NR 606 MIDTERM EXAM – DIAGNOSIS
& MANAGEMENT IN PSYCHIATRIC
MENTAL HEALTH
1. Which neurotransmitter is the primary inhibitory signal in the central nervous system, and
which medication class primarily enhances its activity?
A. Glutamate; NMDA antagonists
B. Dopamine; Stimulants
C. GABA; Benzodiazepines
D. Norepinephrine; SNRIs
Answer: C
Conceptual Explanation: GABA (gamma-aminobutyric acid) is the major inhibitory
neurotransmitter. Benzodiazepines work by facilitating the binding of GABA to its
receptors, thereby increasing neuronal inhibition.
2. In the Mesolimbic pathway, an excess of which neurotransmitter is primarily associated
with the positive symptoms of Schizophrenia?
A. Serotonin
,B. Acetylcholine
C. Glutamate
D. Dopamine
Answer: D
Conceptual Explanation: Excessive dopamine activity in the mesolimbic pathway is linked
to positive symptoms like hallucinations and delusions, which is why D2 antagonists are
used for treatment.
3. A 24-year-old patient presents with a 2-week history of inflated self-esteem, decreased
need for sleep (3 hours), pressured speech, and racing thoughts. What is the most likely
diagnosis?
A. Bipolar I Disorder, Manic Episode
B. Major Depressive Disorder with psychotic features
C. Cyclothymic Disorder
D. Generalized Anxiety Disorder
Answer: A
Conceptual Explanation: A manic episode is defined by at least one week of abnormally
elevated mood and increased energy, accompanied by at least three symptoms like
decreased sleep, pressured speech, and grandiosity.
, 4. Which brain region is most critically involved in the regulation of fear and the ‘fight or
flight’ response, often overactive in PTSD?
A. Prefrontal Cortex
B. Amygdala
C. Hippocampus
D. Basal Ganglia
Answer: B
Conceptual Explanation: The amygdala is the emotional processing center of the brain
responsible for fear conditioning and the stress response.
5. Which side effect of Lamotrigine requires immediate discontinuation and emergency
medical evaluation?
A. Weight gain
B. Benign rash
C. Sedation
D. Stevens-Johnson Syndrome
Answer: D
Conceptual Explanation: Stevens-Johnson Syndrome (SJS) is a rare but life-threatening
dermatological reaction associated with Lamotrigine that requires immediate medical
attention.
& MANAGEMENT IN PSYCHIATRIC
MENTAL HEALTH
1. Which neurotransmitter is the primary inhibitory signal in the central nervous system, and
which medication class primarily enhances its activity?
A. Glutamate; NMDA antagonists
B. Dopamine; Stimulants
C. GABA; Benzodiazepines
D. Norepinephrine; SNRIs
Answer: C
Conceptual Explanation: GABA (gamma-aminobutyric acid) is the major inhibitory
neurotransmitter. Benzodiazepines work by facilitating the binding of GABA to its
receptors, thereby increasing neuronal inhibition.
2. In the Mesolimbic pathway, an excess of which neurotransmitter is primarily associated
with the positive symptoms of Schizophrenia?
A. Serotonin
,B. Acetylcholine
C. Glutamate
D. Dopamine
Answer: D
Conceptual Explanation: Excessive dopamine activity in the mesolimbic pathway is linked
to positive symptoms like hallucinations and delusions, which is why D2 antagonists are
used for treatment.
3. A 24-year-old patient presents with a 2-week history of inflated self-esteem, decreased
need for sleep (3 hours), pressured speech, and racing thoughts. What is the most likely
diagnosis?
A. Bipolar I Disorder, Manic Episode
B. Major Depressive Disorder with psychotic features
C. Cyclothymic Disorder
D. Generalized Anxiety Disorder
Answer: A
Conceptual Explanation: A manic episode is defined by at least one week of abnormally
elevated mood and increased energy, accompanied by at least three symptoms like
decreased sleep, pressured speech, and grandiosity.
, 4. Which brain region is most critically involved in the regulation of fear and the ‘fight or
flight’ response, often overactive in PTSD?
A. Prefrontal Cortex
B. Amygdala
C. Hippocampus
D. Basal Ganglia
Answer: B
Conceptual Explanation: The amygdala is the emotional processing center of the brain
responsible for fear conditioning and the stress response.
5. Which side effect of Lamotrigine requires immediate discontinuation and emergency
medical evaluation?
A. Weight gain
B. Benign rash
C. Sedation
D. Stevens-Johnson Syndrome
Answer: D
Conceptual Explanation: Stevens-Johnson Syndrome (SJS) is a rare but life-threatening
dermatological reaction associated with Lamotrigine that requires immediate medical
attention.
