ADM Neurobiology of Addiction 2

Question 1

Imbalance between GABA (inhibitory) and glutamate (excitatory) systems is most clinically critical during withdrawal from which substance?

Accepted Answer

Alcohol

Answer

Chronic alcohol use suppresses glutamate and enhances GABA; abrupt cessation leads to glutamate rebound and GABA deficit, causing potentially fatal withdrawal seizures.

Question 2

Solomon and Corbit's 'opponent process theory' of addiction describes addiction as:

Accepted Answer

An initial pleasurable A-state followed by an aversive B-state that strengthens with repeated use

Answer

The opponent process theory posits that the hedonic A-state (pleasure) weakens while the opponent B-state (dysphoria/withdrawal) strengthens, driving continued use to avoid the negative state.

Question 3

The corticotropin-releasing factor (CRF) system activated during withdrawal contributes primarily to:

Accepted Answer

Negative affect and anxiety driving relapse

Answer

CRF release during withdrawal activates stress circuits in the extended amygdala, producing negative emotional states (anxiety, dysphoria) that motivate drug use to relieve distress.

Question 4

Berridge and Robinson's 'incentive salience theory' distinguishes between 'wanting' and 'liking' in addiction, proposing that compulsive drug-seeking is driven by:

Accepted Answer

Sensitized 'wanting' (motivation) even as 'liking' decreases

Answer

Incentive salience theory holds that dopamine sensitization amplifies 'wanting' (motivation circuits) independently of 'liking' (hedonic circuits), explaining compulsive use despite reduced pleasure.

Question 5

Chronic opioid exposure leads to upregulation of which intracellular signaling pathway, contributing to dependence?

Accepted Answer

cAMP/PKA pathway (adenylyl cyclase superactivation)

Answer

Opioids acutely inhibit adenylyl cyclase; chronic exposure causes compensatory superactivation of the cAMP/PKA pathway, which manifests as withdrawal when opioids are removed.

(ADM) Board Certified Addiction Medicine Specialist Practice Test

(ADM) Board Certified Addiction Medicine Specialist Practice Test

ADM Neurobiology of Addiction 2