WGUl D345l Objectivel Assessmentl (Latestl
2026l Update)l Psychopharmacologyl forl
Advancedl Psychiatricl Mentall Healthl
Practicel Review|l 100%l Verifiedl Questionsl
&l Answersl |l Gradel A
Q:l whatl isl al specificl sidel effectl ofl pimozide?
Answer:
associatedl withl QTcl prolongationl andl ventricularl tachy
Q:l inl whatl pathwayl dol typicall antipsychoticsl workl tol treatl thel positivel symptomsl ofl
schizo?
Answer:
Decreasel dopaminergicl actionl inl *mesolimbic*l pathway:
nucleusl accumbens,l fornix,l amygdalal andl hippocampus
Q:l Whichl dopaminergicl pathwayl isl responsiblel forl negativel symptomsl ofl schizo?
Answer:
decreasedl dopaminergicl actionl inl *mesocortical*l pathway
secondl generationl
l antipsychoticsl helpl fightl thesel betterl thanl 1stl gene
Q:l Whichl dopaminergicl pathwayl isl responsiblel forl EPSl asl al symptoml ofl firstl
generationl antipsychotics?
,Answer:
Blockl dopaminel inl nigrostriatall pathway
Q:l Whichl dopaminergicl pathwayl isl responsiblel forl gynecomastia/l prolactinemial asl al
symptoml ofl secondl generationl antipsychotics?
Answer:
Blockl dopaminel inl tubuloinfundibularl pathway
Q:l Whatl arel thel EPSl sidel effectsl andl whenl doesl eachl ofl theml typicallyl occur?
Answer:
1.l Acutel dystonia-l sustainedl painfull contractionl ofl musclesl ofl neckl (torticollis),l tongue,l
eyesl (oculogyricl crisis)-l lifel threateningl ifl diaphragml orl airwayl (seenl withinl mins/hoursl
tol days)
-l treatmentl =l anticholinergicsl (diphenhydramine,l benztropine)
2.l Akathisia-l anxiety,l restlessness,l fidgetiness,l can'tl sitl still(seenl withinl days)
-l treatmentl =l beta-blockerl (propranolol)l orl benzosl (lorazepam)
3.l Parkinsonism-l bradykinesia,l masklikel face,l cogwheell rigidity,l pill-rollingl tremorl (seenl
withinl weeks)
-l treatmentl =l benztropinel orl amantadinel (dopaminel agonist/l NMDAl antagonist)
4.l Tardivel dyskinesia-l >6l monthsl afterl use;l writingl (choreoathetoid)l movementsl ofl
mouthl andl tonge;l olderl agel isl riskl factor;l 50%l willl remitl mostl arel permanent
-l discontinuel medication,l tryl clozapine
Q:l inl general,l whatl arel thel categoriesl ofl sidel effectsl youl seel froml antipsychoticl
drugs?
Answer:
1.l Antidopaminergicl sidel effects
-l EPSl [parkinsonism,l akathasia,l dystonia,l tardive)
-l hyperprolactinemial [blockingl tuberoinfundibularl area;l decl libido,l galactorrhea,l
gynecomastia,l impotence,l amenorrhea]
2.l Anti-l HAMl effects
-l antihistamine-l sedation,l weightl gain
,-l antil alpha1l adrenergic-l orthostaticl hypotension,l cardiacl abnormalities,l sexl dysfunction
-l antimuscarinics-l hotl asl al harre,l dryl asl al bone,l madl asl al hatter,l fulll asl al teal cup,l
blindl asl al batl (dryl mouth,l tachycardia,l urinaryl retention,l blurryl vision,l constipation,l
preciptaitonl ofl narrowl anglel glaucoma)
3.l Neurolepticl malignantl syndromel (morel inl malesl earlyl inl txl w/l highl potencyl typicall
antipsychotics)
4.l Opthalmologicl problemsl (retinall pigmentationl w/l thioridazine,l depositsl inl lens/ocrenal
withl chlorpromazine)
5.l Dermatologicl (phosensitivty/rashesl andl blue-grayl skinl discoloraitonl w/chlorpromazine)
6.l Seizures-l alll lowerl thresholdl butl lowl potencyl antipsychoticsl arel morel likely
7.l elevatedl LFTs,l jaundice
Q:l howl dol youl treatl EPSl sxs?
Answer:
-l reducel dosel ofl antipsychotic
-l administerl anticholinergicl medl suchl asl benztropinel (Cogentin)l orl diphenhydraminel
(Benadryl)l orl lessl commonlyl antiparkinsonianl medl suchl asl amantadinel (symmetrel)
Q:l whatl isl thel mortalityl ratel ofl NMSl ifl leftl untreated?l whatl typel ofl medl causesl itl
htel most?
Answer:
20%l mortality
morel withl highl potencyl typicall antipsychotics
Q:l whatl arel thel characteristicsl ofl NMS?
Answer:
Fever
Autonomicl instabilityl (tachy,l labilel HTN,l diaphoresis)
Leukocytosis
Tremor
Eelevatedl CPK
Rigidityl (leadl pipe)
Excessivel sweatingl (diaphoresis)
, Deliriuml (mentall statusl changes)
Q:l whatl isl treatmentl ofl NMS?
Answer:
discontinuel currentl medl
*dantrolene,l bromocrpitinel andl amantadine*l mayl bel usedl butl unclearl efficacy
supportivel managementl (largel borel IV,l coolingl pads,l benzosl readyl forl seizurel activity)
notl preventedl froml startingl samel neurolepticl atl laterl timel butl increasedl riskl ofl anotherl
episode
Q:l whatl isl thel ratel atl whichl youl developl tardivel dyskinesial whenl youl arel treatedl w/l
typicall antipsychotic?
Answer:
5%l chancel eachl yearl treatedl withl typicall antipsychotic
Q:l howl canl youl monitorl forl tradivel dyskinesial (whatl scale?)
Answer:
Abnormall involuntaryl movementl scalel (AIMS)
Q:l whyl dol docsl likel tol usel atypicall antipsychoticsl morel thanl typical?l (i.e.l whatl arel
thel benefits?)
Answer:
lessl likelyl tol causel EPS,l TDl orl NMS
mayl bel morel effectivel inl treatingl negl sxs
usedl tol tx:l acutel mania,l bipolar,l andl adjunctivel medl inl unipolarl depression;l canl alsol
helpl withl bordelrine,l PTSDl andl certainl ticl disorders
Q:l Whatl isl clozapine?l andl whatl arel itsl SEl profile?
2026l Update)l Psychopharmacologyl forl
Advancedl Psychiatricl Mentall Healthl
Practicel Review|l 100%l Verifiedl Questionsl
&l Answersl |l Gradel A
Q:l whatl isl al specificl sidel effectl ofl pimozide?
Answer:
associatedl withl QTcl prolongationl andl ventricularl tachy
Q:l inl whatl pathwayl dol typicall antipsychoticsl workl tol treatl thel positivel symptomsl ofl
schizo?
Answer:
Decreasel dopaminergicl actionl inl *mesolimbic*l pathway:
nucleusl accumbens,l fornix,l amygdalal andl hippocampus
Q:l Whichl dopaminergicl pathwayl isl responsiblel forl negativel symptomsl ofl schizo?
Answer:
decreasedl dopaminergicl actionl inl *mesocortical*l pathway
secondl generationl
l antipsychoticsl helpl fightl thesel betterl thanl 1stl gene
Q:l Whichl dopaminergicl pathwayl isl responsiblel forl EPSl asl al symptoml ofl firstl
generationl antipsychotics?
,Answer:
Blockl dopaminel inl nigrostriatall pathway
Q:l Whichl dopaminergicl pathwayl isl responsiblel forl gynecomastia/l prolactinemial asl al
symptoml ofl secondl generationl antipsychotics?
Answer:
Blockl dopaminel inl tubuloinfundibularl pathway
Q:l Whatl arel thel EPSl sidel effectsl andl whenl doesl eachl ofl theml typicallyl occur?
Answer:
1.l Acutel dystonia-l sustainedl painfull contractionl ofl musclesl ofl neckl (torticollis),l tongue,l
eyesl (oculogyricl crisis)-l lifel threateningl ifl diaphragml orl airwayl (seenl withinl mins/hoursl
tol days)
-l treatmentl =l anticholinergicsl (diphenhydramine,l benztropine)
2.l Akathisia-l anxiety,l restlessness,l fidgetiness,l can'tl sitl still(seenl withinl days)
-l treatmentl =l beta-blockerl (propranolol)l orl benzosl (lorazepam)
3.l Parkinsonism-l bradykinesia,l masklikel face,l cogwheell rigidity,l pill-rollingl tremorl (seenl
withinl weeks)
-l treatmentl =l benztropinel orl amantadinel (dopaminel agonist/l NMDAl antagonist)
4.l Tardivel dyskinesia-l >6l monthsl afterl use;l writingl (choreoathetoid)l movementsl ofl
mouthl andl tonge;l olderl agel isl riskl factor;l 50%l willl remitl mostl arel permanent
-l discontinuel medication,l tryl clozapine
Q:l inl general,l whatl arel thel categoriesl ofl sidel effectsl youl seel froml antipsychoticl
drugs?
Answer:
1.l Antidopaminergicl sidel effects
-l EPSl [parkinsonism,l akathasia,l dystonia,l tardive)
-l hyperprolactinemial [blockingl tuberoinfundibularl area;l decl libido,l galactorrhea,l
gynecomastia,l impotence,l amenorrhea]
2.l Anti-l HAMl effects
-l antihistamine-l sedation,l weightl gain
,-l antil alpha1l adrenergic-l orthostaticl hypotension,l cardiacl abnormalities,l sexl dysfunction
-l antimuscarinics-l hotl asl al harre,l dryl asl al bone,l madl asl al hatter,l fulll asl al teal cup,l
blindl asl al batl (dryl mouth,l tachycardia,l urinaryl retention,l blurryl vision,l constipation,l
preciptaitonl ofl narrowl anglel glaucoma)
3.l Neurolepticl malignantl syndromel (morel inl malesl earlyl inl txl w/l highl potencyl typicall
antipsychotics)
4.l Opthalmologicl problemsl (retinall pigmentationl w/l thioridazine,l depositsl inl lens/ocrenal
withl chlorpromazine)
5.l Dermatologicl (phosensitivty/rashesl andl blue-grayl skinl discoloraitonl w/chlorpromazine)
6.l Seizures-l alll lowerl thresholdl butl lowl potencyl antipsychoticsl arel morel likely
7.l elevatedl LFTs,l jaundice
Q:l howl dol youl treatl EPSl sxs?
Answer:
-l reducel dosel ofl antipsychotic
-l administerl anticholinergicl medl suchl asl benztropinel (Cogentin)l orl diphenhydraminel
(Benadryl)l orl lessl commonlyl antiparkinsonianl medl suchl asl amantadinel (symmetrel)
Q:l whatl isl thel mortalityl ratel ofl NMSl ifl leftl untreated?l whatl typel ofl medl causesl itl
htel most?
Answer:
20%l mortality
morel withl highl potencyl typicall antipsychotics
Q:l whatl arel thel characteristicsl ofl NMS?
Answer:
Fever
Autonomicl instabilityl (tachy,l labilel HTN,l diaphoresis)
Leukocytosis
Tremor
Eelevatedl CPK
Rigidityl (leadl pipe)
Excessivel sweatingl (diaphoresis)
, Deliriuml (mentall statusl changes)
Q:l whatl isl treatmentl ofl NMS?
Answer:
discontinuel currentl medl
*dantrolene,l bromocrpitinel andl amantadine*l mayl bel usedl butl unclearl efficacy
supportivel managementl (largel borel IV,l coolingl pads,l benzosl readyl forl seizurel activity)
notl preventedl froml startingl samel neurolepticl atl laterl timel butl increasedl riskl ofl anotherl
episode
Q:l whatl isl thel ratel atl whichl youl developl tardivel dyskinesial whenl youl arel treatedl w/l
typicall antipsychotic?
Answer:
5%l chancel eachl yearl treatedl withl typicall antipsychotic
Q:l howl canl youl monitorl forl tradivel dyskinesial (whatl scale?)
Answer:
Abnormall involuntaryl movementl scalel (AIMS)
Q:l whyl dol docsl likel tol usel atypicall antipsychoticsl morel thanl typical?l (i.e.l whatl arel
thel benefits?)
Answer:
lessl likelyl tol causel EPS,l TDl orl NMS
mayl bel morel effectivel inl treatingl negl sxs
usedl tol tx:l acutel mania,l bipolar,l andl adjunctivel medl inl unipolarl depression;l canl alsol
helpl withl bordelrine,l PTSDl andl certainl ticl disorders
Q:l Whatl isl clozapine?l andl whatl arel itsl SEl profile?
