NR 546 Advanced Pathophysiology Comprehensive Final Exam Review |
Questions, Answers & Rationales
1. Which dopamine pathway is primarily implicated in the hyperactive
transmission responsible for the positive symptoms of schizophrenia,
such as hallucinations and delusions?
A) Nigrostriatal pathway
B) Mesolimbic pathway
C) Mesocortical pathway
D) Tuberoinfundibular pathway
Correct Answer: B
Rationale: The mesolimbic pathway projects from the ventral tegmental
area (VTA) to the nucleus accumbens and is heavily involved in reward,
pleasure, and the positive symptoms of psychosis when hyperactive.
2. Which amino acid acts as the primary inhibitory neurotransmitter in
the central nervous system, reducing neuronal excitability?
A) Glutamate
B) Serotonin
C) GABA
D) Norepinephrine
Correct Answer: C
,Rationale: Gamma-aminobutyric acid (GABA) is the chief inhibitory
neurotransmitter, decreasing neuroexcitability across the brain to help
regulate relaxation and stress response.
3 What is the primary mechanism of action of selective serotonin
reuptake inhibitors (SSRIs)?
A) Inhibition of monoamine oxidase enzymes
B) Blockage of dopamine D2 receptors
C) Selective inhibition of presynaptic serotonin reuptake pumps
D) Dual reuptake inhibition of serotonin and norepinephrine
Correct Answer: C
Rationale: SSRIs selectively block the serotonin transporter (SERT),
preventing the reuptake of serotonin into the presynaptic neuron and
increasing its availability in the synaptic cleft.
4 Which SSRI is known for having the longest elimination half-life and
possessing an active metabolite (norfluoxetine), making it advantageous
for patients with compliance concerns?
A) Paroxetine
B) Sertraline
C) Citalopram
D) Fluoxetine
Correct Answer: D
,Rationale: Fluoxetine (Prozac) has a half-life of 1 to 3 days, and its active
metabolite norfluoxetine has a half-life of 7 to 15 days, which lowers the
risk of discontinuation syndrome.
5 Blockade of dopamine receptors within which specific pathway leads
to extrapyramidal symptoms (EPS) such as akathisia, dystonia, and
parkinsonism?
A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mesocortical pathway
D) Tuberoinfundibular pathway
Correct Answer: B
Rationale: The nigrostriatal pathway projects from the substantia nigra
to the basal ganglia and controls motor function. D2 receptor blockade
here leads to EPS.
6 Which medication category is considered a first-line mood stabilizer
for the treatment of acute mania and maintenance therapy in Bipolar I
Disorder?
A) Benzodiazepines
B) Lithium
C) Typical antipsychotics
D) Monoamine oxidase inhibitors
Correct Answer: B
, Rationale: Lithium remains a cornerstone first-line treatment for bipolar
disorder, effective in treating acute mania, preventing recurrent manic
and depressive episodes, and reducing suicide risk.
7 Which brain structure, located deep within the temporal lobe, plays a
critical role in emotional regulation, fear conditioning, and the
formation of the acute stress response?
A) Thalamus
B) Amygdala
C) Cerebellum
D) Basal ganglia
Correct Answer: B
Rationale: The amygdala processes emotional significance and is
heavily implicated in fear responses, anxiety disorders, and activation of
the hypothalamic-pituitary-adrenal (HPA) axis.
8 When comparing Serotonin-Norepinephrine Reuptake Inhibitors
(SNRIs) to SSRIs, what unique adverse effect profile is most
characteristic of SNRIs due to norepinephrine reuptake inhibition?
A) Hypoglycemia and weight loss
B) Elevated blood pressure and increased heart rate
C) Severe bradycardia and hypotension
D) Profound respiratory depression
Correct Answer: B
Questions, Answers & Rationales
1. Which dopamine pathway is primarily implicated in the hyperactive
transmission responsible for the positive symptoms of schizophrenia,
such as hallucinations and delusions?
A) Nigrostriatal pathway
B) Mesolimbic pathway
C) Mesocortical pathway
D) Tuberoinfundibular pathway
Correct Answer: B
Rationale: The mesolimbic pathway projects from the ventral tegmental
area (VTA) to the nucleus accumbens and is heavily involved in reward,
pleasure, and the positive symptoms of psychosis when hyperactive.
2. Which amino acid acts as the primary inhibitory neurotransmitter in
the central nervous system, reducing neuronal excitability?
A) Glutamate
B) Serotonin
C) GABA
D) Norepinephrine
Correct Answer: C
,Rationale: Gamma-aminobutyric acid (GABA) is the chief inhibitory
neurotransmitter, decreasing neuroexcitability across the brain to help
regulate relaxation and stress response.
3 What is the primary mechanism of action of selective serotonin
reuptake inhibitors (SSRIs)?
A) Inhibition of monoamine oxidase enzymes
B) Blockage of dopamine D2 receptors
C) Selective inhibition of presynaptic serotonin reuptake pumps
D) Dual reuptake inhibition of serotonin and norepinephrine
Correct Answer: C
Rationale: SSRIs selectively block the serotonin transporter (SERT),
preventing the reuptake of serotonin into the presynaptic neuron and
increasing its availability in the synaptic cleft.
4 Which SSRI is known for having the longest elimination half-life and
possessing an active metabolite (norfluoxetine), making it advantageous
for patients with compliance concerns?
A) Paroxetine
B) Sertraline
C) Citalopram
D) Fluoxetine
Correct Answer: D
,Rationale: Fluoxetine (Prozac) has a half-life of 1 to 3 days, and its active
metabolite norfluoxetine has a half-life of 7 to 15 days, which lowers the
risk of discontinuation syndrome.
5 Blockade of dopamine receptors within which specific pathway leads
to extrapyramidal symptoms (EPS) such as akathisia, dystonia, and
parkinsonism?
A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mesocortical pathway
D) Tuberoinfundibular pathway
Correct Answer: B
Rationale: The nigrostriatal pathway projects from the substantia nigra
to the basal ganglia and controls motor function. D2 receptor blockade
here leads to EPS.
6 Which medication category is considered a first-line mood stabilizer
for the treatment of acute mania and maintenance therapy in Bipolar I
Disorder?
A) Benzodiazepines
B) Lithium
C) Typical antipsychotics
D) Monoamine oxidase inhibitors
Correct Answer: B
, Rationale: Lithium remains a cornerstone first-line treatment for bipolar
disorder, effective in treating acute mania, preventing recurrent manic
and depressive episodes, and reducing suicide risk.
7 Which brain structure, located deep within the temporal lobe, plays a
critical role in emotional regulation, fear conditioning, and the
formation of the acute stress response?
A) Thalamus
B) Amygdala
C) Cerebellum
D) Basal ganglia
Correct Answer: B
Rationale: The amygdala processes emotional significance and is
heavily implicated in fear responses, anxiety disorders, and activation of
the hypothalamic-pituitary-adrenal (HPA) axis.
8 When comparing Serotonin-Norepinephrine Reuptake Inhibitors
(SNRIs) to SSRIs, what unique adverse effect profile is most
characteristic of SNRIs due to norepinephrine reuptake inhibition?
A) Hypoglycemia and weight loss
B) Elevated blood pressure and increased heart rate
C) Severe bradycardia and hypotension
D) Profound respiratory depression
Correct Answer: B
