Eleanor garvey
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Test VI: 1, 2, 5, 9, 10, 12, 55, 57, 59, 70, 71, 73, 76, 78, 79, 87, 101, 102, 110, 111, 117, 122, 131, 136, 141, 148, 149, 150

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Eleanor garvey
Created by Eleanor garvey over 4 years ago
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Psychopharmacology test 6

Question 1 of 28

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Test 6 Question 1. Which of the following cytochrome P450 (CYP) enzymes is responsible for the metabolism of trazodone?

Select one of the following:

  • CYP 2D6

  • CYP 1A2

  • . CYP 2C19

  • CYP 3A4

  • CYP 2C9

Explanation

Question 2 of 28

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Test 6 Question 2. A young man presents to the emergency room with a complaint of several days of progressive lower extremity weakness and numbness bilaterally. History reveals he had a flu-like illness for about 10 days prior to coming to the hospital. Examination confirms the lower-extremity weakness, as well as loss of sensation to all sensory modalities below the middle of the thorax. Deep tendon reflexes are brisker below the waist than above and plantar reflexes are extensor bilaterally. The patient complains of recent episodes of urinary incontinence. The rest of the neurological and physical examinations are unremarkable. A lumbar puncture reveals 23 mononuclear cells, a protein level of 37 mg/dL, and normal glucose. The most likely diagnosis is:

Select one of the following:

  • Spinal epidural abscess

  • Anterior spinal artery infarction

  • Acute transverse myelitis

  • Acute inflammatory demyelinating polyneuropathy

  • Spinal metastasis

Explanation

Question 3 of 28

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Test 6 Question 5. Which of the following pregnancy categories should apply to a drug for which animal studies show adverse fetal effect and no human studies are available?

Select one of the following:

  • Category A

  • Category B

  • Category C

  • Category D

  • Category E

Explanation

Question 4 of 28

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Test 6 Question 9. Which of the following medications is excreted unchanged in the urine?

Select one of the following:

  • Sertraline

  • Olanzapine

  • Risperidone

  • Lamotrigine

  • Gabapentin

Explanation

Question 5 of 28

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Test 6 Question 10. A 55-year-old woman was found wandering around the local bus terminal in a confused and disoriented state. She could recall her name, but not how she got to the bus terminal or why she was there. Her daughter went to pick her up at the local hospital thereafter and tried to reorient her mother many times. Nevertheless, her mother kept asking repetitive questions, even about information she had just been given about her location. Neurologic examination was normal, as were brain magnetic resonance imaging (MRI) and EEG. Within 12 hours the woman’s symptoms subsided entirely. The most likely diagnosis of her problem was:

Select one of the following:

  • Attention-seeking behavior

  • An acute dissociative state

  • An epileptic fugue state

  • Alcohol intoxication

  • Transient global amnesia

Explanation

Question 6 of 28

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Test 6 Question 12. Which of the following procedures would confirm the diagnosis of nonepileptic seizure?

Select one of the following:

  • Hypnotic suggestion

  • Videotelemetry

  • MRI brain scan

  • Observation for a 24-hour period

  • EEG between episodes

Explanation

Question 7 of 28

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Test 6 Question 55. When considering the CYP system, which one of the following statements is false?

Select one of the following:

  • CYP 2D6 and CYP 3A4 are two important enzymes psychiatrists must understand

  • Fluoxetine is a potent inhibitor of CYP 2D6

  • A CYP inhibitor will decrease the plasma levels of a drug over time

  • Genetic polymorphisms in the CYP 2D6 gene can make some patients rapid metabolizers

  • Paroxetine is a potent inhibitor of CYP 2D6

Explanation

Question 8 of 28

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Test 6 Question 57. Which of the following is the most likely age for a patient on neuroleptics to develop tardive dyskinesia?

Select one of the following:

  • 18 years

  • 25 years

  • 35 years

  • 45 years

  • 65 years

Explanation

Question 9 of 28

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Test 6 Question 59. Interactions with which one of the following medications will increase lamotrigine levels?

Select one of the following:

  • Oral contraceptives

  • Valproic acid

  • Carbamazepine

  • Phenytoin

  • Phenobarbital

Explanation

Question 10 of 28

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Test 6 Question 70. Which of the following benzodiazepines is metabolized by glucuronidation?

Select one of the following:

  • Lorazepam

  • Diazepam

  • Triazolam

  • Clonazepam

  • Alprazolam

Explanation

Question 11 of 28

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Test 6 Question 71. Which of the following is the most common side effect of SSRIs early in treatment, leading to discontinuation by patients?

Select one of the following:

  • Sleeplessness

  • Sexual dysfunction

  • Gastrointestinal distress

  • Headache

  • Agitation/anxiety

Explanation

Question 12 of 28

1

Test 6 Question 73. A patient on lithium for bipolar disorder reports feeling slow, dull, and unable to concentrate, despite an excellent response in terms of mood stability. The most likely reason for this is that the patient is:

Select one of the following:

  • Somaticizing

  • Accurately reporting side effects

  • Abusing other substances

  • Rationalizing noncompliance

  • Undervaluing normal mood

Explanation

Question 13 of 28

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Test 6 Question 76. Which of the following blood tests is the most important to monitor in a patient taking carbamazepine?

Select one of the following:

  • Creatinine

  • Fasting glucose

  • Complete blood count

  • Lipid profile

  • Thyroid function tests (thyroid-stimulating hormone and free T4)

Explanation

Question 14 of 28

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Test 6 Question 78. Which of the following agents is contraindicated in patients taking clozapine?

Select one of the following:

  • Carbamazepine

  • Fluoxetine

  • Clonazepam

  • Lithium

  • Nortriptyline

Explanation

Question 15 of 28

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Test 6 Question 79. Which one of the following cognitive-enhancing agents is an N-methyl-d-aspartate (NMDA) receptor antagonist?

Select one of the following:

  • Galantamine

  • Donepezil

  • Rivastigmine

  • Memantine

  • Tacrine

Explanation

Question 16 of 28

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Test 6 Question 87. A patient is doing individual therapy in an interpersonal psychotherapy (IPT) framework for depression. In the first five sessions, the patient and therapist come to identify the patient’s unresolved grief due to the recent death of the patient’s spouse as the area of greatest concern, and this is related to the patient’s current feelings of depression. Which of the following will be the focus of the next phase in the patient’s treatment?

Select one of the following:

  • Identifying and testing the validity of the patient’s maladaptive assumptions

  • Finding new activities and relationships to offset the patient’s loss

  • Providing the patient with a corrective emotional experience in the treatment

  • Resolving guilt about conflicted feelings toward the patient’s spouse

  • Reframing the patient’s catastrophizing and fortune-telling over the spouse’s death

Explanation

Question 17 of 28

1

Test 6 Question 101. Which of the following benzodiazepines is phase II metabolized but not phase I metabolized?

Select one of the following:

  • Diazepam

  • Clonazepam

  • Lorazepam

  • Alprazolam

  • Triazolam

Explanation

Question 18 of 28

1

Test 6 Question 102. In which pregnancy category are benzodiazepines?

Select one of the following:

  • Category A

  • Category B

  • Category C

  • Category D

  • Category E

Explanation

Question 19 of 28

1

Test 6 Question 110. An elderly bipolar patient is brought into the emergency room. He was found comatose at home by his son. His serum sodium is 115 mmol/L. Which of the following medications is the most likely cause of his sodium imbalance?

Select one of the following:

  • Lithium

  • Olanzapine

  • Carbamazepine

  • Quetiapine

  • Topiramate

Explanation

Question 20 of 28

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Test 6 Question 111. Which of the following is not part of the recommended monitoring for patients taking risperidone?

Select one of the following:

  • Weight

  • Blood pressure

  • Glucose

  • Thyroid function tests

  • Lipid profile

Explanation

Question 21 of 28

1

Test 6 Question 117. A 35-year-old woman with bipolar disorder gives birth to a child with an abnormally formed tricuspid valve. Which of the following medications was she most likely taking?

Select one of the following:

  • Haloperidol

  • Lithium

  • Valproic acid

  • Lamotrigine

  • Carbamazepine

Explanation

Question 22 of 28

1

Test 6 Question 122. Lithium has been associated with which one of the following?

Select one of the following:

  • Neutropenia

  • Hyperparathyroidism

  • Pancreatitis

  • Hepatic failure

  • Eosinophilic colitis

Explanation

Question 23 of 28

1

Test 6 Question 131. Which of the following tests is not considered routine monitoring for patients taking lithium?

Select one of the following:

  • Complete blood count

  • Serum electrolytes

  • 24-hour urine for creatinine and protein

  • Blood urea nitrogen and creatinine

  • Thyroid function tests

Explanation

Question 24 of 28

1

Test 6 Question 136. Which of the following is least likely to cause weight gain?

Select one of the following:

  • Clozapine

  • Olanzapine

  • Valproic acid

  • Lamotrigine

  • Lithium

Explanation

Question 25 of 28

1

Test 6 Question 141. A 23-year-old male with severe obsessions, compulsions, and tics comes to you for evaluation. Which of the following would be the best medication combination for this patient?

Select one of the following:

  • Citalopram plus lorazepam

  • Paroxetine plus buspirone

  • Sertraline plus naltrexone

  • Fluoxetine plus alprazolam

  • Fluvoxamine plus haloperidol

Explanation

Question 26 of 28

1

Test 6 Question 148. You have a patient on clozapine who develops a white blood cell (WBC) count between 2000 and 3000 with an absolute neutrophil count (ANC) of 700. What is your next step in management?

Select one of the following:

  • Continue clozapine and repeat absolute neutrophil count (ANC)

  • Stop clozapine; you may rechallenge if ANC count increases in the future

  • Continue clozapine; draw twice-weekly ANC

  • Continue clozapine; draw weekly ANC for the next 4 weeks

  • Stop clozapine; you may not rechallenge this patient in the future

Explanation

Question 27 of 28

1

Test 6 Question 149. Prolongation of the QTc interval above which of the following is an indication to stop a QTc-prolonging neuroleptic?

Select one of the following:

  • 100 milliseconds

  • 200 milliseconds

  • 300 milliseconds

  • 400 milliseconds

  • 500 milliseconds

Explanation

Question 28 of 28

1

Test 6 Question 150. You are doing a shift in the emergency room and a patient comes in complaining of depressed mood. On further questioning you discover that he is also suffering from fatigue and cognitive inefficiency. He provides you with a list of medications prescribed by his primary care physician. Of the following medications, which one could be responsible for exacerbating the patient’s symptoms?

Select one of the following:

  • Interferon

  • Ranitidine

  • Verapamil

  • Modafinil

  • Amoxicillin

Explanation

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