Final Exam: Psychopharmacology (PSY 87700) - Questions and Answers

This document presents a final exam for a Psychopharmacology course (PSY 87700), consisting of 60 multiple-choice questions covering a range of topics within the field. The questions assess understanding of antidepressants, including their side effects and interactions; anxiety disorders and their treatment with various medications like SSRIs and benzodiazepines; schizophrenia and the use of antipsychotic drugs, including newer and traditional options; bipolar disorder and the role of lithium and other mood stabilizers; obsessive-compulsive disorder treatment; and attention deficit disorder management. Furthermore, the exam delves into pharmacokinetics, neurotransmitters, and the ethical considerations for psychotherapists regarding psychopharmacology. The questions require knowledge of drug mechanisms, therapeutic indices, and potential medical causes of psychiatric symptoms.

FINAL EXAM
PSY 87700:
Psychopharmacology
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entire exam.
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:
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
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