Eleanor garvey
Quiz by , created more than 1 year ago

Test V: 3, 7, 27, 43, 55, 61, 73, 91, 96, 100, 101, 105, 109, 112, 114, 115, 120, 121, 123, 126, 128, 130, 135, 147, 150

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Eleanor garvey
Created by Eleanor garvey about 4 years ago
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Psychopharmacology Test 5

Question 1 of 25

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Test 5 Question 3. While working in the emergency room you evaluate a patient with confusion, myoclonus, diarrhea, hypotension, tachycardia, and a normal creatine phosphokinase (CPK) level. The patient is not speaking. His family tells you that he was recently started on a new medication by his psychiatrist for treatment of bipolar disorder. They don’t know the name of the medication or what kind of medication it was. Using your astute clinical skills and significant psychiatric knowledge you narrow the diagnosis down to either neuroleptic malignant syndrome (NMS) or serotonin syndrome. But alas, you must pick one diagnosis for the medical record. Which one will it be and why?

Select one of the following:

  • NMS because the patient is confused

  • NMS because rigidity is more commonly part of serotonin syndrome

  • Serotonin syndrome because it commonly presents with hypotension

  • NMS because it usually presents with normal CPK

  • Serotonin syndrome because it more commonly presents with myoclonus and gastrointestinal (GI) symptoms

Explanation

Question 2 of 25

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Test 5 Question 7. Which one of the following is not an inhibitor of cytochrome P450 (CYP) 1A2?

Select one of the following:

  • Amiodarone

  • Tobacco

  • Cimetidine

  • Fluvoxamine

  • Grapefruit juice

Explanation

Question 3 of 25

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Test 5 Question 27. A patient in treatment for bipolar disorder reports severe mid-upper abdominal pain radiating to the back, nausea, anorexia, fever, and evidence of acute abdominal pain. Pain is worse after eating and upon lying down. She is taking citalopram
and valproic acid. Which of the following tests would be most useful in making a diagnosis?

Select one of the following:

  • Complete blood count

  • Basic metabolic panel

  • Liver function tests

  • Amylase

  • Prolactin level

Explanation

Question 4 of 25

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Test 5 Question 43. Which one of the following is not a substrate for CYP 2D6?

Select one of the following:

  • Aripiprazole

  • Bupropion

  • Codeine

  • Duloxetine

  • Haloperidol

Explanation

Question 5 of 25

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Test 5 Question 55. Caution should be exercised when prescribing which one of the following to a patient on carbamazepine because the combination will increase carbamazepine levels?

Select one of the following:

  • Cyclosporine

  • Doxycycline

  • Erythromycin

  • Phenobarbital

  • Theophylline

Explanation

Question 6 of 25

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Test 5 Question 61. Why does mirtazapine decrease nausea?

Select one of the following:

  • 5-HT 2 antagonism

  • 5-HT 3 antagonism

  • 5-HT 2 agonism

  • α2 Antagonism

  • α2 Agonism

Explanation

Question 7 of 25

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Test 5 Question 73. Mirtazapine works via action on which of the following receptors?

Select one of the following:

  • Dopamine type 2 (D2)

  • α2

  • Glutamate

  • α1

  • γ-Aminobutyric acid (GABA)

Explanation

Question 8 of 25

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Test 5 Question 91. Which of the following classes of psychotropic medications has the best documented treatment effects for agitation in the demented patient?

Select one of the following:

  • Antipsychotics

  • Mood stabilizers

  • Benzodiazepines

  • Selective serotonin reuptake inhibitor (SSRI) antidepressants

  • Tricyclic antidepressants

Explanation

Question 9 of 25

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Test 5 Question 96. Which one of the following properties of atypical antipsychotics is hypothesized to be responsible for these medications being less likely to produce extrapyramidal side effects?

Select one of the following:

  • Decreased binding to D2 receptors

  • Rapid dissociation from D2 receptors

  • Affinity for muscarinic cholinergic receptors

  • Binding to multiple dopamine receptors other than D2 receptors

  • Higher affinity for D1 receptors

Explanation

Question 10 of 25

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Test 5 Question 100. When triiodothyronine is added to a tricyclic antidepressant for augmentation, the clinician needs to be cautious if:

Select one of the following:

  • The patient is a woman over 50years of age

  • The patient has subclinical hypothyroidism

  • The patient has a history of hypertension

  • The patient has a history of cognitive deficits with depression

  • The patient relapsed while on a previously effective tricyclic antidepressant

Explanation

Question 11 of 25

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Test 5 Question 101. One of your patients has been taking zolpidem for sleep recently and started having sleep-walking episodes on the medication. She finds these episodes to be disturbing. She asks you about taking eszopiclone instead. Which of the following possible responses to her question is most accurate?

Select one of the following:

  • Eszopiclone is a bad choice because she will develop tolerance over time

  • Eszopiclone can also cause sleep walking

  • Eszopiclone works as a melatonin receptor agonist

  • Eszopiclone is used to treat both sleep and depression

  • Unlike with zolpidem, hallucinations do not occur with eszopiclone

Explanation

Question 12 of 25

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Test 5 Question 105. Which of the following is true about administering different mood stabilizers together?

Select one of the following:

  • Valproic acid will increase lamotrigine levels

  • Lamotrigine will increase valproic acid levels

  • Valproic acid will decrease lamotrigine levels

  • Valproic acid will decrease carbamazepine levels

  • Carbamazepine will increase lithium levels

Explanation

Question 13 of 25

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Test 5 Question 109. Which of the following statements about benzodiazepines is correct?

Select one of the following:

  • Clonazepam has a rapid rate of absorption

  • Alprazolam has a half-life of 2.5hours

  • Diazepam has a half-life of 200 hours

  • Lorazepam is considered a short-acting benzodiazepine

  • Clonazepam is considered a short-acting benzodiazepine

Explanation

Question 14 of 25

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Test 5 Question 112. The following choices are potential side effects of lithium except:

Select one of the following:

  • Hair loss

  • Tremor

  • Confusion

  • Neural tube defects

  • Seizures

Explanation

Question 15 of 25

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Test 5 Question 114. Which of the following terms refers to spastic contractions of discrete muscle groups such as the neck, tongue, eyes, or back?

Select one of the following:

  • Akathisia

  • Tardive dyskinesia

  • Acute dystonia

  • Blepharospasm

  • Tardive dystonia

Explanation

Question 16 of 25

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Test 5 Question 115. Which one of the following is not an inducer of CYP 3A4?

Select one of the following:

  • Carbamazepine

  • Oxcarbazepine

  • Phenytoin

  • Fluoxetine

  • Rifampin

Explanation

Question 17 of 25

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Test 5 Question 120. A 67-year-old male carries a diagnosis of bipolar disorder and is being treated with carbamazepine. His family brings him to the ER because he has become confused and disoriented over the past 2 days. He is afebrile and has no neurological deficits. Although you could reasonably order any of the following tests to evaluate his condition, which of the following is most important that you check given the patient’s history?

Select one of the following:

  • Head CT

  • Chest X-ray

  • Urinalysis

  • Basic metabolic panel

  • TSH

Explanation

Question 18 of 25

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Test 5 Question 121. Which of the following medications would be the best choice for a patient with psychosis and impaired hepatic function?

Select one of the following:

  • Olanzapine

  • Quetiapine

  • Paliperidone

  • Ziprasidone

  • Risperidone

Explanation

Question 19 of 25

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Test 5 Question 123. Which one of the following statements is false concerning desvenlafaxine extended-release tablets (Pristiq)?

Select one of the following:

  • Desvenlafaxine may cause orthostasis and hyponatremia in the elderly

  • Dosage should be adjusted for patients with renal disease

  • Monitoring must be conducted for increase in suicidality during treatment, especially in children and teens

  • Taking desvenlafaxine in combination with an monoamine oxidase inhibitor (MAOI) may precipitate a serotonin syndrome

  • Desvenlafaxine has no impact on blood pressure, unlike venlafaxine

Explanation

Question 20 of 25

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Test 5 Question 128. Naltrexone extended-release injectable suspension (Vivitrol) is indicated for treatment of which of the following disorders?

Select one of the following:

  • Major depressive disorder

  • Generalized anxiety disorder

  • Psychosis

  • Alcohol dependence

  • Cocaine withdrawal

Explanation

Question 21 of 25

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Test 5 Question 130. Which of the following medications is a serotonin and norepinephrine reuptake inhibitor, lacks significant antihistaminic effects, can cause withdrawal symptoms if stopped abruptly, and has an indication for neuropathic pain?

Select one of the following:

  • Mirtazapine

  • Quetiapine

  • Nefazodone

  • Paroxetine

  • Duloxetine

Explanation

Question 22 of 25

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Test 5 Question 126. Which one of the following statements is false concerning atomoxetine (Strattera)?

Select one of the following:

  • Atomoxetine works as a norepinephrine reuptake inhibitor

  • Full results are seen within 2 weeks of initiating treatment with atomoxetine

  • Once-daily dosing of atomoxetine works well for most patients

  • Most common side effects include dizziness and reduced appetite

  • Atomoxetine carries a black box warning for suicidality

Explanation

Question 23 of 25

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Test 5 Question 135. Which of the following statements is correct concerning clozapine?

Select one of the following:

  • Smoking will not affect clozapine levels

  • Risk of agranulocytosis is dose-related

  • Clozapine carries a high risk of prolactin elevation

  • Doses of clozapine greater than 600 mg/day carry a much higher risk of seizures than lower doses

  • Adding lithium to clozapine lowers the chances of NMS

Explanation

Question 24 of 25

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Test 5 Question 147. Which of the following medications is a partial nicotine agonist that decreases craving and withdrawal in patients trying to stop smoking?

Select one of the following:

  • Bupropion

  • Buspirone

  • Nicotine gum

  • Nicotine nasal spray

  • Varenicline

Explanation

Question 25 of 25

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Test 5 Question 150. One of your patients asks you for information about mirtazapine. If you made all of the following statements to the patient, which one would be considered factually inaccurate?

Select one of the following:

  • Mirtazapine blocks serotonin reuptake

  • Mirtazapine causes minimal sexual dysfunction

  • Mirtazapine can be very sedating

  • Mirtazapine is a potent H1 receptor antagonist

  • Mirtazapine can cause weight gain

Explanation

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