NR546 ADVANCED
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. Which SSRI is uniquely identified by its 5-HT2C antagonistic properties, which may lead to
an energizing effect?
A. Paroxetine
B. Fluvoxamine
C. Sertraline
D. Fluoxetine
Answer: D
Conceptual Explanation: Fluoxetine is the only SSRI that also acts as a 5-HT2C antagonist,
which can increase dopamine and norepinephrine levels in the prefrontal cortex, often
providing an activating effect.
,2. A patient taking Lithium for Bipolar I Disorder presents with coarse tremors, ataxia, and
confusion. What is the most likely serum lithium level?
A. 0.6 mEq/L
B. 2.0 mEq/L
C. 1.2 mEq/L
D. 0.9 mEq/L
Answer: B
Conceptual Explanation: Coarse tremors, ataxia, and confusion are signs of moderate to
severe lithium toxicity, typically occurring at levels above 1.5 to 2.0 mEq/L.
3. Which mechanism of action distinguishes Second-Generation Antipsychotics (SGAs) from
First-Generation Antipsychotics (FGAs)?
A. 5-HT2A receptor antagonism and D2 antagonism
B. D2 receptor antagonism only
C. GABA-A receptor modulation
D. NMDA receptor antagonism
Answer: A
Conceptual Explanation: SGAs are characterized by their ability to block both D2 and 5-
HT2A receptors, which helps mitigate Extrapyramidal Symptoms (EPS) compared to FGAs.
, 4. To minimize the risk of Stevens-Johnson Syndrome (SJS) when starting Lamotrigine, what is
the standard titration protocol?
A. Start at 100mg daily
B. Start at 25mg every other day
C. Start at 50mg daily for one week
D. Start at 25mg daily for two weeks
Answer: D
Conceptual Explanation: Lamotrigine must be started at 25mg daily for the first two
weeks to reduce the risk of life-threatening rashes like SJS.
5. Which antidepressant is contraindicated in patients with a history of bulimia or seizure
disorders?
A. Vortioxetine
B. Mirtazapine
C. Duloxetine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with eating disorders due to potential electrolyte imbalances.
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. Which SSRI is uniquely identified by its 5-HT2C antagonistic properties, which may lead to
an energizing effect?
A. Paroxetine
B. Fluvoxamine
C. Sertraline
D. Fluoxetine
Answer: D
Conceptual Explanation: Fluoxetine is the only SSRI that also acts as a 5-HT2C antagonist,
which can increase dopamine and norepinephrine levels in the prefrontal cortex, often
providing an activating effect.
,2. A patient taking Lithium for Bipolar I Disorder presents with coarse tremors, ataxia, and
confusion. What is the most likely serum lithium level?
A. 0.6 mEq/L
B. 2.0 mEq/L
C. 1.2 mEq/L
D. 0.9 mEq/L
Answer: B
Conceptual Explanation: Coarse tremors, ataxia, and confusion are signs of moderate to
severe lithium toxicity, typically occurring at levels above 1.5 to 2.0 mEq/L.
3. Which mechanism of action distinguishes Second-Generation Antipsychotics (SGAs) from
First-Generation Antipsychotics (FGAs)?
A. 5-HT2A receptor antagonism and D2 antagonism
B. D2 receptor antagonism only
C. GABA-A receptor modulation
D. NMDA receptor antagonism
Answer: A
Conceptual Explanation: SGAs are characterized by their ability to block both D2 and 5-
HT2A receptors, which helps mitigate Extrapyramidal Symptoms (EPS) compared to FGAs.
, 4. To minimize the risk of Stevens-Johnson Syndrome (SJS) when starting Lamotrigine, what is
the standard titration protocol?
A. Start at 100mg daily
B. Start at 25mg every other day
C. Start at 50mg daily for one week
D. Start at 25mg daily for two weeks
Answer: D
Conceptual Explanation: Lamotrigine must be started at 25mg daily for the first two
weeks to reduce the risk of life-threatening rashes like SJS.
5. Which antidepressant is contraindicated in patients with a history of bulimia or seizure
disorders?
A. Vortioxetine
B. Mirtazapine
C. Duloxetine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with eating disorders due to potential electrolyte imbalances.
