Question: Which of the following medications is thought to achieve its therapeutic effects by enhancing the release of dopamine, acting as a muscarinic antagonist, and acting at the NMDA receptor?

Answer Choices:
A. Benztropine (Cogentin®)
B. Selegiline (Eldepryl®)
C. Trihexyphenidyl (Artane®)
D. Amantadine (Symmetrel®)

Answer: Amantadine (Symmetrel®)

Question: Which of the following medications has the greatest risk to cause a patient to have sudden muscle rigidity in the upper body?

Answer Choices:
A. Aripiprazole (Abilify®)
B. Fluphenazine (Prolixin®)
C. Olanzapine (Zyprexa®)
D. Quetiapine (Seroquel®)

Answer: Fluphenazine (Prolixin®)

Question: ___ are responsible for the generation and coordinated transmission of action potentials throughout the nervous system.

Answer Choices:
A. Voltage-gated sodium channels
B. Voltage-gated potassium channels
C. L-type calcium channels
D. Sodium-potassium pumps

Answer: Voltage-gated sodium channels

Question: A patient with schizophrenia was started on risperidone. Which of the following counseling points should you cover when educating the patient and family?

Answer Choices:
A. Please monitor for signs/symptoms of hyperprolactinemia such as irregular menses, breast milk production, and gynecomastia.
B. This medication is only available in a sublingual tablet.
C. This medication should be taken with 350 calories of food.
D. Please monitor for abnormal muscle movements while taking this medication.

Answer: Monitor for hyperprolactinemia symptoms

Question: The neurodevelopmental model of schizophrenia states:

Answer Choices:
A. Early brain injury (such as neonatal hypoxia) can lead to the disorder later in life.
B. Decreased ventricle size leads to low CSF levels that are associated with the disorder.
C. At the onset of symptoms, neurons migrate to cause functional impairment in brain circuits.
D. Decreased NMDA receptor signaling leads to increased sprouting of glutamatergic neurons.

Answer: Early brain injury can lead to the disorder later in life

Question: Which of the following pain medications are voltage-gated Na⁺ channel blockers? (Possible answers provided)

Answer Choices:
Tetracaine
Cyclobenzaprine
Dantrolene
Procaine
Gabapentin
Bupivacaine

Answer: Tetracaine, Procaine, and Bupivacaine

Question: People with bipolar disorder often have which two findings on their neuroimaging (MRI)? (Select two)

Answer Choices:
A. Pineal gland atrophy
B. White matter hyperintensities
C. Cerebral atrophy
D. Altered amygdala volume

Answer: B (White matter hyperintensities) and D (Altered amygdala volume)

Question: Absence seizures are triggered in the thalamus when:

Answer Choices:
A. Voltage-gated potassium channels are blocked
B. Voltage-gated sodium channel activity is reduced
C. Sodium-potassium pumps are inhibited
D. T-type calcium channels are activated, resulting in sustained-burst firing

Answer: T-type calcium channels are activated

Question: Which of the following pain medications is classified as a GABAergic muscle relaxant?

Answer Choices:
A. Ketamine
B. Ropivacaine
C. Dantrolene
D. Baclofen

Answer: Baclofen

Question: You have been tasked with creating a medication for schizophrenia to control positive symptoms. Which is the best option for how the medication should work?

Answer Choices:
A. It should block M₁ receptors in the limbic system.
B. It should block M₄ receptors in the frontal cortex.
C. It should block D₂ receptors in the limbic system.
D. It should block D₄ receptors in the frontal cortex.

Answer: Block D₂ receptors in the limbic system

Question: Why is lamotrigine (Lamictal®) not effective for use in acute mania?

Answer Choices:
A. The dosing titration is too slow to be used in an acute episode.
B. It increases lithium metabolism.
C. It decreases lithium metabolism.
D. It increases mania symptoms.

Answer: The dosing titration is too slow

Question: A patient with obesity, hypertension, and QTc of 501 ms is diagnosed with schizophrenia. Which antipsychotic would you recommend starting?

Answer Choices:
A. Olanzapine
B. Aripiprazole
C. Clozapine
D. Haloperidol

Answer: Aripiprazole

Question: Which medication would most likely cause a patient to get dizzy if they stand up quickly, and has a high risk of acute dystonia? (Referring to a Ki data table with A, B, C, D, E)

Answer Choices:
A. Drug A
B. Drug B
C. Drug C
D. Drug D
E. Drug E

Answer: (Strong D₂ and α₁ blockade)

Question: Which medication would most likely cause urinary retention and constipation? (Using the same Ki data table with A, B, C, D, E)

Answer Choices:
A. Drug A
B. Drug B
C. Drug C
D. Drug D
E. Drug E

Answer: (Strongest antimuscarinic effect)

Question: Which statement is true regarding skeletal muscle relaxants?

Answer Choices:
A. Recommended for long-term treatment of musculoskeletal injury
B. Recommended by the American Diabetes Association for painful diabetic neuropathy
C. Include gabapentin and pregabalin
D. Cause central nervous system depression

Answer: They cause CNS depression

Question: Which of the following medications is NOT associated with the development of Stevens-Johnson Syndrome?

Answer Choices:
A. Gabapentin (Neurontin®)
B. Lamotrigine (Lamictal®)
C. Carbamazepine (Tegretol®)
D. Phenytoin (Dilantin®)

Answer: Gabapentin

Question: Which of the following labs are necessary to monitor for patients on chronic lithium therapy?

Answer Choices:
A. Lithium levels, renal function, thyroid function, electrolytes
B. Lithium levels, liver function tests, thyroid function, electrolytes
C. Lithium levels, renal function, pulmonary function tests, electrolytes
D. Lithium levels, renal function, liver function tests, electrolytes

Answer: Lithium levels, renal function, thyroid function, electrolytes

Question: Which of the following interventions is the best option to treat the “wearing-off” effect associated with carbidopa/levodopa?

Answer Choices:
A. Switch to carbidopa/levodopa ER (Rytary®)
B. Decrease the dosing frequency
C. Decrease the individual dose
D. Add entacapone

Answer: Add entacapone

Question: A 29-year-old female in status epilepticus. Which medication should she receive for emergent initial therapy?

Answer Choices:
A. Lorazepam (Ativan®)
B. Topiramate (Topamax®)
C. Valproic acid (Depakote®)
D. Fosphenytoin (Cerebyx®)

Answer: Lorazepam (Ativan®)

Question: Which of the following functions primarily as an inhibitor of GABA transaminase (GABA-T)?

Answer Choices:
A. Vigabatrin
B. Oxcarbazepine
C. Phenytoin
D. Carbamazepine

Answer: Vigabatrin

Question: Which of the following is most likely to cause an increase in lithium levels?

Answer Choices:
A. Increase in sodium intake
B. Dehydration
C. Aspirin
D. Excessive hydration

Answer: Dehydration

Question: A patient with hand tremor, nausea, vomiting, and confusion on lithium. What lithium level would you expect?

Answer Choices:
A. >4 mEq/L
B. 1.5–2.9 mEq/L
C. 0–1.4 mEq/L
D. 3–3.9 mEq/L

Answer: 1.5–2.9 mEq/L

Question: Which medication has the greatest selectivity for blocking 5-HT₂A receptors relative to D₂ receptors? (Based on the Ki table with A, B, C, D, E)

Answer Choices:
A. Drug A
B. Drug B
C. Drug C
D. Drug D
E. Drug E

Answer: (Very high D₂ Ki vs low 5-HT₂A Ki)

Question: A 25-year-old female with seizure disorder, substance use history, hyponatremia, planning pregnancy, and poor adherence. Which AED do you recommend?

Answer Choices:
A. Lamotrigine
B. Phenobarbital
C. Levetiracetam
D. Valproic acid

Answer: Levetiracetam

Question: Gingival hyperplasia is most commonly associated with the use of which AED?

Answer Choices:
A. Phenytoin (Dilantin®)
B. Lorazepam (Ativan®)
C. Ethosuximide (Zarontin®)
D. Phenobarbital (Luminal®)

Answer: Phenytoin (Dilantin®)

Question: One proposed mechanism of action of lithium is lithium competing for low-affinity binding sites of which metal ion?

Answer Choices:
A. K⁺
B. Mg²⁺
C. Na⁺
D. Ca²⁺

Answer: Mg²⁺

Question: Which of the following antipsychotics is NOT available in a long-acting injection formulation?

Answer Choices:
A. Haloperidol
B. Quetiapine
C. Olanzapine
D. Aripiprazole

Answer: Quetiapine

Question: Which of the following is the result of COMT blockade?

Answer Choices:
A. Decreased breakdown of L-DOPA in the periphery
B. Increased dopamine release from the striatum
C. Decreased dopamine synthesis
D. Increased uptake of L-DOPA through the DAT

Answer: Decreased breakdown of L-DOPA in the periphery