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Psychopharmacology 6630 Midterm Exam Review 2021

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What is the strongest established risk factor for bipolar disorder? Female Male A. Family history of bipolar disorder B. Male female C. Being diagnosed with Major Depressive Disorder D. Which of the following medications are known as selective serotonin re-uptake inhibitors (SSRIs)? i. Nortriptyline ii. Citalopram iii. Duloxetine iv. Fluoxetine v. Venlafaxine i, iii, and v only A. iii and v only B. i only C. ii and iv only D. i, ii, iii, iv, and v E. Which disease state of a non-adherent patient is at greater risk for substance use, violence, and victimization as well as worse overall quality of life? Parkinson’s Disease a. Multiple Sclerosis b. Schizophrenia c. Major depressive disorder d. Patient is a 72-year-old male with a past medical history significant for atrial fibrillation and COPD with a new diagnosis of major depression disorder. Based on his comorbid conditions, what antidepressant would you recommend as first-line? Fluoxetine A.

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Review Test Submission: Midterm
Exam - Week 6
User Smiles Smiler Smillest
Course NURS-6630N,Approaches to Treatment.2020 Winter Qtr 11/30-02/21
Test Midterm Exam - Week 6
Started 1/8/21
Submitted 1/9/21
Due Date 1/11/21
Status Completed
Attempt Score 64 out of 100 points
Time Elapsed 2 hours, 29 minutes out of 2 hours and 30 minutes
Results Displayed Feedback
• Question 1
What is the strongest established risk factor for bipolar disorder? Family History



Response Feedback: “The strongest established risk factor for BPD is a family history of BPD.”


• Question 2
Which of the following medications are known as selective serotonin re-uptake inhibitors

(SSRIs)? i. Nortriptyline

ii.
Citalo
pram iii.
Dulox
etine iv.
Fluox
etine
v. Venlafaxine




• Question 3
Which disease state of a non-adherent patient is at greater risk for substance use, violence, and
victimization as well as worse overall quality of life? Schizophrenia

,• Question 4
Patient is a 72-year-old male with a past medical history significant for atrial fibrillation and COPD with a
new diagnosis of major depression disorder. Based on his comorbid conditions, what antidepressant
would you recommend as first-line? Atomoxetine


Response (Options C & D are both TCA antidepressants and, based on the patient’s age and
comorbid conditions, a TCA would likely result in more side effects, such as increased fall
Feedback:
risk due to potential for orthostatic hypotension and anticholinergic-related side effects.
In addition, patient has a history for cardiac abnormalities due to A. fib diagnosis - TCAs
result in electrocardiographic changes in susceptible individuals, therefore, would likely
avoid. Choice B is used more for ADHD purposes than as an antidepressant)
Page numbers used: Page 39 for TCA side-effect profile


• Question 5
Which of the following is an appropriate strategy for managing treatment-resistant depression?

Use both SSRI and SNRI




• Question 6
Which of the following medications is best to AVOID in maintenance treatment of bipolar disorder and
why?



Response “As noted previously, antidepressants may contribute to an increase in mood Feedback:
episode frequency.”


• Question 7
With second-generation antipsychotics, what is the main side effect that requires frequent monitoring?



Response table 7-6 & page 80, table 7-7; Page 78: “However, attention over the past decade has
Feedback: focused on effect of second-generation antipsychotics on glucose metabolism and lipids and
associated metabolic syndrome.”


• Question 8
Which amino acid is involved in the synthesis of both norepinephrine and dopamine?

, • Questi.on 9
An 81-year-old male comes to your cli.ni.c today complai.ni.ng of dry mouth, blurred vi.si.on, and
consti.pati.on. He has a past medi.cal hi.story si.gni.fi.cant for hypertensi.on, heart fai.lure, and
depressi.on. Of the followi.ng medi.cati.ons, whi.ch one i.s li.kely contri.buti.ng to these si.de effects?

Response Only TCA i.s li.sted wi.th most anti.choli.nergi.c effects; Page 39 for TCA si.de effect
Feedback: profi.le: “dry mouth, blurred vi.si.on, consti.pati.on, uri.nary hesi.tancy, tachycardi.a,
memory di.ffi.culti.es, and ejaculatory di.ffi.culti.es”
• Questi.on 10
Whi.ch medi.cati.on has been studi.ed and recommended i.n pati.ents wi.th a soci.al anxi.ety di.sorder who
also suffer from an alcohol use di.sorder?


Response “Suggested that treatment wi.th the SSRI. paroxeti.ne decreased the anxi.ety and may
Feedback: have reduced the alcohol use as well”


• Questi.on 11
M. B. was just di.agnosed wi.th Generali.zed Anxi.ety Di.sorder and pharmacotherapy i.s needed. Whi.ch of
the followi.ng would be a fi.rst-li.ne treatment opti.on for M. B.?

I. Duloxeti.ne
II. Queti.api.ne
III. Di.azepam
IV. Esci.talopram



Response “As i.s true for pani.c and the other anxi.ety di.sorders, the SSRI.s and SNRI.S are generally
Feedback: consi.dered fi.rst-li.ne agents for the treatment of GAD because of thei.r favorable si.de
effect profi.le….”


• Questi.on 12
The serotoni.n system i.s i.nvolved i.n many processes i.n psychi.atry, i.ncludi.ng, most promi.nently,
mood, sleep, and psychosi.s. Of the followi.ng neurons li.sted, from where i.s serotoni.n synthesi.zed?



Response Feedback: under serotoni.n subheadi.ng and fi.gure 1-18 on page 16:
Locus Coeruleus: Norepi.nephri.ne
Nucleus basali.s: choli.nergi.c neurons
Substanti.a Ni.gra: dopami.ne Ventral
Tegmental area: dopami.ne


• Questi.on 13

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