Psychopharmacology Final Exam.
Psychopharmacology Final Exam.
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FINAL EXAM
PSY 87700:
Psychopharmacology
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1) Which of the following medical conditions is not typically associated with depression?
a. AIDS
b. Diabetes
c. Gout
d. Cushing’s Disease
2) A symptom which is found in clinical depression but not in grief is:
a. Intense sadness
b. Sleep disturbance
c. Crying
d. Loss of self-esteem
3) Uncomplicated bereavement is best reduced by
a. Antidepressant medication
b. Psychoanalytic psychotherapy
c. Mourning and the passage of time
d. Antianxiety medication
4) Some symptoms are common to all depressions, whereas others indicate a biochemical dysfunction which may be responsive to antidepressants. Which one of the following symptoms is not uniquely associated with biochemical depression?
a. Appetite Disturbance
b. Sleep disturbance
c. Reduced Libido
d. Suicidal Ideas
5) A patient on an antidepressant complains of dry mouth, blurred vision, constipation, and trouble urinating. These symptoms are most likely:
a. Symptoms of depression
b. Anticholinergic side effects
c. Hypochondriacal complaints
d. Due to inactivity
6) When under treatment with an MAO inhibitor, one should avoid:
a. Red meat
b. Pea Soup
c. Aged cheese
d. Jello
7) A patient is taking Prozac for depression and is not responding. His physician asks you if you think augmentation with Parnate would be a good idea. You should tell the physician:
a. This is a sensible treatment approach
b. No — this combination could be fatal
c. The combination is harmless, but probably won’t reduce depression
d. Combining these two medications will probably increase depression
8) A depressed patient has a history of sexual dysfunction, and fears that anti-depressants will make his problem worse. You would prescribe:
a. buproprion
b. desipramine
c. imipramine
d. doxepin
9) Which one of the following is not likely to be a cause of depression?
a. Antihypertensives
b. Antibiotics
c. Antiparkinson drugs
d. Birth control pills
10) A depressed patient has been taking adequate doses of an SSRI for ten days and complains to you that she has felt no improvement. You would advise this patient:
a. That she needs to stay on the medication longer before she feels Improvement
b. To ask her physician to try a new medication
c. To discontinue her medication
d. To take St. John’s Wort along with her medication
11) Medications which should be initially considered for Generalized Anxiety Disorder include:
a. benzodiazepines and SSRIs
b. buspirone and lithium
c. buspirone, Effexor, and SSRIs
d. Valium, Librium, and Xanax
12) Classes of medications typically used for treating anxiety disorders include:
a. SSRIs
b. Benzodiazepines
c. MAO inhibitors
d. All of the above
13) Stress induced insomnia is typically treated with short-term:
a. SSRIs
b. Benzodiazepines
c. MAO inhibitors
d. Neuroleptics
14) Beta blockers control which anxiety-related symptoms?
a. Sense of dread
b. Anxiety-evoking cognitions
c. Rapid heartbeat
d. Concentration difficulties
15) The two phases of treating panic disorder are:
a. Reducing panic intensity with medication or relaxation; exposure to feared situations
b. Benzodiazepine treatment; SSRI treatment
c. Immobilization; Reactivation
d. Antidepressant medication; antianxiety medication
16) Medication used for social phobia is usually:
a. MAOIs or beta blockers
b. Benzodiazepines
c. Haldol
d. Amphetamines in low doses
17) Which of the following is probably not a biochemical cause of anxiety?
a. High levels of caffeine consumption
b. Heavy use of aspirin
c. Alcohol withdrawal
d. Steroid use
18) A patient has a history of frequently engaging in risky and self-defeating behaviors which produce anxiety. The treatment of choice would be:
a. Long-term benzodiazepines
b. Xanax
c. Psychotherapy
d. PRN benzodiazepines
19)Serotonin levels are increased by:
a. SSRIs
b. Benzodiazepines
c. Antipsychotic drugs
d. Desipramine
20) Medical causes of anxiety symptoms include:
a. Hyperthyroidism
b. Adrenal tumor
c. Hypoglycemia
d. Any of the above
21) A schizophrenic patient taking antipsychotic medication is extremely restless, unable to sit still. This probably is:
a. An attention deficit disorder
b. A medication side effect
c. A reaction to delusional thoughts
d. A primary symptom of psychosis
22) A patient has been on antipsychotic medication for the past ten years. He shows odd lip, tongue, and extremity movement. This is probably:
a. Tardive dyskinesia
b. A response to hallucinations
c. A compulsive ritual
d. Seizure activity
23) A patient on antipsychotic medication presents with her head twisted to one side. The likely treatment would be:
a. Hypnosis and relaxation
b. An IM anticholinergic agent
c. Antispasmodic drugs
d. Discontinuing all medication
24) If a sedating effect is desired when treating a psychotic patient with antipsychotic drugs, one would most likely use:
a. A high potency antipsychotic
b. A low potency antipsychotic
c. Augmentation with a benzodiazepine
d. Q.i.d. dosing
25) An advantage of newer antipsychotic drugs such as clozapine over traditional antipsychotics is:
a. Reduced risk of agranulocytosis
b. Better control of positive psychotic symptoms
c. Better control of negative psychotic symptoms
d. Antidepressant effects
26) Which of the following antipsychotic medications is least likely to cause weight gain?
a. Abilify
b. Haldol
c. Risperdal
d. Stelazine
27) Dementias can be differentiated from schizophrenia in the following way: Psychopharmacology Final Exam.
a. In schizophrenia, orientation and short-term memory is relatively intact
b. In dementias, orientation and short-term memory is relatively intact
c. Early morning awakening is more likely to be seen in schizophrenic patients
d. Late evening confusion is more likely to be seen in schizophrenic patients Psychopharmacology Final Exam.
28) A dose of 1000 mg. of Thorazine has the equivalent antipsychotic effect as what dose of Zyprexa?
a. 3 mg.
b. 20 mg.
c. 500 mg
d. 1000 mg
29) The first schizophrenic symptoms to respond to antipsychotic medication are:
a. Hallucinations
b. Delusions
c. Agitation
d. Poor reality testing
30) In treatment of a psychotic depression:
a. Both an antipsychotic and antidepressant might be used
b. The prescriber would always choose between an antipsychotic and antidepressant; these two types of medication would not be combined
c. The treatment would always be only an antidepressant
d. The treatment would always be only an antipsychotic
31) In the treatment of Bipolar Disorder, a combination of antipsychotic medication and lithium would most likely be used when the patient:
a. presents in a depressed phase
b. is suicidal
c. presents in a manic episode
d. is Bipolar ll
32) In the treatment of Bipolar Disorder, a combination of bupropion and lithium would most likely be used when the patient:
a. presents in a depressed phase
b. presents in a manic episode
c. is Bipolar I
d. these two medications should never be combined
33) A patient on lithium presents with lethargy, nausea, slurred speech, and complains that she hears a ringing in her ears. You would suspect:
a. That she is experiencing a psychotic depression
b. Lithium toxicity
c. Alcohol abuse
d. That she has not been taking her lithium
34) Blood tests are frequently done with bipolar patients before initiating lithium treatment. The reason for this is:
a. Determine if a lithium deficiency is present
b. To determine kidney function is adequate
c. Differentiate bipolar illness from major depression
d. Differentiate Bipolar I from Bipolar II
35) Bipolar I disorder, compared to Bipolar II has:
a. Manic episodes which are more pronounced
b. Manic episodes which are less pronounced
c. No depressive episodes
d. Has depressive and manic episodes which are more pronounced
36) Rapid cycling bipolar patients are often treated with:
a. Anticonvulsants
b. MAOI medication
c. Benzodiazepines
d. Stimulants
37) A man is brought in by his wife, who notes that he has not slept in two days. He presents with rapid, pressured speech, racing thoughts, grandiose plans, and euphoria. The least likely diagnosis is:
a. Methamphetamine intoxication
b. Manic phase of bipolar illness
c. Encephalitis
d. Anxiety disorder
38) A typical therapeutic blood level of lithium is:
a. 0.5 mEq/L
b. 1.2 mEq/L
c. 3.0 mEq/L
d. 600 mEq/L
39) When symptoms of depression and mania occur simultaneously, this is called:
a. Dysphoric mania
b. Delirium
c. Ataxia
d. Cognitive dissonance
40) The medications other than lithium which are used as mood stabilizers are in which class of drugs?
a. Antidepressant
b. Antiviral
c. Anticonvulsant
d. Neuroleptic
41) Medications used to treat obsessive-compulsive disorders are:
a. Antidepressants which increase serotonin availability
b. Antidepressants which increase norepinephrine availability
c. Anxiolytics
d. Neuroleptics
42) The classic medical treatment for ADD is:
a. Stimulants
b. ECT
c. Sedatives
d. Barbiturates
43) Pharmacokinetics refers to:
a. Absorption, Distribution, Biotransformation, Excretion
b. Regulation of neurotransmitters
c. Manufacture and purification of medications
d. The physical properties of a medication (pill, capsule, liquid, etc.)
44) The first pass effect can be circumvented by administering a drug:
a. Orally
b. t.i.d.
c. IV
d. At bedtime
45) A prodrug is a
a. Drug which activates another drug
b. A relatively inactive compound which is metabolized into a more active form
c. Vitamin
d. Certain drugs taken by professional athletes to improve performance
46) Steady state refers to
a. Stabilization of psychiatric symptoms
b. A form of a drug which can be stored for long periods without a loss of potency
c. The point at which administration and elimination of a drug are in equilibrium
d. A drug isotope which is not radioactive
47) With regular dosing of a drug with a half-life of 12 hours, steady state would be reached in about:
a. 12 hrs.
b. 24 hrs.
c. 2 1/2 days
d. 30 days
48) Drug X produces a therapeutic response in 50% of patients at a dose of 50 mg. It is lethal in 50% of patients at a dose of 400 mg. The Therapeutic Index for this drug is:
a. 0.125
b. 4
c 8
d 16
49) The insulation covering nerve fibers is the
a. Myelin sheath
b. Neuronal channel
c. Calcium channel
d. Lipid layer
50) In a neuron at rest
a. The electrical potential of the immediate interior and exterior of the neuronal membrane is equal
b. The electrical potential of the immediate interior of the neuronal membrane is negative relative to the exterior
c. The electrical potential of the immediate interior of the neuronal membrane is positive relative to the exterior
d. There is no electrical potential
51) The body’s main inhibitory neurotransmitter/neuromodulator is:
a. glutamate
b. L-dopa
c. GABA
d. tryptophan
52) Which of the following are found in the soma?
a. Terminal button and axon.
b. The dendrites and the terminal buttons
c. The axon and the dendrites
d. The nucleus and the mitochondria.
53) Which of these is the correct progression of events?
a. Action potential, exocytosis, re-uptake.
b. Exocytosis, action potential, re-uptake.
c. Re-uptake, action potential, exocytosis.
d. None of these.
54) The physical space between neurons is called:
a. the intracellular space
b. the extracellular space
c. the cytoplasm
d. the synapse
55) GABA is the body’s main inhibitory neurotransmitter substance, and ___________ is the excitatory substance.
a. tryptophan
b. calcium phosphate
c. glutamate
d. none of these
56) A non-medical psychotherapist says that she has focused her training exclusively on psychotherapeutic intervention. She says that she has intentionally not learned about psychopharmacology so that she can avoid liability for medication issues. You would respond to her by suggesting:
a. That her stance is reasonable
b. That this is not an effective strategy for avoiding liability
c. That her stance is only reasonable if she discloses to her clients that she has no knowledge of psychopharmacology
d. That she is on safe ground if she says “talk to your doctor” whenever a medication issue is raised or noticed
57) Excessive amounts of ________ may be implicated in psychosis.
a. serotonin
b. norepinephrine
c. GABA
d. dopamine
58) When the client focuses on medication issues throughout the therapeutic session, to the exclusion of focus on inner thoughts and feelings, this may be seen as a form of therapeutic:
a. Resistance
b. Insight
c. Hysteria
d. Sociopathy
59) Dopamine, norepinephrine, and serotonin are all types of:
a. Neurotransmitters
b. Medications
c. Neurons
d. Hormones
60) The terminal bouton in a neuron is a:
a. Long fiber
b. Post-synaptic structure
c. Pre-synaptic structure
d. Neurochemical
61) Patients with an obsessive-compulsive personality style might be expected to respond to a prescription for psychotropic medication in the following way:
a. Insist on detailed information about the medication and its side effects
b. Discuss even minor side effects in great detail
c. Bring up issues around loss-of-control due to medication effects or side effects
d. Any of the above
62) Tiny containers for neurotransmitters are found in the terminal bouton and protect the neurotransmitters from enzymes. These containers are called:
a. Corpuscles
b. Micro-boutons
c. Axons
d. Vesicles
63) Second Messengers are:
a. Extracellular signaling substances
b. Intracellular signaling molecules that trigger physiological changes
c. Medications that activate neural transmission
d. A way to transmit a prescription to a pharmacy
64) Heart rate, breathing and blood pressure are regulated by the:
a. Limbic system
b. Cortex
c. Basal ganglia
d. Brain stem
65) The part of the brain associated with procedural learning, such as riding a bicycle, is the:
a. Limbic system
b. Cerebellum
c. Amygdala
d. Brain stem
66) Digestion, decreased heart rate, and muscle relaxation is associated with the:
a. Sympathetic nervous system
b. Somatic nervous system
c. Spinal cord
d. Parasympathetic nervous system
67) The study of how a patient’s body absorbs, distributes, modifies and excretes a drug is known as:
a. Pharmacodynamics
b. Physiological processing
c. Metabolism
d. Pharmacokinetics
68) Which of the following diseases/disorders has been known to cause or worsen depression?
a. Alzheimer’s
b. Congestive heart failure
c. Fibromyalgia
d. All of the above
69) A person’s body using enzymes to chemically convert medication to other substances is an example of:
a. Excretion
b. Absorption
c. Reduction
d. Metabolism
70) The kidney is an organ of:
a. Metabolism
b. Absorption
c. Digestion
d. Excretion
71) Which of the following describes a drug interaction?
a. One drug increases the effect of another
b. One drug cancels the effect of another
c. Two drugs, taken at therapeutic doses, become lethal when combined
d. Any of the above
72) A medication that binds to a serotonin receptor and imitates the effect of serotonin is a(n):
a. Agnostic
b. Antagonist
c. Pathomimetic drug
d. Agonist
73) You are working with a patient with OCD. Which of the following medications is not considered an anti-obsessive?
a. Prozac
b. Anafranil
c. Wellbutrin
d. Luvox
74) “Serotonin syndrome” includes all of the following symptoms except:
a. slow heart rate
b. fever
c. muscle rigidity
d. hypertension
75) A typical daily dose of Prozac or Paxil is:
a. 2-4 mg.
b. 20-40 mg.
c. 75-100 mg.
d. 200-300 mg.
76) Which of the following benzodiazepines is often used for its mood-stabilizing properties?
a. Xanax
b. Ativan
c. Klonopin
d. All of the above
77) A patient presents with high levels of anxiety of recent origin. Your first diagnostic step would be to:
a. Develop a thorough understanding of his personality structure
b. Distinguish between various anxiety diagnoses: panic disorder, phobia, GAD, etc.
c. Rule out non-psychiatric medical causes
d. Interview significant family members to develop a full picture of the client
78) Typical two-drug combinations for Bipolar Illness include:
a. An SSRI plus an MAOI
b. An SSRI plus a neuroleptic
c. Lithium plus an anticonvulsant
d. All of the above
79) Which of the following is approved primarily for Generalized Anxiety Disorder?
a. Buspar
b. Ativan
c. Xanax
d. None of these
80) In treating Social Anxiety Disorder, the best results are achieved with:
a. TCAs
b. Atypical Antipsychotics
c. SSRIs or MAOIs
d. None of these
81) For spot treating specific social phobias like public speaking, one may consider:
a. Buspar
b. Klonopin
c. Prozac
d. Inderal
82) All of the following EXCEPT ______ are typically used to treat PTSD symptoms.
a. SSRIs
b. Effexor
c. Mood stabilizers
d. Stimulants
83) A patient comes to you, reporting that he started seeing “ghosts” a few days ago. He realizes the experience is abnormal, he has never had odd experiences like this before, and has not had any recent stresses that he can think of. You would:
a. Work on improving his insight
b. Suspect schizophrenia and refer him for antipsychotic medication
c. Suggest he ignore the ghosts and get on with his life
d. Suspect a non-psychiatric medical problem and refer him for medical evaluation
84) All of the following are atypical antipsychotics except:
a. Zyprexa
b. Fanapt
c. Abilify
d. Navane
85) Which of the following is a vegetative depressive symptom?
a. Feeling sad
b. Low self-esteem
c. Obsessional thinking
d. Weight loss and anorexia
86) How can you distinguish Major Depression with Psychotic Features from Schizoaffective Disorder?
a. The distinction is based upon clinical judgment
b. With Schizoaffective Disorder, psychosis occurs only during a depressive episode
c. Schizoaffective Disorder always includes manic episodes
d. With Major Depression, psychosis occurs only during a depressive episode
87) Irregularities of which neurotransmitter(s) has been implicated in ADHD?
a. Serotonin
b. Norepinephrine
c. Dopamine
d. both b and c
88) Which of the following is not a stimulant per se, but rather an antidepressant with stimulant qualities?
a. Cylert
b. Ritalin
c. Stratera
d. Adderal
89) Monoamines are:
a. Enzymes that break down neurotransmitters
b. The neurotransmitters dopamine, noradrenaline and serotonin
c. A class of amino acids
d. A byproduct of polyamines
90) To be diagnosed with Bipolar I disorder, a client needs to have had:
a. Two or more manic or mixed episodes
b. At least one manic or mixed episode and at least one depressive episode
c. Two or more manic episodes and at least one depressive episode
d. At least one manic or mixed episode
91) The anticholinergic side effects are more common with which type of antidepressants?
a. tricyclics
b. SSRIs
c. MAOIs
d. none of these
92) When ruling out non-psychiatric medical causes for mania, one would be most likely to review which lab findings?
a. Lipids
b. CBC
c. Thyroid function tests
d. PSA
93) Bipolar illness often starts with specific stressful events, but later manic episodes are more likely to occur spontaneously. This is best predicted by:
a. Kindling theory
b. Cognitive-behavioral theory
c. Operant conditioning
d. Psychoanalytic theory
94) Which of the following drugs is thought to be the “gold standard” for treating Bipolar Illness?
a. Lamictal
b. Topamax
c. Lithium
d. Tegretol
95) When prescribing benzodiazepines, one of the most important concerns is:
a. Addictive potential
b. Increased seizure potential
c. Weight gain
d. Triggering a manic episode
96) S-adenosyl-methionine or SAM-e is available without a prescription. Research has shown it to be:
a. A stimulant, similar to caffeine
b. An effective antidepressant
c. No more effective than placebo
d. A useful dieting aide
97) Continuous writhing movements of the extremities and involuntary movements of the mouth and tongue are symptoms of:
a. Acute dystonia
b. Psychosis
c. Tardive dyskinesia
d. Seizure disorder
98) The two broad areas of dysfunction found in ADHD are:
a. Inattention and social deficits
b. Hyperactivity and inattention
c. Hyperactivity and social deficits
d. Inattention and antisocial behavior
99) Lithium has a narrow therapeutic index. This means that:
a. The therapeutic dose is close to the toxic dose
b. Large doses are required for effectiveness
c. Similar doses are required for patients with different characteristics
d. The ineffective dose is close to the effective dose
100) The serum concentration level of Drug Z is 100 mcg/ml at noon and 25 mcg/ml at 4 pm. The drug’s half-life is:
a. One hour
b. Two hours
c. Four hours
d. Eight hours
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