Question: Carbamazepine is an enzyme inducer or inhibitor? How should lamotrigine be titrated accordingly?
Answer Choices:
A. Carbamazepine is an enzyme inducer; lamotrigine should be titrated using higher initial doses
B. Carbamazepine is an enzyme inhibitor; lamotrigine should be titrated using higher initial doses
C. Carbamazepine is an enzyme inducer; lamotrigine should be titrated using lower initial doses
D. Carbamazepine is an enzyme inhibitor; lamotrigine should be titrated using lower initial doses
Answer: Carbamazepine is an inducer; use higher initial lamotrigine doses
Question: Which of the following symptoms represent an acute manic episode? (Select all that apply)
Answer Choices:
A. Anhedonia
B. Increased self-esteem
C. Increased goal-directed activity
D. Flight of ideas/racing thoughts
Answer: B, C, D
Question: The observance of nonlinear pharmacokinetics in the elimination of a drug is most often the result of:
Answer Choices:
A. A saturable metabolic pathway
B. Induction of phase II metabolism
C. Coadministration of a p450 inhibitor
D. An autoinduced metabolic pathway
Answer: A saturable metabolic pathway
Question: A 58-year-old newly diagnosed with Parkinson’s disease, mild resting tremor not bothersome, no cognitive impairment. Most appropriate intervention?
Answer Choices:
A. Start safinamide (Xadago®)
B. Start carbidopa-levodopa (Sinemet®)
C. Start pramipexole (Mirapex ER®)
D. No medication intervention is recommended at this time
Answer: No medication intervention at this time
Question: Due to increased risk of birth defects and polycystic ovary syndrome, which medication should be avoided in people of childbearing potential?
Answer Choices:
A. Ethosuximide (Zarontin®)
B. Valproic acid (Depakene®)
C. Tiagabine (Gabitril®)
D. Oxcarbazepine (Trileptal®)
Answer: Valproic acid (Depakene®)
Question: Which counseling points should be included in patient education when starting carbidopa/levodopa? (Select all that apply)
Answer Choices:
A. Carbidopa/levodopa has been shown to cure Parkinson disease.
B. Do not stop taking carbidopa/levodopa abruptly.
C. Side effects may include nausea/upset stomach, dizziness, fatigue.
D. Taking carbidopa/levodopa with tyramine-containing food may cause hypertensive crisis.
Answer: B and C
Question: What is the major cation that flows out of a neuron during an action potential?
Answer Choices:
A. Na⁺
B. K⁺
C. Mg²⁺
D. Ca²⁺
Answer: K⁺
Question: What is the most common adverse event associated with skeletal muscle relaxants?
Answer Choices:
A. Hepatotoxicity
B. Myocardial infarction
C. CNS depression
D. Peptic ulcers
Answer: CNS depression
Question: Which of the following drugs is appropriately matched with its associated black box warning? (Select all that apply)
Answer Choices:
A. Valproic acid — Serious or life-threatening psychiatric/behavioral adverse reactions (e.g. hostility, homicidal ideation)
B. Lamotrigine — Hepatotoxicity
C. Clonazepam — Risk for misuse, withdrawal reactions, and physical dependence
D. Vigabatrin — Permanent, irreversible vision loss
E. Carbamazepine — Serious dermatologic reactions
Answer: C, D, E
Question: According to the DSM-5, at least one of three characteristic symptoms MUST be present to meet diagnostic criteria for schizophrenia. Which is NOT one of these three?
Answer Choices:
A. Delusions
B. Disorganized speech
C. Catatonic behavior
D. Hallucinations
Answer: Catatonic behavior (not required as the “must have” symptom)
Question: Which of the following serum lithium concentrations is within the therapeutic window for the treatment of bipolar disorder?
Answer Choices:
A. 0.2 mEq/L
B. 0.1 mEq/L
C. 1.0 mEq/L
D. 2.0 mEq/L
Answer: 1.0 mEq/L
Question: Rachel has a lithium level of 0.6 mEq/L on 300 mg BID. If we add another 300 mg daily, how much would you expect her level to increase?
Answer Choices:
A. 0.4–0.5 mEq/L
B. 0.15–0.35 mEq/L
C. 0.05–0.1 mEq/L
D. 0.5–0.7 mEq/L
Answer: 0.15–0.35 mEq/L
Question: Which of the following would most likely induce a seizure?
Answer Choices:
A. Prolonging the inactivation period of voltage-gated sodium channels
B. Inhibiting the opening of voltage-gated potassium channels
C. Reducing the release of glutamate
D. Increasing the inhibitory actions of GABA
Answer: Inhibiting the opening of voltage-gated potassium channels
Question: Which of the following pathologies is present in Parkinson’s disease?
Answer Choices:
A. Deposition of alpha-synuclein in dopaminergic cells
B. Nigrostriatal damage caused by MPTP toxicity
C. Downregulation of DA receptors in the striatum
D. Death of the dopaminergic cells of the thalamus
Answer: Deposition of alpha-synuclein in dopaminergic cells
Question: Which of the following are black box warnings for clozapine? (Select all that apply)
Answer Choices:
A. Hepatotoxicity
B. Seizures
C. Severe neutropenia
D. Orthostatic hypotension, bradycardia, and syncope
E. Increased suicidality
Answer: B, C, D
Question: Elderly patients with ____ who are treated with antipsychotics have an increased risk of death compared to placebo. This is a black box warning on all antipsychotics.
Answer Choices:
A. Dementia-related psychosis
B. Seizures
C. Small-bowel obstruction
D. Agranulocytosis
Answer: Dementia-related psychosis
Question: Which of the following antipsychotics is known for causing the least weight gain?
Answer Choices:
A. Olanzapine (Zyprexa®)
B. Aripiprazole (Abilify®)
C. Quetiapine (Seroquel®)
D. Clozapine (Clozaril®)
Answer: Aripiprazole (Abilify®)
Question: Which of the following medications requires co-administration with levodopa?
Answer Choices:
A. Entacapone (Comtan®)
B. Apomorphine (Apokyn®)
C. Pramipexole (Mirapex®)
D. Amantadine (Symmetrel®)
Answer: Entacapone (Comtan®)
Question: Tiagabine’s (Gabitril®) effectiveness as an AED is primarily mediated by its ability to:
Answer Choices:
A. Block the GABA reuptake channel GAT-1
B. Activate GABA-mediated chloride channels
C. Inhibit synaptic metabolism of GABA
D. Enhance neuronal synthesis of GABA
Answer: Block the GABA reuptake channel GAT-1
Question: Which of the following is a potential side effect of ropinirole (Requip®)?
Answer Choices:
A. Hyperkalemia
B. Hyperlipidemia
C. Hyposmia
D. Orthostatic hypotension
Answer: Orthostatic hypotension
Question: Post-herpetic pain would be best classified as:
Answer Choices:
A. Functional
B. Noxious
C. Neuropathic
D. Nociceptive
Answer: Neuropathic
Question: A 52-year-old man with a tooth abscess expects moderate pain for 3–7 days post-procedure. Which medication should he receive for his pain?
Answer Choices:
A. Metaxalone
B. Lidocaine
C. Ketamine
D. Ibuprofen
Answer: Ibuprofen
Question: The “ceiling effect” observed with some analgesics is best described as:
Answer Choices:
A. The highest dose of an opioid analgesic which does not cause any adverse effects
B. The euphoric sensation experienced with higher doses of opioid analgesics
C. The point at which increased doses of an analgesic agent offer no additional therapeutic effect
D. The excessive cost associated with increasing doses
Answer: The point at which increased doses offer no additional effect
Question: Which of the following is considered a first-line treatment for diabetic peripheral neuropathy?
Answer Choices:
A. Tramadol
B. Pregabalin
C. Nortriptyline
D. Cyclobenzaprine
Answer: Pregabalin
Question: A 29-year-old male on risperidone 4 mg nightly presents with extreme restlessness/akathisia. Most appropriate recommendation?
Answer Choices:
A. Change to paliperidone
B. Change to haloperidol
C. Start propranolol
D. Increase risperidone
Answer: Start propranolol
Question: Ketamine reduces pain by affecting which ion channel?
Answer Choices:
A. NMDA receptor
B. GABA receptor
C. Voltage-gated calcium channel
D. Voltage-gated sodium channel
Answer: NMDA receptor
Question: Which of the following lists includes ONLY positive symptoms of schizophrenia?
Answer Choices:
A. Disorganized behavior, hallucinations, affect flattening
B. Disorganized behavior, avolition, thought insertion
C. Hallucinations, delusions, anhedonia
D. Hallucinations, delusions, catatonia
Answer: Hallucinations, delusions, catatonia