Psychopharmacology test 6

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

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:

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?

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

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:

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

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

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

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

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

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

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:

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

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

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

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?

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

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

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?

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

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?

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

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

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

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?

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?

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

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?