1.

To a patient who developed a very important drowsiness, after the intake of only one
drug, a second drug is injected and a fast waking is observed. The first drug taken by the
patient was (to choose among A and B), the second was (to choose among C, D and E):
a. Haloperidol
b. Clorazepate
c. Flumazenil
d. Diazepam
e. Carbamazepine

2. A person regularly takes high doses of morphine. A compound is injected to him and
the fast advent of symptoms such as anxiety, agitation, diarrhea, mydriasis, is observed.
This compound can be:

a. Morphine itself
b. A placebo
c. A morphine antagonist
d. Methadone
e. A benzodiazepine such as diazepam

3. The following drugs can induce as adverse effect, the triad automaticity, disinhibition,
amnesia:

a. phenothiazines, such as chlorpromazine

b. benzodiazepines, such as triazolam
c. barbiturates such as Phenobarbital
d. anxiolytics, such as meprobamate
e. tricyclic antidepressants such as imipramine

4. Adverse effects of neuroleptic agents, such as galactorrhea, gynecomastia, ejaculation

disorders, are attributed to:

a. an antimuscarinic effect
b. an inhibition of angiotensin receptors
c. an inhibition of dopamine receptors
d. an increase of prolactin secretion
e. a and b
f. c and d

5. Cannabis due to tetrahydrocannabinol which it contains acts on receptors of

 a. Noradrenaline
b. Serotonin
c. GABA
d. Anandamide
e. Glutamate

6. Side effects of lithium include all except

a. Leucocytosis
b. Acne
c. Alopecia
d. T wave inversion and QRS narrowing
e. Memory impairment

7. The following statements are true:

a. A rise in plasma sodium results in a rise in plasma lithium levels

b. Dehydration results in a fall in plasma lithium levels
c. Although lithium can treat bipolar illness, it has no effect on the number of
relapses
d. Thyroid gland disorders do not respond to thryoxine
e. Lithium is distributed widely in the body

8. The following statements are true except

a. Lithium inhibits the release of iodine, and thyroid hormones
b. Lithium induces thyroid auto antibodies
c. Lithium does not cross the placenta
d. Lithium is excreted in breast milk
e. Long term treatment does not seem to affect GFR

9. The following are true except

a. The major inhibitory neurotransmitters are glycine and GABA
b. Dopamine is inhibitory on D1 and D5 receptors
c. Acetylcholine has excitatory and inhibitory properties
d. Adrenaline distribution is mainly in midbrain and brainstem
e. Glycine is implicated in learning and memory

10. The principle neurotransmitters not involved with anxiety

a. Acetylcholine
b. dopamine
c. Noradrenaline
d. Serotonin
e. GABA

11. Side effects of Valproate include all except

 a. Acute pancreatitis
b. Renal failure
c. Hepatic enzyme changes
d. Hepatic toxicity and death
e. Valproate should be stopped if jaundice occurs

12. Amisulpride:
a. Is a D2/ D3 agonist
b. Blocks autoreceptors at low doses and can increase synaptic dopamine levels
c. Does not increase prolactin levels
d. Has a similar level of EPS across the whole dose range
e. Is clinically not effective for negative symptoms of schizophrenia at low doses
(<300mg/ day)

13. All is true about Quetiapine except

a. Has a similar binding profile to clozapine
b. Has a high affinity for muscarinic receptors
c. Has lower affinity for all receptors than clozapine
d. Causes less weight gain than olanzapine and clozapine
e. Can cause constipation

14. Olanzapine:
a. Has lower affinity for the D2 and 5-HT2A receptors than Clozapine
b. Has higher affinity for the D1 receptor than Clozapine
c. Causes negligible weight gain
d. Has high levels of Extra-pyramidal side effects
e. Can cause marked sedation

15. Which of the following drug types is used to treat a Parkinsonian syndrome caused
by the antipsychotic drug chlorpromazine:
a. Nicotinic receptor antagonists (e.g. hexamethonium)
b. Muscarinic receptor antagonists (e.g. benztropine)
c.  adrenoceptor antagonists (e.g. phentolamine)
d. Anticholinesterases (e.g. physostigmine)
e. A precursor of dopamine (e.g. levodopa)

16. Which of the following is NOT a common adverse effect of chlorpromazine

a. Hypotension
b. Constipation
c. Parkinsonian syndrome
d. Urinary retention
e. Hypersalivation
17. Epileptic seizures are NOT controlled by:
a. Clonazepam
b. Carbamazepine
c. Phenytoin
d. Primidone
e. Levodopa

18. The side effects associated with tricyclic antidepressant therapy DO NOT include:
a. Tachycardia
b. Dry mouth
c. Sweating
d. Hypertension
e. Blurred vision

19. Lithium:
a. Is used in the treatment of anxiety
b. Produces extra pyramidal side effects
c. Inhibits the re uptake of noradrenaline into adrenergic nerve terminals
d. May cause renal toxicity in very high doses
e. Is used in the treatment of unipolar depression

The following information relates to questions 20 – 24:

a. Ethosuxamide
b. Carbamazepine
c. Sodium valproate
d. Phenytoin
e. Clonazepam
20. Is exclusively used in treating absence type seizures
21. Is a benzodiazepine used in status epilepticus
22. May cause facial hair growth as one of its side effects
23. Facilitates GABA mediated inhibition
24. May produce gingival hyperplasia

25. A pt of Parkinsonism is getting a combination of carbidopa and levodopa. The role of

carbidopa is to block

a. Reuptake of dopamine in substantia nigra

b. Dopa decarboxylase in the brain
c. Dopa decarboxylase in peripheral tissues
d. Monoamine oxidase in neostriatum
e. COMT in peripheral tissue

The following information relates to questions 26 – 30:

a. Metoclopramide
 b. Haloperidol
c. Thioridazine
d. Clozapine
e. Promethazine
26. Is a phenothiazine used to treat schizophrenia
27. Is a butyrophenone with neuroleptic activity
28. Is a dopamine receptor antagonist used as an entiemetic but not as a neuroleptic agent
29. Is a phenothizine used to treat motion sickness
30. Is associated with a decreased likelihood of developing tardive dyskinesia when used
to treat schizophrenia

31. Which of the following is false in relation to psychopharmacology?

In pregnancy?
a. Gastric motility is decreased.
b. The permeability of the blood brain barrier is greater in a
c. fetus than in an adult.
d. SSRIs are generally considered safe in pregnancy.
e. Hepatic metabolism is increased.
f. The GFR is decreased.

32. Which of the following antipsychotics is not available as a depot formulation?

a. Haloperidol
b. Risperidone
c. Zuclopenthixol
d. Flupenthixol
e. Trifluoperazine

33. Which of the following is not a treatment for dementia?

a. Rivastigmine
b. Galantamine
c. Memantine
d. Donepezil
e. Tetrabenazine

34. Which of the following is not correct regarding classification of antipsychotic?

a. Trifluoperazine: phenothiazine
b. Chlorpromazine: thioxanthine
c. Risperidone: benzisoxazole
d. Amisulpiride: substituted benzamide
e. Clozapine: dibenzodiazepine

35. Fluphenazine has been prescribed to 20 yrs old male patient. His schizophrenic
symptoms have improved enough. He visits the psychiatrists with a list of complaints
about his medicines. Which of the following is least likely to be on his list?
 a. Constipation
b. Dizziness if he stands up too quickly
c. He has become disinterested in sex
d. He salivates excessively
e. Newspaper print is hard to see

36. Which of the following statements regarding adverse effects of anti psychotics is
correct?
a. The late occurring choreoathetoid movements caused by conventional anti
psychotics are reduced by antimuscarinic agents.
b. Retinal pigmentation is a dose dependent toxic effect of olanzapine
c. Uncontrollable restlessness in a patient taking antipsychotics is alleviated by
increasing the drug dose.
d. Acute dystonic reactions occur very infrequently with olanzapine
e. Blurring of vision and urinary retention are common side effects of haloperidol

37. Haloperidol would NOT be an appropriate drug for the management of

a. Acute mania
b. The amenorrhea-galactorrhea syndrome
c. Phencyclidine intoxication
d. Schizoaffective disorders
e. Tourette’s syndrome

38. A 30 year old male patient is on treatment for a psychiatric disorder.

He complains that he feels “flat” and he gets confused at times.
He has been gaining weight and has lost his sex drive. As he moves his hands, you note a
slight tremor. He tells you that since he has been on medication, he is always thirsty and
frequently has to urinate. The drug most likely he is taking is
a. clonazepam
b. clozapine
c. haloperidol
d. lithium
e. trifluoperazine

39. which of the following drugs has a high affinity for 5-Ht2 receptors in the brain, does
not cause extrapyramidal dysfunction or hemotoxicity, and is reported to increase the risk
of significant QT prolongation?
a. chlorpromazine
b. clozapine
c. fluphenazine
d. olanzapine
e. ziprasidone

40. a young male patient recently diagnosed as suffering from Schizophrenia develops
severe muscle cramps with torticollis a short time after drug therapy is initiated with
haloperidol. The best course of action would be to
 a. add clozapine to the drug regimen
b. discontinue haloperidol and observe the patient
c. give oral diphenhydramine
d. switch patient to fluphenaizne
e. inject benztropine

41. Drugs like donepezil (Aricept*) and rivastigmine (Exelon*) act by:

a. increasing acetylcholine release

b. inhibiting cholinesterases
c. inhibiting monoamine oxidase
d. stimulating 5HT3 serotonin receptors
e. stimulating alpha-2 adrenergic receptors

42. A neuronal cell body located in Raphe nucleus has fine axonal projections to most
brain levels. The neurotransmitters that it releases, which can be either excitatory or
inhibitory is most likely to be
a. acetylcholine
b. dopamine
c. glutamic acid
d. norepinephrine
e. serotonin

43. If one of the patients is taking amitriptyline and other one is taking chlorpromazine,
they are both likely to be experiencing
a. excessive salivation
b. extra pyramidal dysfunction
c. gynecomastia
d. increased gastrointestinal motility
e. postural hypotension

44. An atypical antipsychotic that is quite sedating and associated with significant weight
gain, hyperlipidemia and increased risk of type II diabetes is
a. bupropion
b. clonazepam
c. haloperidol
d. olanzapine
e. trifluperazine

45. A drug that is used in the treatment of Parkinsonism and will also attenuate reversible
extrapyramidal side effects of neuroleptics is
a. amantadine
 b. levodopa
c. pergolide
d. selegiline
e. trihexyphenidyl

46. A 38 yr old man is brought to ER room at night. In early morning hours the patient
becomes very happy, excited and talkative. An hour later he becomes dizzy and quite pale
and then vomited. Later his fingers and lips start to twitch and he starts hallucinating. On
examination, his BP is 180/110, heart rate >100/min, a R.R of >20/min., pale and dry
mucous membranes, mydriasis, hyperthermia, and increased deep tendon reflexes. The
patient is intoxicated by
a. cocaine
b. ethanol
c. flunitrazepam
d. hashish
e. heroin

47. A drug that exerts its anti convulsant effect by blocking sodium channels in neuronal
membranes
a. acetazolamide
b. carbamezapine
c. diazepam
d. gabapentin
e. vigabatrin

48. After ingestion of a meal that includes sardines, cheese and red wine, a pt taking an
antidepressant drug experiences a hypertensive crisis. The drug most likely to be
responsible is
a. bupropion
b. fluoxetine
c. imipramine
d. phenelzine
e. trazodone
49. A woman taking haloperidol develops amenorrhea-galactorrhea syndrome and extra
pyramidal dysfunction that includes bradykinesia, muscle rigidity, and tremor at rest. Her
psychiatrist prescribes her a different antipsychotic that improves both +ive and –ive
symptoms with fewer side effects caused by dopamine receptor blockade.
Blood weekly test is not required. The prescribed drug is
a. bupropion
b. clozapine
c. nefazodone
d. olanzapine
e. sertraline
50. A 24 yr old man with a history of partial seizures has been treated with standard
anticonvulsants for several years. He is currently taking valproic acid which is not fully
effective. His doctor prescribes a new drug in adjunction but the patient develops toxic
epidermal necrolysis. The new drug prescribed is
a. felbamate
b. gabapentin
c. lamotrigine
d. tiagabine
e. vigabatrin

51. The introduction of which of the following drug treats depressive illness because it
appears to act as an antagonist at α2 adrenoceptors in CNS
a. amoxapine
b. bupropion
c. citalopram
d. mirtazapine
e. paroxetine

ANSWERS

1. b,c 45. e
2. c 46. a
3. b 47. b
4. f 48. d
5. d 49. d
6. d 50. c
7. e 51. d
8. c
9. b
10. a
11. b
12. b
13. b
14. e
15. b
16. e
17. e
18. d
19. d
20. a
21. e
 22. d
23. e
24. d
25. c
26. c
27. b
28. a
29. e
30. d
31. e
32. e
33. e
34. b
35. d
36. d
37. b
38. d
39. e
40. e
41. b
42. e
43. e
d