MCQs for USMLE review on psychopharmacology: antipsychotics, benzodiazepines, antidepressants and lithium

These pharmacology MCQs from the UMKC School of Medicine have a different degree of difficulty, but are useful to review pharmacology of psychotropics.

Psychotropics
Item Number: 11667 correct answer: 4 category: Psychotropics
1. The symptoms of tardive dyskinesia will acutely improve with:
1. administration of diphenhydramine
2. administration of amantadine
3. administration of bromocriptine
4. increase of neuroleptic dose
5. All of the above

Item Number: 8777 correct answer: 5 category: Psychotropics
2. Psychopharmacology includes the judicious of all the following EXCEPT:
1. haloperidol
2. lithium carbonate
3. imipramine
4. chlordiazepoxide
5. selegiline

Item Number: 11641 correct answer: 2 category: Psychotropics
3. Major tranquilizers of the phenothiazine group produce all of the following
EXCEPT:
1. autonomic effects
2. anesthesia
3. extrapyramidal effects
4. control of psychotic behavior
5. prevention of vomiting

Item Number: 11652 correct answer: 4 category: Psychotropics
4. Neuroleptic malignant syndrome is characterized by all of the following
EXCEPT:
1. hyperpyrexia
2. increase in serum creatine phosphokinase
3. catatonia
4. akathisia
5. All of the above

Item Number: 10533 correct answer: 5 category: Psychotropics
5. Pigment deposits in the anterior lens capsule and posterior surface of the
cornea can be seen by slit-lamp examination in one third to one half of some
groups receiving certain phenothiazine tranquilizers. Phenothiazine
tranquilizers which have caused this state include:
1. chlorpromazine
2. promazine
3. thioridazine
4. All of the above
5. 1,3

Item Number: 11754 correct answer: 4 category: Psychotropics
6. Pharmacologic effects of thioridazine include all of the following EXCEPT:
1. control of psychotic behavior
2. orthostatic hypotension
3. antiemesis
4. hypoprolactinemia
5. All of the above

Item Number: 10699 correct answer: 2 category: Psychotropics
7. A substance which decreases or inhibits the metabolism of benzodiazepines
metabolized to active metabolites in the liver is:
1. ranitidine
2. cimetidine
3. rifampin
4. carbamazepine
5. phenytoin

Item Number: 10484 correct answer: 5 category: Psychotropics
8. Systems on which antipsychotic agents exhibit pharmacologic action include all
of the following EXCEPT:
1. central nervous system
2. autonomic nervous system
3. cardiovascular
4. endocrine system
5. pulmonary

Item Number: 10645 correct answer: 5 category: Psychotropics
9. Pharmacologic effects of cyclic antidepressants include all of the following
EXCEPT:
1. sedation
2. flattened or inverted T waves on EKG
3. urinary retention and mydriasis
4. mood elevation
5. raise the seizure threshold

Item Number: 10486 correct answer: 4 category: Psychotropics
10. Uses for antipsychotics include all of the following EXCEPT:
1. Gilles de la Tourette syndrome
2. hiccups
3. schizophrenia
4. Parkinson’s disease
5. manic phase of manic depression

Item Number: 5262 correct answer: 5 category: Psychotropics
11. The pharmacological agent which is useful as an antiemetic is:
1. tetracycline
2. naloxone
3. caffeine
4. epinephrine
5. chlorpromazine

Item Number: 10663 correct answer: 4 category: Psychotropics
12. All of the following are monoamine oxidase inhibitors EXCEPT:
1. phenelzine
2. isocarboxazid
3. tranylcypromine
4. maprotiline
5. All of the above

Item Number: 10666 correct answer: 2 category: Psychotropics
13. The pharmacologic action of monoamine oxidase inhibitors is:
1. block the reuptake of monoamine neurotransmitter into the presynaptic cleft
2. blocks the metabolism of monoamine neurotransmitters
3. decreases 5HT and NE monoamines
4. enhances REM sleep
5. selective MAO-B inhibitors may be useful in psychosis

Item Number: 10687 correct answer: 5 category: Psychotropics
14. Effects of benzodiazepines include all of the following EXCEPT:
1. paradoxical stimulation
2. tolerance
3. dependence and withdrawal
4. respiratory depression in patients with obstructive lung disease
5. lower seizure threshold

Item Number: 10681 correct answer: 1 category: Psychotropics
15. Pharmacologic effects of lorazepam include:
A. sedation/hypnosis
B. anterograde amnesia
C. increased seizure threshold
D. inhibition of prolactin secretion
1. A,B,C
2. A,C
3. B,D
4. D only
5. All of the above

Item Number: 10682 correct answer: 4 category: Psychotropics
16. The elimination of all of the following benzodiazepines are influenced by
liver disease or advanced aging EXCEPT:
1. alprazolam
2. midazolam
3. chlordiazepoxide
4. lorazepam
5. diazepam

Item Number: 10648 correct answer: 4 category: Psychotropics
17. The appropriately matched tricyclic antidepressant and metabolite is:
1. amitriptyline – desipramine
2. imipramine – nortriptyline
3. imipramine – trimipramine
4. imipramine – desipramine
5. fluoxetine – protriptyline

Item Number: 6702 correct answer: 2 category: Psychotropics
18. A recognized side effect of  lithium carbonate is:
1. hypermagnesemia
2. polyuria and polydipsia
3. transient fall in BUN and serum creatinine
4. hypochloremia
5. proximal tubular degeneration

Item Number: 11648 correct answer: 5 category: Psychotropics
19. Endocrine effects of chlorpromazine include all of the following EXCEPT:
1. decrease in adrenocorticotropins
2. decrease in gonadotropins
3. decrease in release of pituitary growth hormone
4. increase in prolactin secretion
5. decrease in thyroid hormone production

Item Number: 3750 correct answer: 1 category: Psychotropics
20. Cholestasis is the principle derangement observed in hepatotoxicity
associated with:
1. phenothiazines
2. monoamine oxidase inhibitors
3. para-aminosalicylic acid
4. carbon tetrachloride
5. None of the above

Item Number: 11758 correct answer: 4 category: Psychotropics
21. Phenelzine can result in a hypertensive crisis when coadministered with all of
the following EXCEPT:
1. pickled herring (tyramine)
2. amphetamines
3. phenylpropanolamine
4. diazepam
5. ephedrine

Item Number: 10680 correct answer: 4 category: Psychotropics
22. The neurotransmitter through which benzodiazepines exert their action is:
1. norepinephrine
2. epinephrine
3. dopamine
4. gamma amino butyric acid
5. serotonin

Item Number: 10612 correct answer: 1 category: Psychotropics
23. The neuroleptic available as ester salts for intramuscular injection with slow
absorption characteristics is:
1. haloperidol
2. prochlorperazine
3. thioridazine
4. perphenazine
5. All of the above

Item Number: 10500 correct answer: 2 category: Psychotropics
24. Anticholinergic side effects are most common with:
1. haloperidol
2. thioridazine
3. fluphenazine
4. trifluoperazine
5. All of the above

Item Number: 11642 correct answer: 5 category: Psychotropics
25. Reserpine normally has a tranquilizing effect. However, prior administration
of some drugs can produce excitement in a patient taking reserpine. Classes
of drugs which will produce this paradoxical effect include:
1. anticholinesterases
2. antihistamines
3. atropine-type muscarinic blockers
4. alpha-adrenergic blockers
5. monoamine oxidase inhibitors

Item Number: 11697 correct answer: 4 category: Psychotropics
26. Fluoxetine is FDA-approved to treat:
1. schizophrenia
2. mania
3. anxiety
4. depression
5. obesity

Item Number: 11659 correct answer: 2 category: Psychotropics
27. Compliance with neuroleptics medications can be increased by the
administration of depot injections of:
1. loxapine hydrochloride
2. fluphenazine enanthate
3. molindone hydrochloride
4. chlorpromazine hydrochloride
5. All of the above

Item Number: 11766 correct answer: 5 category: Psychotropics
28. Drugs that reduce the renal clearance of lithium include all of the following
EXCEPT:
1. ibuprofen
2. hydrochlorothiazide
3. indomethacin
4. chlorothiazide
5. theophylline

Item Number: 11617 correct answer: 2 category: Psychotropics
29. The potential central nervous system effects of haloperidol is:
1. monoamine oxidase inhibition
2. blockade of dopamine in the chemoreceptor trigger zone
3. cholinesterase inhibition
4. blockade of serotonin in the basal ganglia
5. blockade of dopamine reuptake

Item Number: 10497 correct answer: 2 category: Psychotropics
30. The correct statements regarding extrapyramidal effects of antipsychotics is:
1. acute dystonic reactions occur most commonly with low potency agents
2. excess dopaminergic activity is hypothesized to be a mechanism of
tardive dyskinesia
3. akathisia is characterized by oral facial dyskinesia
4. cholinergic agents are useful in the management of neuroleptic-induced
Parkinsonism
5. tardive dyskinesia occurs early on in therapy and is reversible upon
discontinuation of therapy

Item Number: 10625 correct answer: 1 category: Psychotropics
31. Agents which are tricyclic or atypical cyclic antidepressants include all of
the following EXCEPT:
1. imipramine
2. fluoxetine
3. trazodone
4. bupropion
5. All of the above

Item Number: 1362 correct answer: 1 category: Psychotropics
32. You treat a 40-year-old female for neurotic depression. After a few visits
you prescribe amitriptyline to relieve her depression. After 4 days she calls
you to say the pills are having no effect and she still feels depressed. The
best course of action would be to advise her to:
1. continue on the medication as prescribed, as the drug often takes up to
2-6 weeks to have its antidepressant, effect
2. double the dose
3. stop the pills and you will order other treatment from the pharmacist
4. continue on the same dose and you will call in an order for a second
drug to use in combination with it
5. take the pills with an alcoholic drink to increase their effect

Item Number: 11709 correct answer: 4 category: Psychotropics
33. All of the following benzodiazepines are metabolized to active products
EXCEPT:
1. alprazolam
2. chlordiazepoxide
3. midazolam
4. lorazepam
5. diazepam

Item Number: 11705 correct answer: 4 category: Psychotropics
34. The cyclic antidepressants which selectively block serotonin reuptake is:
1. imipramine
2. doxepin
3. amoxapine
4. fluoxetine
5. maprotiline

Item Number: 10669 correct answer: 5 category: Psychotropics
35. Adverse effects of monoamine oxidase inhibitors include all of the following
EXCEPT:
1. dry mouth, constipation, urinary retention
2. hyperreflexia, fatigue, muscle twitching
3. hypertensive reactions if administered with tyramine containing substances
4. orthostatic hypotension
5. raise seizure threshold

Item Number: 10499 correct answer: 5 category: Psychotropics
36. Adverse effects of antipsychotic agents include all of the following EXCEPT:
1. orthostatic hypotension
2. mydriasis
3. gynecomastia
4. jaundice
5. hypothyroidism

Item Number: 10639 correct answer: 3 category: Psychotropics
37. A patient on medication develops severe hypertension after eating some cheese.
The combination of substances found in the cheese and medication,
respectively, which is the most likely cause of this reaction is:
1. ergotamine and amphetamine
2. acetylcholine and reserpine
3. tyramine and phenelzine
4. angiotensin and propranolol
5. dopamine and phentolamine

Item Number: 10622 correct answer: 4 category: Psychotropics
38. The correct statement which describes the dopamine theory of schizophrenia is:
1. schizophrenia is due to a relative lack of the neurotransmitter dopamine
2. schizophrenia is due to a relative decrease in sensitivity of
postsynaptic CNS dopamine receptors
3. schizophrenia is a result of a deficiency in the decarboxylase enzyme
necessary for dopamine synthesis
4. schizophrenia is due to a functional excess of the neurotransmitter
dopamine or to a hypersensitivity of dopamine receptors or a global
imbalance in dopaminergic function within the area A-10 of the brain
5. All of the above

Item Number: 10657 correct answer: 5 category: Psychotropics
39. Indications for and/or uses of cyclic antidepressants include all of the
following EXCEPT:
1. major depression
2. eating disorders
3. chronic pain
4. obsessive-compulsive disorders
5. epilepsy

Item Number: 10483 correct answer: 2 category: Psychotropics
40. Correct pairs of pharmacologic action with CNS region of dopamine blockade
include:
A. extrapyramidal effects – basal ganglia
B. increase prolactin secretion – limbic
C. antiemetic – chemoreceptor trigger zone
D. antipsychotic – basal ganglia
1. A,B,C
2. A,C
3. B,D
4. D only
5. All of the above

Item Number: 11749 correct answer: 4 category: Psychotropics
41. The predominant action of the demethylated biotransformation product of
imipramine is inhibition of:
1. serotonin synthesis
2. serotonin uptake
3. dopamine release
4. norepinephrine uptake
5. dopamine reuptake

Item Number: 10076 correct answer: 2 category: Psychotropics
42. Lithium carbonate is used as an alternative to the major tranquilizers in
the control of manic-depressive illness. After the drug is started, how many days
elapse before the antimanic effect is reached?
1. 1-5 days
2. 7-10 days
3. 11-15 days
4. 16-20 days
5. 21-25 days

Item Number: 10621 correct answer: 5 category: Psychotropics
43. Drug interactions with neuroleptics include all of the following EXCEPT:
1. opioids
2. guanethidine
3. phenobarbital
4. levodopa
5. furosemide

Item Number: 6923 correct answer: 3 category: Psychotropics
44. An attempted suicide with chlorpromazine is admitted to the hospital in a
semi-comatose state. Blood pressure is low. An injection of epinephrine is
given to restore the cardiovascular system and the patient immediately goes
into shock. Blood pressure is now unobtainable. The responsible factor is:
1. chlorpromazine depresses the respiratory center
2. epinephrine has a positive inotropic effect on the heart
3. chlorpromazine is an alpha-adrenergic blocking agent
4. chlorpromazine causes hypertension in toxic doses
5. epinephrine slows the heart rate

Item Number: 8220 correct answer: 3 category: Psychotropics
45. Compared to other major tranquilizers, thioridazine appears to produce
significantly fewer instances of:
1. ventricular dysrhythmias
2. retinopathy
3. Parkinsonism
4. All of the above
5. 1,3

Item Number: 11761 correct answer: 1 category: Psychotropics
46. Adverse effects of lithium that may persist with chronic therapy include all
of the following EXCEPT:
1. severe nausea and vomiting
2. fine tremor
3. leukopenia
4. polyuria
5. hypothyroidism

Item Number: 10673 correct answer: 4 category: Psychotropics
47. Adverse effects of lithium include all of the following EXCEPT:
1. tremors
2. polyuria
3. sedation
4. tardive dyskinesia
5. hypothyroidism

Item Number: 10489 correct answer: 4 category: Psychotropics
48. Extrapyramidal side effects is most common with which of the following
neuroleptics?
1. thioridazine
2. triflupromazine
3. mesoridazine
4. haloperidol
5. All of the above

Item Number: 11651 correct answer: 2 category: Psychotropics
49. Cholestatic jaundice is a rare hypersensitivity reaction which reportedly
occurs with:
1. amitriptyline
2. chlorpromazine
3. lithium
4. chlordiazepoxide
5. alprazolam

Item Number: 5700 correct answer: 5 category: Psychotropics
50. Overdosage of lithium carbonate prescribed for psychiatric disorders may be
serious. Correct statements include:
1. hemodialysis is an effective means of lithium removal and is helpful in
severe overdoses
2. activated charcoal binds lithium in the GI tract and prevents absorption
3. symptoms include edema, tremor, polyuria, and disturbed consciousness
4. All of the above
5. 1,3

Send comments to willoughby@cctr.umkc.edu.

Illustrated Psychopharmacology Lectures in Your Inbox

  • Mechanisms of action, adverse effects and indications of psychotropic medications.
  • Concise and illustrated presentations. 
  • Practical tips for mental health professionals.

laptop2


 

 

Are you a visual learner interested in learning psychopharmacology? Click here to get our videos