decrease serotonin C. Increase norepinephrine and decrease serotonin D. Increase norepinephrine and increase serotonin D. Increase norepinephrine and increase serotoninNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) A 40-year-old woman presents with a major depressive episode. Her clinician is considering prescribing the antidepressant vilazodone,which has what two major mechanisms of action? A. Serotonin and norepinephrine reuptake inhibition B. Serotonin reuptake inhibition and serotonin 2A antagonism C. Serotonin reuptake inhibition and serotonin 1A partial agonism D. Serotonin and dopamine reuptake inhibition C. Serotonin reuptake inhibition and serotonin 1A partial agonism Serotonin reuptake inhibition and serotonin 1A partial agonism A 48-year-old patient with depression was recently started on 20 mg/day fluoxetine to combat his presenting symptoms of apathy, fatigue, problems concentrating, and hypersomnia. The patient reports that he is feeling much more energized and can see improvements in his cognition and attention within a day or two of starting fluoxetine. Which of the following properties of fluoxetine is theoretically most likely responsible for this patient's positive response? A. 5HT2C antagonism B. Norepinephrine reuptake inhibition C. Serotonin reuptake inhibition A. 5HT2C antagonism A 25-year-old patient with first-episode major depressive disorder is being prescribed an antidepressant. The time course for therapeutic effects of antidepressants correlates with: A. Increase in presynaptic neurotransmission B. Increase in postsynaptic neurotransmission C. Changes in receptor sensitivity C. Changes in receptor sensitivity 48. A 23-year-old female college student has gotten in significant trouble for her risky and impulsive behavior, stealing a fire extinguisher, driving on the common area lawn, and hostilely addressing a professor. Which of the following monoamine projections may account for her recent behavior? Projections to the: A. Amygdala B. Hypothalamus C. Prefrontal cortex D. Striatum C. Prefrontal cortex Which of the following statements regarding mood symptoms is true? A. Symptoms related to reduced positive affect are hypothetically linked to serotonergic (and noradrenergic) dysfunction C.B. Symptoms related to increased negative affect are hypothetically linked to dopaminergic (and noradrenergic) dysfunction C. Symptoms related to reduced positive affect are hypothetically linked to dopaminergic (and serotonergic) dysfunction D. Symptoms related to increased negative affect are hypothetically linked to serotonergic (and noradrenergic) dysfunction D. Symptoms related to increased negative affect are hypothetically linked to serotonergic (and noradrenergic) dysfunction A 19-year-old female requires a hospital consultation, after she was admitted following an attempted suicide. Her family reports that she has been suffering from severe depression for the last 3 years. What area of the brain may best be described as hypothetically involved in her feelings of worthlessness and suicidality? A. AmygdalaNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) B. Basal forebrain C. Hypothalamus D. Nucleus accumbens A. Amygdala mother whose daughter has just been diagnosed with major depressive disorder wants to know more about the underlying cause. Recent research largely supports the hypothesis that depression is due to a measurable deficiency of monoamines in the brain. A. True B. False B. False A 27-year-old male who has been treated with risperidone for the last eight weeks is now having his medication changed to quetiapine. What is the recommended switching method in this situation, assuming the need to do this expeditiously, but not urgently, as an outpatient? A. Maintain therapeutic dose of risperidone while uptitrating quetiapine to effective dose, then discontinue risperidone B. Down-titrate risperidone over several weeks while uptitrating quetiapine over the same time period C. Down-titrate risperidone over at least 1 week while uptitrating quetiapine over at least 2 weeks D. Down-titrate risperidone over at least 2 weeks while uptitrating quetiapine over 1 week C. Down-titrate risperidone over at least 1 week while uptitrating quetiapine over at least 2 weeks A 34-year-old patient with schizophrenia is not responding to a standard dose of an antipsychotic. Which of the following might you suspect? A. Dopamine 2 receptor occupancy less than 60% B. Dopamine 2 receptor occupancy less than 80% (60?80%) C. Dopamine 2 receptor occupancy less than 100% (80?100%) A . Dopamine 2 receptor occupancy less than 60% A 34-year-old man with schizophrenia has a history of side effects and/or partial response with antipsychotics, including agitation with ziprasidone, sedation with quetiapine, orthostatic hypotension with risperidone, and gastrointestinal problems with aripiprazole. His clinician elects to prescribe iloperidone and begins treatment according to the dosing schedule in the label. What is the rationale for the slow dosing schedule with iloperidone? A. Minimize agitation B. Minimize risk of EPS C. Prevent orthostatic hypotensionD. Prevent gastrointestinal upse C. Prevent orthostatic hypotension A patient with schizophrenia has been stabilized on medication but is complaining that he is so tired and sleepy all the time that he no longer wants to take it. Which of the following switching options might be the least likely to cause sedation? A. Aripiprazole B. Olanzapine C. Paliperidone D. Risperidone A. Aripiprazole A 26-year-old man is being prescribed an atypical antipsychotic for first- episode schizophrenia. What measures should be taken by the mental health professional prior to prescribing and during treatment with the antipsychotic? A. Blood pressure B. Blood pressure and body mass index (BMI)NR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) C. Blolod pressure, BMI, and fasting triglycerides D. Blood pressure, BMI, fasting triglycerides, and fasting gluco D. Blood pressure, BMI, fasting triglycerides, and fasting glucose A patient who has been taking an atypical antipsychotic for six months has experienced a 22-pound weight gain since baseline. Which of the following pharmacologic properties most likely underlies this patient's weight change? A. Serotonin 2A antagonism and serotonin 2C antagonism B. Serotonin 2C antagonism and histamine 1 antagonism C. Histamine 1 antagonism and dopamine 2 antagonism D. Dopamine 2 antagonism and serotonin 2A antagonism B. Serotonin 2C antagonism and histamine 1 antagonism 34. Dopamine 2 partial agonists cause receptor output that is less than that caused by dopamine but more than that caused by a conventional antipsychotic. A. True B. False A. True A 21-year-old man with first-episode psychosis is prescribed an antipsychotic that has serotonin 2A antagonism. According to a leading hypothesis, blockade of serotonin 2A receptors in the cortex can ultimately increase dopamine in the striatum through what initial mechanism? A. Decreased glutamate and thus increased GABA in the brainstem B. Decreased glutamate and thus decreased GABA in the brainstem C. Increased glutamate and thus decreased GABA in the brainstem D. Increased glutamate and thus increased GABA in the brainstem B. Decreased glutamate and thus decreased GABA in the brainstem 38-year-old woman was diagnosed with schizophrenia approximately two years ago and after multiple trials of different medications has been maintained on haloperidol for the last several months with good response. Two weeks ago she began exhibiting mild motor symptoms representative of parkinsonism. Which of the following would be the most appropriate adjunct medication for this patient? A. Alpha 1 adrenergic agonist B. Cholinesterase inhibitor C. Histamine 1 antagonist D. Muscarinic 1 antagonist D. Muscarinic 1 antagonist A 44-year-old male with schizophrenia has been taking anantipsychotic medication since initial diagnosis twelve years ago. He has recently begun experiencing difficulty with fluid movement of his arms as well as involuntary facial grimaces. Which of the following likely underlies these symptoms? A. Upregulation of serotonin 2A receptors B. Downregulation of serotonin 2A receptors C. Upregulation of dopamine 2 receptors D. Downregulation of dopamine 2 receptors C. Upregulation of dopamine 2 receptors Conventional antipsychotics may worsen negative symptoms, presumably through their actions in the: A. Mesolimbic pathwayNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) B. Mesolimbic and mesocortical pathways C. Mesolimbic, mesocortial, and nigrostrital pathways B. Mesolimbic and mesocortical pathways During cognitive challenges, individuals with schizophrenia demonstrate: A. Hypoactivation in the DLPFC B. Hyperactivation in the DLPFC C. Normal activation in the DLPFC D.A and B D. A and B D. A and B The activation of AMPA (alpha-amino-3-hydroxy-5-methyl-4- isoxazole- propionic acid) receptors requires the presence of: A. Glutamate only B. Glutamate and glycine C. Glutamate, glycine, and magnesium D. None of the above A. Glutamate only A leading hypothesis of schizophrenia is: A. Hyperfunctioning NMDA receptors B. Hypofunctioning NMDA receptors B. Hypofunctioning NMDA receptorsB. Hypofunctioning NMDA receptors The activation of N-methyl-d-aspartate (NMDA) receptors requires the presence of: A. Glutamate only . Glutamate and glycine C. Glutamate, glycine, and magnesium D. Glutamate and magnesium B. Glutamate and glycine Symptoms of schizophrenia are hypothetically attributable to malfunctioning in the: A. Mesolimbic and nigrostriatal pathways B. Nigrostriatal and tuberoinfundibular pathways C. Tuberoinfundibular and mesocortical pathways D. Mesocortical and mesolimbic pathways D. Mesocortical and mesolimbic pathways The alpha 2 delta subunit of voltage-sensitive calcium channels is believed to help regulate opening and closing of the voltagesensitive calcium channel. A. When voltage-sensitive sodium channels are open and activated, the flow of sodium is: A. Into the neuron B. Out of the neuron A. Into the neuron Which of the following is true? A. Positive allosteric modulation ispossible only in the presence of a neurotransmitter, while negative allosteric modulation is possible only in the absence of a neurotransmitter B. Negative allosteric modulation is possible only in the presence of a neurotransmitter, while positive allosteric modulation is possible only in the absence of a neurotransmitter C. Both positive and negative allosteric modulations are possible only in the absence of a neurotransmitter D. Both positive and negative allosteric modulations are possible only in the presence of a neurotransmitte D. Both positive and negative allosteric modulations are possible only in the presence of a neurotransmitte 18.NR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) receptor will stop responding to an agonist: A. When the agonist stops binding to itNR546 / NR 546 Actual Final Exam 2024 Prediction Questions (All correct answers, Already graded A) B. When the receptor becomes desensitized C. When the receptor becomes inactivated D. A and C E. A, B, and C E. A, B, and C receptor with four transmembrane regions changes conformation as GABA binds. Which system is this process describing? A. Presynaptic transporter B. Ligand-gated ion channel C. Voltage-sensitive ion chann B. Ligandgated ion channel A partial agonist has what effect on neurotransmission? A. Net agonism when neurotransmission is deficient B. Net antagonism when neurotransmission is excessive C. A and B D. Neither A nor BC. A and B Transport of monoamines requires energy, which is supplied by a: A. Calcium pump B. Potassium pump C. Sodium pump c. Sodium Pump In a G protein-linked signal transduction cascade, the second messenger can be synthesized: A. Intracellularly B. Extracellularly C. Either intra- or extracellularly A. Intracellularly An example of volume neurotransmission is: A. Dopamine in the prefrontal cortex B. Dopamine in the striatum C. Norepinephrine in the prefrontal cortex D. Norepinephrine in the striatum A. Dopamine in the prefrontal cortex Examples of neurotransmitters produced specifically as retrograde neurotransmitters (i.e., those that communicate from postsynaptic neuron to presynaptic neuron) include: A. GABA B. Galanin C. Histamine D. Nitric oxide D. Nitric oxide 29-year-old patient is morbidly obese and reports that he is "addicted to food". Hunger circuitry is connected to reward circuitry via dopaminergic projections from the hypothalamus to the nucleus accumbens. A. TrueB. False A. True