American Board of Psychiatry and Neurology ABPN Neuropharmacology and Psychopharmacology 2

Question 1

Which mechanism best describes how benzodiazepines produce their sedative-anxiolytic effects?

Accepted Answer

Potentiate GABA-A chloride channel opening

Answer

Block NMDA glutamate receptors

Answer

Inhibit dopamine reuptake

Answer

Block serotonin 5-HT3 receptors

Question 2

Which antidepressant is CONTRAINDICATED in patients with a seizure disorder or eating disorders due to lowered seizure threshold?

Accepted Answer

Bupropion

Answer

Sertraline

Answer

Mirtazapine

Answer

Escitalopram

Question 3

A patient stabilized on olanzapine gains 25 pounds over 6 months and develops hyperglycemia. This best exemplifies which pharmacological mechanism?

Accepted Answer

H1 histamine receptor antagonism and 5-HT2C blockade

Answer

D2 receptor blockade

Answer

Muscarinic M1 receptor blockade

Answer

Alpha-2 adrenergic agonism

Question 4

Which drug interaction is MOST clinically significant in a patient taking valproate who starts carbamazepine?

Accepted Answer

Carbamazepine induces CYP enzymes, decreasing valproate levels

Answer

Carbamazepine increases valproate levels causing toxicity

Answer

Valproate inhibits carbamazepine metabolism causing toxicity

Answer

No significant interaction occurs between these agents

Question 5

What is the mechanism by which acetylcholinesterase inhibitors improve symptoms in Alzheimer's disease?

Accepted Answer

They increase acetylcholine availability at synapses

Answer

They increase dopamine in the prefrontal cortex

Answer

They prevent amyloid beta aggregation

Answer

They block glutamate NMDA receptor excitotoxicity

Question 6

Which medication is FDA-approved for the treatment of alcohol use disorder by blocking opioid reward pathways?

Accepted Answer

Naltrexone

Answer

Disulfiram

Answer

Acamprosate

Answer

Topiramate