MSN 571 FINAL COMPREHENSIVE EXAM
PREP QUESTIONS AND SOLUTIONS
VERIFIED STUDY RESOURCE
●● How do stimulants vs. non-stimulants differ in their mechanism of
transport into neurons?
Answer: Stimulants typically block the reuptake of DA and NE or
promote their release via transporters, while non-stimulants selectively
inhibit the reuptake of NE.
●● What is a preferred ADHD treatment option for a patient with a
history of substance use?
Answer: Non-stimulants such as Atomoxetine or Alpha-2 agonists
(Guanfacine, Clonidine) are preferred due to no abuse potential.
●● What causes the adverse effects (EPS/Tardive Dyskinesia) associated
with First-Generation Antipsychotics (FGAs)?
Answer: High-affinity D2 blockade in the nigrostriatal pathway.
●● What are the cardinal signs of Neuroleptic Malignant Syndrome
(NMS)?
Answer: Lead-pipe muscle rigidity, high fever (hyperpyrexia),
autonomic instability, and altered mental status.
,●● Which screening labs are essential before initiating and during
antipsychotic treatment?
Answer: Fasting glucose/A1C, lipid panel, and weight/BMI.
●● Why do Tricyclic Antidepressants (TCAs) have a higher risk of
overdose compared to newer SSRIs?
Answer: TCAs are cardiotoxic in overdose due to sodium channel
blockade, leading to QTc prolongation, arrhythmias, and seizures.
●● What is the mechanism of action for NDRIs like Bupropion?
Answer: Inhibition of the reuptake of Norepinephrine and Dopamine.
●● What is the strict protocol for switching from an SSRI to an MAOI?
Answer: A washout period (usually 2 weeks; 5 weeks for Fluoxetine) is
required to avoid Serotonin Syndrome.
●● What is 'California Rocket Fuel'?
Answer: A combination of Mirtazapine (Alpha-2 antagonist) and
Venlafaxine (SNRI) used for treatment-resistant depression.
●● What labs must be monitored for a patient on Lithium?
Answer: Lithium therapeutic levels (0.6-1.2 mEq/L), Thyroid function
(TSH), and Renal function (BUN/Creatinine).
, ●● What are the risks of discontinuing mood stabilizers abruptly?
Answer: High risk of relapse into a manic or depressive episode and,
specifically with anticonvulsants like Valproate, a risk of seizures.
●● How do Benzodiazepines affect neurotransmission?
Answer: They act as Positive Allosteric Modulators (PAMs) at the
GABA-A receptor, increasing the frequency of chloride channel opening
to enhance inhibitory effects.
●● What is the mechanism of action of Donepezil (Aricept)?
Answer: It is a Cholinesterase Inhibitor, which increases the availability
of Acetylcholine in the synaptic cleft to improve cognitive function in
dementia.
●● What is the neurotransmitter basis for cocaine withdrawal?
Answer: A crash or depletion of Dopamine stores following the chronic
overstimulation of the reward system.
●● What is the difference between Buprenorphine and Suboxone?
Answer: Buprenorphine is a partial opioid agonist; Suboxone adds
Naloxone to prevent misuse by triggering withdrawal if injected.
●● Which medication is used for Alcohol Use Disorder to discourage
drinking by causing physical illness?
PREP QUESTIONS AND SOLUTIONS
VERIFIED STUDY RESOURCE
●● How do stimulants vs. non-stimulants differ in their mechanism of
transport into neurons?
Answer: Stimulants typically block the reuptake of DA and NE or
promote their release via transporters, while non-stimulants selectively
inhibit the reuptake of NE.
●● What is a preferred ADHD treatment option for a patient with a
history of substance use?
Answer: Non-stimulants such as Atomoxetine or Alpha-2 agonists
(Guanfacine, Clonidine) are preferred due to no abuse potential.
●● What causes the adverse effects (EPS/Tardive Dyskinesia) associated
with First-Generation Antipsychotics (FGAs)?
Answer: High-affinity D2 blockade in the nigrostriatal pathway.
●● What are the cardinal signs of Neuroleptic Malignant Syndrome
(NMS)?
Answer: Lead-pipe muscle rigidity, high fever (hyperpyrexia),
autonomic instability, and altered mental status.
,●● Which screening labs are essential before initiating and during
antipsychotic treatment?
Answer: Fasting glucose/A1C, lipid panel, and weight/BMI.
●● Why do Tricyclic Antidepressants (TCAs) have a higher risk of
overdose compared to newer SSRIs?
Answer: TCAs are cardiotoxic in overdose due to sodium channel
blockade, leading to QTc prolongation, arrhythmias, and seizures.
●● What is the mechanism of action for NDRIs like Bupropion?
Answer: Inhibition of the reuptake of Norepinephrine and Dopamine.
●● What is the strict protocol for switching from an SSRI to an MAOI?
Answer: A washout period (usually 2 weeks; 5 weeks for Fluoxetine) is
required to avoid Serotonin Syndrome.
●● What is 'California Rocket Fuel'?
Answer: A combination of Mirtazapine (Alpha-2 antagonist) and
Venlafaxine (SNRI) used for treatment-resistant depression.
●● What labs must be monitored for a patient on Lithium?
Answer: Lithium therapeutic levels (0.6-1.2 mEq/L), Thyroid function
(TSH), and Renal function (BUN/Creatinine).
, ●● What are the risks of discontinuing mood stabilizers abruptly?
Answer: High risk of relapse into a manic or depressive episode and,
specifically with anticonvulsants like Valproate, a risk of seizures.
●● How do Benzodiazepines affect neurotransmission?
Answer: They act as Positive Allosteric Modulators (PAMs) at the
GABA-A receptor, increasing the frequency of chloride channel opening
to enhance inhibitory effects.
●● What is the mechanism of action of Donepezil (Aricept)?
Answer: It is a Cholinesterase Inhibitor, which increases the availability
of Acetylcholine in the synaptic cleft to improve cognitive function in
dementia.
●● What is the neurotransmitter basis for cocaine withdrawal?
Answer: A crash or depletion of Dopamine stores following the chronic
overstimulation of the reward system.
●● What is the difference between Buprenorphine and Suboxone?
Answer: Buprenorphine is a partial opioid agonist; Suboxone adds
Naloxone to prevent misuse by triggering withdrawal if injected.
●● Which medication is used for Alcohol Use Disorder to discourage
drinking by causing physical illness?
