NR577 Pharm# 3: Advanced Clinical
Pharmacology and Diagnostic Decision-Making
Review: Lithium Toxicity, ACE Inhibitor
Interactions, Rapid Cycling Bipolar Disorder,
SSRI Monotherapy Risks, Stevens-Johnson
Syndrome, Metformin-Associated Lactic
Acidosis, Insulin Glargine Dose Adjustment,
Atypical Antipsychotic–Induced Metabolic
Syndrome, Benzodiazepine Respiratory
Suppression, Migraine Prophylaxis in Pregnancy,
Graves Disease Management, Atrial Fibrillation
Rate Control, SGLT2 Inhibitor–Associated
Euglycemic Ketoacidosis, Valproic Acid
Hepatotoxicity, Antidepressant Use in
Pregnancy, Stimulant-Induced Hypertension,
NPH Insulin Hypoglycemia Risk, Alcohol Use
Disorder Pharmacotherapy, Clozapine ANC
Monitoring, Serotonin-Norepinephrine Reuptake
Inhibitors for Neuropathic Pain,
Thiazolidinedione–Associated Heart Failure
Exam Questions Verifies and Provided with
Complete A+ Graded Rationales Latest Updated
2026
1. A patient on lithium presents with tremor
diarrhea, and confusion after starting lisinopril. What is the cause? A. Serotonin syndrome B. Lithium
toxicity C. Neuroleptic malignant syndrome D. Thyroid storm, B. Lithium toxicity
2. A patient with bipolar disorder and rapid cycling should avoid which antidepressant strategy? A. SSRI
with mood stabilizer B. Atypical antipsychotic C. Mood stabilizer alone D. SSRI monotherapy
D. SSRI monotherapy
, 3. A patient with epilepsy develops a rash after starting lamotrigine. This finding is concerning for: A.
Agranulocytosis B. Stevens-Johnson syndrome C. Serotonin syndrome D. Hepatotoxicity
B. Stevens-Johnson syndrome
4. Which diabetes medication should be stopped during acute illness or dehydration? A. Sulfonylurea B.
GLP-1 RA C. Metformin D. Insulin
C. Metformin
5. A patient on insulin glargine reports nocturnal hypoglycemia. Best adjustment? A. Increase dose B.
Switch to NPH C. Decrease dose D. Add sulfonylurea
C. Decrease dose
6. Which medication is most associated with weight gain and metabolic syndrome? A. Ziprasidone B.
Aripiprazole C. Quetiapine D. Olanzapine
D. Olanzapine
7. A patient with panic disorder and COPD should avoid which medication? A. SSRI B. SNRI C.
Benzodiazepine D. Buspirone
C. Benzodiazepine
8. Which migraine preventive is contraindicated in pregnancy? A. Propranolol B. Amitriptyline C.
Topiramate D. Magnesium
C. Topiramate
Pharmacology and Diagnostic Decision-Making
Review: Lithium Toxicity, ACE Inhibitor
Interactions, Rapid Cycling Bipolar Disorder,
SSRI Monotherapy Risks, Stevens-Johnson
Syndrome, Metformin-Associated Lactic
Acidosis, Insulin Glargine Dose Adjustment,
Atypical Antipsychotic–Induced Metabolic
Syndrome, Benzodiazepine Respiratory
Suppression, Migraine Prophylaxis in Pregnancy,
Graves Disease Management, Atrial Fibrillation
Rate Control, SGLT2 Inhibitor–Associated
Euglycemic Ketoacidosis, Valproic Acid
Hepatotoxicity, Antidepressant Use in
Pregnancy, Stimulant-Induced Hypertension,
NPH Insulin Hypoglycemia Risk, Alcohol Use
Disorder Pharmacotherapy, Clozapine ANC
Monitoring, Serotonin-Norepinephrine Reuptake
Inhibitors for Neuropathic Pain,
Thiazolidinedione–Associated Heart Failure
Exam Questions Verifies and Provided with
Complete A+ Graded Rationales Latest Updated
2026
1. A patient on lithium presents with tremor
diarrhea, and confusion after starting lisinopril. What is the cause? A. Serotonin syndrome B. Lithium
toxicity C. Neuroleptic malignant syndrome D. Thyroid storm, B. Lithium toxicity
2. A patient with bipolar disorder and rapid cycling should avoid which antidepressant strategy? A. SSRI
with mood stabilizer B. Atypical antipsychotic C. Mood stabilizer alone D. SSRI monotherapy
D. SSRI monotherapy
, 3. A patient with epilepsy develops a rash after starting lamotrigine. This finding is concerning for: A.
Agranulocytosis B. Stevens-Johnson syndrome C. Serotonin syndrome D. Hepatotoxicity
B. Stevens-Johnson syndrome
4. Which diabetes medication should be stopped during acute illness or dehydration? A. Sulfonylurea B.
GLP-1 RA C. Metformin D. Insulin
C. Metformin
5. A patient on insulin glargine reports nocturnal hypoglycemia. Best adjustment? A. Increase dose B.
Switch to NPH C. Decrease dose D. Add sulfonylurea
C. Decrease dose
6. Which medication is most associated with weight gain and metabolic syndrome? A. Ziprasidone B.
Aripiprazole C. Quetiapine D. Olanzapine
D. Olanzapine
7. A patient with panic disorder and COPD should avoid which medication? A. SSRI B. SNRI C.
Benzodiazepine D. Buspirone
C. Benzodiazepine
8. Which migraine preventive is contraindicated in pregnancy? A. Propranolol B. Amitriptyline C.
Topiramate D. Magnesium
C. Topiramate
