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Psychopharmacology MCQs

Total questions: 101

Worksheet time: 51mins

Name
Class
Date
1.

Which of the following is a selective serotonin reuptake inhibitor (SSRI)?

a)

Imipramine

b)

Fluoxetine

c)

Bupropion

d)

Trazodone

2.

Which antidepressant carries the highest risk of seizure at high doses?

a)

Venlafaxine

b)

Paroxetine

c)

Bupropion

d)

Fluoxetine

3.

Which class of drugs requires a strict tyramine-free diet?

a)

SSRIs

b)

MAOIs

c)

SNRIs

d)

TCAs

4.

What is the mechanism of action of benzodiazepines?

a)

Dopamine receptor blockade

b)

GABA-A receptor modulation

c)

NMDA receptor antagonism

d)

Acetylcholine inhibition

5.

Which antipsychotic is most associated with agranulocytosis?

a)

Risperidone

b)

Olanzapine

c)

Clozapine

d)

Haloperidol

6.

Which neurotransmitter is primarily increased by stimulants like methylphenidate?

a)

Serotonin

b)

GABA

c)

Norepinephrine

d)

Acetylcholine

7.

Which mood stabilizer is known to cause nephrogenic diabetes insipidus?

a)

Lamotrigine

b)

Lithium

c)

Valproate

d)

Carbamazepine

8.

What is the therapeutic plasma level range for lithium in acute treatment?

a)

0.2-0.5 mEq/L

b)

0.6-1.5 mEq/L

c)

2.0-2.5 mEq/L

d)

5.0-6.5 mEq/L

9.

Which brain region shows hyperactivity in OCD patients?

a)

Hippocampus

b)

Orbitofrontal cortex

c)

Dorsolateral PFC

d)

Brainstem

10.

Which SSRI has the longest half-life?

a)

Fluvoxamine

b)

Paroxetine

c)

Citalopram

d)

Fluoxetine

11.

Which of the following is a high-potency typical antipsychotic?

a)

Chlorpromazine

b)

Haloperidol

c)

Clozapine

d)

Olanzapine

12.

What is the primary action of valproate?

a)

GABA degradation

b)

Enhances GABA synthesis

c)

Blocks dopamine receptors

d)

Inhibits serotonin uptake

13.

What syndrome is characterized by lead-pipe rigidity, fever, and autonomic instability?

a)

Serotonin syndrome

b)

Akathisia

c)

Neuroleptic malignant syndrome

d)

Malignant hyperthermia

14.

Which of the following increases the risk of lithium toxicity?

a)

SSRIs

b)

Benzodiazepines

c)

NSAIDs

d)

Buspirone

15.

Which neurotransmitter is deficient in Parkinson-like EPS from antipsychotics?

a)

Glutamate

b)

GABA

c)

Dopamine

d)

Serotonin

16.

Which antidepressant is associated with priapism as a rare side effect?

a)

Trazodone

b)

Fluoxetine

c)

Mirtazapine

d)

Bupropion

17.

Which mood stabilizer inhibits GSK-3 and increases BDNF expression?

a)

Fluoxetine

b)

Carbamazepine

c)

Lithium

d)

Diazepam

18.

Which stimulant has the longest half-life in adults?

a)

Methylphenidate

b)

Dexedrine

c)

Cylert

d)

Adderall

19.

SSRIs are contraindicated with which substance?

a)

Benzodiazepines

b)

MAO inhibitors

c)

Buspirone

d)

Propranolol

20.

What is the primary inhibitory neurotransmitter in the CNS?

a)

Glutamate

b)

GABA

c)

Dopamine

d)

Serotonin

21.

Which neurotransmitter is primarily associated with positive symptoms in schizophrenia?

a)

Serotonin

b)

Acetylcholine

c)

Dopamine

d)

GABA

22.

Which medication is a DA/NE reuptake inhibitor used in depression and ADHD?

a)

Venlafaxine

b)

Bupropion

c)

Fluoxetine

d)

Paroxetine

23.

Benzodiazepine withdrawal is more severe with:

a)

Long half-life agents

b)

Short half-life agents

c)

GABA antagonists

d)

SSRIs

24.

Which drug is used as adjunctive treatment in PTSD and targets CRH receptors?

a)

Buspirone

b)

Paroxetine

c)

Diazepam

d)

None are CRH receptor-specific

25.

What is the effect of NMDA receptor hypofunction in schizophrenia?

a)

Decreased dopamine in mesolimbic areas

b)

Increased prefrontal glutamate

c)

Disinhibition of limbic dopamine release

d)

Increased serotonin release

26.

Which medication increases hippocampal volume over long-term use?

a)

Fluoxetine

b)

Lithium

c)

Haloperidol

d)

Risperidone

27.

Which antipsychotic is least likely to cause extrapyramidal side effects?

a)

Risperidone

b)

Haloperidol

c)

Clozapine

d)

Fluphenazine

28.

Which neurotransmitter is synthesized in the locus coeruleus?

a)

Serotonin

b)

GABA

c)

Dopamine

d)

Norepinephrine

29.

What receptor activity causes weight gain and sedation in antipsychotics?

a)

D2 antagonism

b)

5-HT2A antagonism

c)

H1 antagonism

d)

M1 antagonism

30.

SSRIs are metabolized primarily by which liver enzyme?

a)

CYP1A2

b)

CYP2D6

c)

CYP3A4

d)

Both B and C

31.

Which of the following drugs is a serotonin and norepinephrine reuptake inhibitor (SNRI)?

a)

Sertraline

b)

Bupropion

c)

Venlafaxine

d)

Fluvoxamine

32.

What is the recommended treatment duration for a first episode of major depression after remission?

a)

1 month

b)

3 months

c)

6-12 months

d)

Lifelong

33.

What psychiatric condition is most associated with hyperactivity in the amygdala?

a)

Obsessive-compulsive disorder

b)

Generalized anxiety disorder

c)

Bipolar disorder

d)

Substance use disorder

34.

Which medication is approved for PMDD (premenstrual dysphoric disorder)?

a)

Bupropion

b)

Sertraline

c)

Mirtazapine

d)

Nortriptyline

35.

Which of the following is not a typical symptom of SSRI discontinuation syndrome?

a)

Flu-like symptoms

b)

Hallucinations

c)

Lightheadedness

d)

Diarrhea

36.

Which benzodiazepine has no active metabolites and a short half-life?

a)

Clonazepam

b)

Diazepam

c)

Oxazepam

d)

Chlordiazepoxide

37.

Which of the following medications is commonly used to augment antidepressants in treatment-resistant depression?

a)

Propranolol

b)

Lorazepam

c)

Lithium

d)

Methylphenidate

38.

What is the mechanism of action of SSRIs?

a)

Serotonin synthesis enhancement

b)

Serotonin reuptake inhibition

c)

Serotonin receptor agonism

d)

MAO inhibition

39.

Which antipsychotic is most sedating due to H1 antagonism?

a)

Haloperidol

b)

Clozapine

c)

Aripiprazole

d)

Risperidone

40.

What is a defining feature of atypical antipsychotics?

a)

Strong D2 antagonism only

b)

Pure serotonin antagonism

c)

Combined D2 and 5-HT2A receptor antagonism

d)

High extrapyramidal side effects

41.

What is the main mechanism of buspirone?

a)

GABA-A modulation

b)

5-HT1A partial agonism

c)

Dopamine antagonism

d)

Alpha-2 antagonism

42.

In ADHD, what brain region is typically underactive?

a)

Occipital lobe

b)

Prefrontal cortex

c)

Hippocampus

d)

Amygdala

43.

Which neurotransmitter is excitatory and involved in learning?

a)

GABA

b)

Glutamate

c)

Serotonin

d)

Dopamine

44.

What is the approximate therapeutic range for valproate (µg/mL)?

a)

5-15

b)

20-30

c)

50-100

d)

100-200

45.

What drug is contraindicated in patients with a history of eating disorders due to seizure risk?

a)

Venlafaxine

b)

Sertraline

c)

Bupropion

d)

Nortriptyline

46.

What symptom is most commonly treated with propranolol in psychiatry?

a)

Auditory hallucinations

b)

Tremor

c)

Mania

d)

Cognitive impairment

47.

Which theory explains psychiatric illness through early life conflict and unconscious dynamics?

a)

Cognitive theory

b)

Behavioral theory

c)

Psychoanalytic theory

d)

Neurochemical theory

48.

What is the most common mechanism of drug interaction involving SSRIs?

a)

Hepatic enzyme induction

b)

CYP inhibition

c)

Anticholinergic effects

d)

Dopamine antagonism

49.

What is a core mechanism of lamotrigine in bipolar disorder?

a)

Sodium channel blockade

b)

Calcium channel opening

c)

Dopamine antagonism

d)

NMDA stimulation

50.

What is the minimum number of depressive episodes that warrants indefinite antidepressant maintenance?

a)

1

b)

2

c)

3

d)

4

51.

What is the most common endocrine side effect of risperidone?

a)

Hyperthyroidism

b)

Hyperprolactinemia

c)

Adrenal insufficiency

d)

Hypoglycemia

52.

Which of the following psychiatric disorders is most strongly associated with an enlarged lateral ventricle volume?

a)

PTSD

b)

OCD

c)

Schizophrenia

d)

Panic Disorder

53.

Which genetic method is best to differentiate between environmental and inherited traits?

a)

Genome-wide association studies

b)

Twin studies

c)

Family pedigree

d)

Structural MRI

54.

In PTSD, which brain structure shows reduced volume?

a)

Prefrontal cortex

b)

Amygdala

c)

Hippocampus

d)

Locus coeruleus

55.

What mechanism contributes to lithium's mood stabilizing effects?

a)

MAO inhibition

b)

Serotonin reuptake inhibition

c)

Inhibition of inositol monophosphatase

d)

Dopamine receptor antagonism

56.

Which antidepressant may prolong the QT interval the most?

a)

Sertraline

b)

Citalopram

c)

Bupropion

d)

Mirtazapine

57.

Which factor is considered precipitating in the etiology of mental illness?

a)

Genetic predisposition

b)

Traumatic childhood

c)

Divorce 3 weeks before onset

d)

Lack of family support

58.

Which of the following medications is approved for bipolar depression?

a)

Fluoxetine

b)

Lamotrigine

c)

Nortriptyline

d)

Trazodone

59.

What type of symptom is poverty of speech in schizophrenia?

a)

Positive

b)

Cognitive

c)

Disorganized

d)

Negative

60.

Which receptor is blocked by first-generation antipsychotics to reduce hallucinations?

a)

5-HT2A

b)

D2

c)

H1

d)

Alpha-1

61.

Which condition has been linked to HPA axis dysregulation?

a)

Schizophrenia

b)

Depression

c)

ADHD

d)

Alzheimer's Disease

62.

A child with inattentiveness and hyperactivity most likely has underactivation of:

a)

Amygdala

b)

Cerebellum

c)

Prefrontal cortex

d)

Brainstem

63.

What is a perpetuating factor in depression?

a)

Alcoholism

b)

Genetic risk

c)

Acute trauma

d)

Low birth weight

64.

What is the best indicator of suicide risk in a depressed patient?

a)

Low serotonin

b)

Poor sleep

c)

Hopelessness

d)

Family history

65.

Atypical antipsychotics differ from typicals in that they:

a)

Cause more EPS

b)

Are D2-only blockers

c)

Also block 5-HT2A

d)

Are sedating due to dopamine blockade

66.

What psychological theory describes mental illness as maladaptive cognition?

a)

Psychoanalytic theory

b)

Behaviorism

c)

Humanistic theory

d)

Cognitive theory

67.

Which drug is a partial agonist at D2 receptors?

a)

Risperidone

b)

Aripiprazole

c)

Haloperidol

d)

Quetiapine

68.

Which of the following drugs acts primarily at the norepinephrine transporter?

a)

Duloxetine

b)

Clonidine

c)

Atomoxetine

d)

Fluoxetine

69.

What is the best first-line treatment for acute mania?

a)

Paroxetine

b)

Lithium

c)

Diazepam

d)

Trazodone

70.

Which of the following medications is most effective in reducing suicide risk in bipolar disorder?

a)

Olanzapine

b)

Valproate

c)

Lithium

d)

Fluoxetine

71.

Which class of medications has the highest risk of metabolic syndrome?

a)

SSRIs

b)

Typical antipsychotics

c)

Atypical antipsychotics

d)

Benzodiazepines

72.

Which of the following is a risk of using benzodiazepines in the elderly?

a)

Tardive dyskinesia

b)

Orthostatic hypotension

c)

Cognitive impairment and falls

d)

Serotonin syndrome

73.

What is the primary site of serotonin synthesis?

a)

Amygdala

b)

Substantia nigra

c)

Raphe nuclei

d)

Locus coeruleus

74.

Which of the following best describes the mechanism of tricyclic antidepressants (TCAs)?

a)

Serotonin reuptake inhibition only

b)

Dopamine reuptake inhibition

c)

Inhibition of serotonin and norepinephrine reuptake

d)

Direct receptor agonism

75.

Electroconvulsive Therapy (ECT) is especially useful in:

a)

PTSD

b)

Treatment-resistant depression

c)

ADHD

d)

GAD

76.

Which class of medication is most associated with hyponatremia in the elderly?

a)

SSRIs

b)

TCAs

c)

MAOIs

d)

Anticonvulsants

77.

Which stimulant has a high risk of abuse and is a Schedule II drug?

a)

Atomoxetine

b)

Modafinil

c)

Methylphenidate

d)

Buspirone

78.

What is the neurodevelopmental theory of schizophrenia?

a)

Inflammation causes NMDA blockade

b)

Prenatal brain abnormalities predispose to later illness

c)

Dopamine overactivity in the thalamus

d)

Childhood trauma leads to neurogenesis

79.

Which disorder is most responsive to exposure therapy?

a)

Generalized anxiety disorder

b)

Panic disorder

c)

OCD

d)

Social phobia

80.

Which neurotransmitter system is targeted in Alzheimer's disease treatment?

a)

Serotonin

b)

Dopamine

c)

Acetylcholine

d)

GABA

81.

Which neurotransmitter system is primarily targeted by acetylcholinesterase inhibitors in Alzheimer's disease?

a)

Serotonin

b)

Dopamine

c)

Acetylcholine

d)

GABA

82.

A patient taking MAOIs must avoid which of the following?

a)

High-fat meals

b)

Tyramine-rich foods

c)

Alcohol

d)

Gluten

83.

NMDA receptor antagonists such as ketamine are showing promise in the treatment of:

a)

Schizophrenia

b)

Generalized anxiety disorder

c)

Treatment-resistant depression

d)

Bipolar mania

84.

Which prodromal symptom is commonly seen before the onset of schizophrenia?

a)

Hyperactivity

b)

Increased appetite

c)

Social withdrawal

d)

Elevated mood

85.

Which brain region is critically involved in the regulation of fear and threat responses?

a)

Cerebellum

b)

Thalamus

c)

Amygdala

d)

Basal ganglia

86.

Which of the following is both an anticonvulsant and a mood stabilizer?

a)

Buspirone

b)

Valproate

c)

Bupropion

d)

Atomoxetine

87.

What serious adverse effect is associated with clozapine treatment?

a)

Nephrotoxicity

b)

Hypertension

c)

Agranulocytosis

d)

Hepatitis

88.

Which two neurotransmitters are most affected by stimulants used in ADHD treatment?

a)

GABA and glutamate

b)

Serotonin and dopamine

c)

Dopamine and norepinephrine

d)

Acetylcholine and serotonin

89.

Which gland releases cortisol in response to HPA axis activation?

a)

Pituitary gland

b)

Pineal gland

c)

Adrenal gland

d)

Hypothalamus

90.

Chronic stress leads to which of the following changes in the HPA axis?

a)

Increased hippocampal volume

b)

Enhanced prefrontal inhibition

c)

Impaired negative feedback from the hippocampus

d)

Decreased cortisol secretion

91.

Elevated cortisol levels are most commonly seen in:

a)

Panic disorder

b)

PTSD

c)

Major depressive disorder

d)

Autism

92.

Which neurotransmitter is overactive in the mesolimbic pathway in schizophrenia?

a)

Serotonin

b)

Glutamate

c)

Dopamine

d)

GABA

93.

What is the main function of the prefrontal cortex in psychiatric function?

a)

Motor coordination

b)

Emotional memory

c)

Executive functioning and decision making

d)

Autonomic regulation

94.

What is a key feature of bipolar I disorder?

a)

Hypomanic episodes

b)

Full manic episodes

c)

Chronic low mood

d)

Phobia-related obsessions

95.

Which brain structure is primarily responsible for encoding emotional memory?

a)

Thalamus

b)

Amygdala

c)

Brainstem

d)

Insula

96.

What is a common side effect of valproate?

a)

Hypernatremia

b)

Hepatotoxicity

c)

Psychosis

d)

Hypertension

97.

A key component of cognitive-behavioral therapy is:

a)

Free association

b)

Systematic desensitization

c)

Challenging automatic thoughts

d)

Projective testing

98.

In which disorder is serotonin dysregulation most implicated?

a)

Schizophrenia

b)

ADHD

c)

Major depressive disorder

d)

Alzheimer's disease

99.

Which antidepressant class can cause orthostatic hypotension due to alpha-1 blockade?

a)

SSRIs

b)

TCAs

c)

MAOIs

d)

SNRIs

100.

Which of the following medications is most sedating?

a)

Fluoxetine

b)

Venlafaxine

c)

Mirtazapine

d)

Sertraline

101.

. What is the purpose of psychoeducation in psychiatric care?

a)

To teach neuroanatomy

b)

To inform patients about their diagnosis and treatment

c)

To administer psychological tests

d)

To monitor liver function

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