NR 546 Week 3 Antipsychotics Table – Advanced Pharmacology Notes
(2026/2027)|Chamberlain
1. Which dopamine pathway is associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: A
Rationale: The mesolimbic pathway is responsible for the ‘positive’ symptoms of
schizophrenia when there is an overabundance of dopamine.
2. Antipsychotic-induced Extrapyramidal Symptoms (EPS) are primarily caused
by D2 receptor blockade in which pathway?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: The nigrostriatal pathway controls motor function; blocking D2 receptors here
leads to EPS and tardive dyskinesia.
,3. An increase in prolactin levels leading to side effects like galactorrhea is
caused by D2 blockade in which pathway?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: C
Rationale: The tuberoinfundibular pathway regulates prolactin secretion. Blockade of D2
receptors in this pathway increases prolactin levels.
4. Which dopamine pathway is hypothesized to be responsible for the ‘negative’
and cognitive symptoms of schizophrenia when dopamine is deficient?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: A
Rationale: The mesocortical pathway is associated with cognitive, executive, and negative
symptoms when there is low dopamine activity.
5. What is the primary mechanism of action for First-Generation Antipsychotics
(FGAs)?
A. Dopamine D2 receptor antagonism
B. Serotonin 5HT2A antagonism
C. Dopamine D2 partial agonism
D. Norepinephrine reuptake inhibition
Answer: A
Rationale: FGAs primarily work by blocking D2 receptors in all dopamine pathways, which
is why they carry a higher risk of EPS.
, 6. Which statement best describes the mechanism of Second-Generation
Antipsychotics (SGAs)?
A. Strong D2 antagonism with no serotonin involvement
B. Serotonin-Dopamine Antagonism (D2 and 5HT2A blockade)
C. Purely GABAergic modulation
D. Glutamate receptor stimulation
Answer: B
Rationale: SGAs are characterized by their ability to block both D2 receptors and 5HT2A
serotonin receptors.
7. Which antipsychotic is most famous for its risk of agranulocytosis and
requires strict ANC monitoring?
A. Olanzapine
B. Clozapine
C. Risperidone
D. Quetiapine
Answer: B
Rationale: Clozapine carries a Black Box Warning for agranulocytosis and requires regular
monitoring of the Absolute Neutrophil Count (ANC).
8. Aripiprazole is unique among common antipsychotics because it acts as a:
A. D2 receptor full antagonist
B. D2 receptor partial agonist
C. Pure serotonin agonist
D. GABA-A modulator
Answer: B
Rationale: Aripiprazole is a D2 partial agonist, which allows it to modulate dopamine
levels rather than completely blocking them.
(2026/2027)|Chamberlain
1. Which dopamine pathway is associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: A
Rationale: The mesolimbic pathway is responsible for the ‘positive’ symptoms of
schizophrenia when there is an overabundance of dopamine.
2. Antipsychotic-induced Extrapyramidal Symptoms (EPS) are primarily caused
by D2 receptor blockade in which pathway?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: The nigrostriatal pathway controls motor function; blocking D2 receptors here
leads to EPS and tardive dyskinesia.
,3. An increase in prolactin levels leading to side effects like galactorrhea is
caused by D2 blockade in which pathway?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: C
Rationale: The tuberoinfundibular pathway regulates prolactin secretion. Blockade of D2
receptors in this pathway increases prolactin levels.
4. Which dopamine pathway is hypothesized to be responsible for the ‘negative’
and cognitive symptoms of schizophrenia when dopamine is deficient?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: A
Rationale: The mesocortical pathway is associated with cognitive, executive, and negative
symptoms when there is low dopamine activity.
5. What is the primary mechanism of action for First-Generation Antipsychotics
(FGAs)?
A. Dopamine D2 receptor antagonism
B. Serotonin 5HT2A antagonism
C. Dopamine D2 partial agonism
D. Norepinephrine reuptake inhibition
Answer: A
Rationale: FGAs primarily work by blocking D2 receptors in all dopamine pathways, which
is why they carry a higher risk of EPS.
, 6. Which statement best describes the mechanism of Second-Generation
Antipsychotics (SGAs)?
A. Strong D2 antagonism with no serotonin involvement
B. Serotonin-Dopamine Antagonism (D2 and 5HT2A blockade)
C. Purely GABAergic modulation
D. Glutamate receptor stimulation
Answer: B
Rationale: SGAs are characterized by their ability to block both D2 receptors and 5HT2A
serotonin receptors.
7. Which antipsychotic is most famous for its risk of agranulocytosis and
requires strict ANC monitoring?
A. Olanzapine
B. Clozapine
C. Risperidone
D. Quetiapine
Answer: B
Rationale: Clozapine carries a Black Box Warning for agranulocytosis and requires regular
monitoring of the Absolute Neutrophil Count (ANC).
8. Aripiprazole is unique among common antipsychotics because it acts as a:
A. D2 receptor full antagonist
B. D2 receptor partial agonist
C. Pure serotonin agonist
D. GABA-A modulator
Answer: B
Rationale: Aripiprazole is a D2 partial agonist, which allows it to modulate dopamine
levels rather than completely blocking them.
