1 Which of the following class of anti depressant is NOT preferred due to chances of

dangerous interactions and lesser effectiveness

1. TCAs
2. SSRIs
3. Other newer A.D
4. MAOIs

Ans; 4

2 Safest A.D in elderly patients would be

1. Escitalopram
2. Paroxetine
3. Clomipramine
4. Fluoxetine

Ans; 1

3. Postural hypotension is MOST commonly seen as a S.E of

1. TCAs
2. Mood stabilizers
3. Anti epileptics
4. Anti psychotics

Ans; 1

4. In case of recurrent depression , maintenance treatment is required for

1.4 wks
2.4 months
3.4 years
4. At least 5 years and possibly indefinitely

Ans; 4

5. Which drug requires a strict monitoring of serum levels every 3 months and is
likely to cause sodium imbalances

1. Valproic acid
2. Clomipramine
3. Lithium
4. Lamotrigine

Ans; 3

6. Which of the following class of drugs should be prescribed for the SHORTEST
possible time, in the LOWEST possible dose
1. Anti epileptics
 2. Typical anti psychotics
3. TCAs
4.Benzodiazapines

Ans;4

7. Newer anti epileptics include

1.Carbamezipine,pregablin
2.Gabapentin,topiramate
3.Lamotrigine,clonazepam

Ans;2

8. SSRIs are preferred over TCAs because they have

1.Less GI symptoms
2.Less bleeding disorders
3.Less potential SE and better tolerated
4.Better response in severely ill

Ans;3

9. Possibility of deliberate over dosage risk should be kept in mind when

prescribing
1.Lithium
2.Valproic acid
3.Comipramine
4.Sertraline

Ans;3

10. Drug used in children under 18 years of age for management of depressive
illness is
1.Fluoxetine
2.Mitrazapine
3.Paroxetine
4.Venlafaxine

Ans;1

11.Anti manic drugs are also known as

1.Anti epileptics
2.Mood stabilizers
3.Anti depressants
4.Anxiolytics
Ans;2

12. Which of the following is used as adjuvant in partial seizures not controlled
with any other
1. Gabapentin
2. Pregablin
3. Lamotrigine
3. Topiramate

Ans; 1

13. Which of the following is used as an adjuvant in epilepsy

1. Clonazepam
2. Oxazepam
3. Lorazepam
4. Diazepam

Ans; 1

14. Benzodiazepines are thought to cause sedative and/or anxiolytic effects by

1. Increasing functional activity at GABAB receptiors
2. Blocking the NMDA glutamate receptor subtype
3. Facilitating GABA-medicated increases in chloride ion conductance

Ans: 3

15. Tricyclic antidepressants

1. Increase the antihypertensive effect of guanerthidine

2. Have anticonvulsant activity
3. Should not be used in patients with glaucoma
4. May increase oral absorption of levodopa
5. Are sometimes used as antiarrhythmics

Ans; 3

16. If the seizures are to be effectively controlled without excessive sedation, the
most appropriate drug is

1. Acctazolamide
2. Carbamazepine
3. Clonazepam
4. Valproic acid
 5. Vigabatrin

Ans: 4

17. In the management of this patient with the most appropriate drug, which one of
the following considerations is LEAST important?

1. Abdominal pain and heartburn are likely side effects

2. Liver enzymes should be monitored
3. She should be examined every 2 or 3 months for deep tendon reflex activity
4. She should contact her physician immediately if she becomes prenant
5. The Patient should avoid barbiturates

Ans: 3

18. A young male patient suffers from a seizure disorder characterized by tonic
rigidity of the extremities followed in 15-30 seconds by tremor progressing to
massive jerking of the body. This clonic phase lasts for a minute or two, leaving the
patient in a stuporouts state. The anti-seizure drug of choice for chronic
management of this patient is

1. Clonazepam
2. Ethosuximide
3. Fosphenytoin
4. Lamotrigine
5. Valproic acid

Ans: 5

19. A- year-old women presents with symptoms of major depression that are
unrelated to ageneral medical condition, bereavement, or substance abuse. She is
not currently taking any prescription or over-the counter medications. Drug
treatment is to be initiated with a selective serotonin reuptake inhibitor. In your
information to the patient, you would NOT tell her that

1. Divided doses may help to reduce nausea and gastrointestinal distress

2. Muscle cramps and twitches sometimes occur
3. She must inform you if she anticipates using other medications
4. Taking the drug in the evening will ensure a good night’s sleep
5. The drug may require 2 weeks or more to become effective

Ans: 4
20. Regarding the clinical use of antidepressant drugs, which one of the following
statements is false?

1. Patients should be advised not to abruptly discontinue antidepressant medications

2. In selecting an appropriate drug for treatment of depression, the past history of
patient, response to specific drugs is a valuable guide
3. In the treatment of major depressive disorders, sertraline is usually more effective
than fluoxtine
4. MAO inhibitors are sometimes effective in depressions with attendant anxiety,
phobic features, and hypoehondriasis
5. Weight loss often occurs in patients taking SSRIs

Ans: 3

Item 21-22. A patient under treatment for a major depressive disorder is brought to the
emergency room after ingesting 30 times the normal daily therapcutic dose of
amitriptyline.

21. Of the possible signs and symptoms in this patient, which one of the following is
not likely to be observed?

1. Acidosis
2. Coma and shock
3. Hot dry skin
4. Hypotension
5. Pinpoint pupils

Ans: 5

22. In sever tricyclie antidepressant overdose, it would NOT be of value to

1. Administer lidocaine (to hasten drug elimination)

2. Institute hemodialysis (to hasten drug elimination)
3. Administer bicarbonate and potassium chloride (to correct acidosis and
hypokalemia)
4. Provide intravenous diazepam (to control seizures)
5. Maintain the rhythm of the heart by electrical pacing

Ans: 2

23. A recently bereaved 74- year old female patient was treated with a
 benzodiazepine for several weeks after the death of her husband, but she did not
like the daytime sedation it causes. She has no major medical problems but
appears rather infirm for her age and has poor eyesight. Because her depressive
symptoms are not abating, you decide on a trial of an antidepressant medication.
When one of the following drugs would be the most appropriate choice for this
patient?

1. Amitriptyline
2. Mirtazapine
3. Paroxetine
4. Phenelzine
5. Trazodone

Ans: 3

24. Which one of the following drugs is most likely to be f value in obsessive-
compulsive disorders (OCD)?

1. Amitriptyline
2. Bupropion
3. Clomipramine
4. Desipramine
5. Mirtazapine

Ans: 3

25. Established clinical uses of this drug include enuresis and chronic pain.

1. Bupropion
2. Fluvoxamine
3. Impipramine
4. Phenelzine
5. Selegiline

Ans: 3

26. A 56- year- old man, very overweight, complains of not sleeping well and feeling
tired during the day. He tells his wife is the cause of the problem because she wakes
him up several times during the night due to his loud snores. This appears to be a
breathing-related sleep disorder, so you will probably write a prescription for
 1. Clorazepate
2. Flurazepam
3. Secobarbital
4. Triazolam
5. None of the above

Ans: 5

27. Regarding the characteristic properties of SSRIs prescribed in a young man, the
physician should inform the patient to anticipate

1. Additive CNS depression wityh alcoholic beverages

2. A significiant effect on memory
3. That the drug will take a week or so to begin working
4. A need to gradually increase drug dosage because of tolerance
5. That if he stops taking the drug abruptly he will experience withdrawal signs

Ans: 3

28. A 28-year-old woman has sporadic attacks of intense anxiety, with marked
physical symptoms including hyperventilation, tachyeardia, and sweating. If she is
diagnosed as suffering form a panic disorder, the most appropriate drug to use is

1. Alprazolam
2. Chloral hydrate
3. Flurazepam
4. Meprobamate
5. Propranolol

Ans: 1

29. A 26-year-old woman develops a seizure disorder characterized by recurrent

contractions of the muscles in the right hand which then spread to the right arm
and to the right side of the face ("jacksonian march"). Consciousness is not impaired,
and the attacks usually last for only a minute or two. Which one of the following
drugs is LEAST likely to be useful in the treatment of this patient?
1. Carbamazcpinc
2. Ethosuximidc
3. Lumotrigine
4. Phcnytoin
5. Primidonc

Ans: 2
30. A 9-year-old child is having learning difficulties at school. He has brief
lapses of awareness with eyelid fluttering that occur every 5-.0 minutes. EEC
studies reveal brief 3-Hz spike and wave discharges appearing synchronously
in all leads. Which one of the following drugs would be effective in this child but
has the disadvantages of causing sedation and tolerance

1. Clonazcpam
2. Diazcpam
3. Ethosuximide
4. Phcnobarbital
5. Valproicacid

Ans: 1

31. Adverse effects of neuroleptic agents, such as galactorrhea, gynecomastia,

ejaculation disorders, are attributed to:
1. an antimuscarinic, anticholinergic effect
2. an inhibition of angiotensin receptors
3. an inhibition of dopamine, increase in prolactin
4. an increase of serotonin secretion
5. a stimulation of the alpha1 adrenergic receptors

Ans: 3

32. Drugs like donepezil (Aricept*) and rivastigmine (Exelon*) act by:

1. increasing acetylcholine release

2. inhibiting cholinesterases
3. inhibiting monoamine oxidase
4. stimulating 5HT3 serotonin receptors
5. stimulating alpha-2 adrenergic receptors
Ans .2

33. A patient a few hours after having taken a neuroleptic agent such as haloperidol
presents an acute facial dyskinesia . The following drugs could correct this disorder:
1. propranolo
2. trihexylphenidyl
3. trinitrite
4. naltrexone
5. dexamethasone
Ans: 2
34. The following drug (s) decrease(s) or suppress(es) delusions and hallucinations:

1. diazepam
2. imipramine
3. phenobarbital
4. a phenothiazine such as chlorpromazine
5. a SSRI
Ans: 4
35. The following drug (s) induce(s) adversely an increase of prolactin secretion
(with galactorrhea, amenorrhea…):

1. Oxazepam
2. Haloperidol
3. lorazepam
4. procalmadiol
5. mirtazapine
Ans: 2

36. - zepam or - zolam: the drugs whose common name ends by the suffix - zepam or
- zolam are:
1. benzodiazepines
2. antidepressants
3. cephalosporins
4. allosteric modulators of GABA-A receptors
5. sulfonylureas
ans: 1
37. Antipsychotic drug with least extrapyramidal toxicity:
1. fluphenazine (Prolixin)
2. haloperidol (Haldol)
3. clozapine (Clozaril)
4. thiothixene (Navane)
5. chlorpromazine (Thorazine)

Ans: 3

38. Most common antipsychotic neurological side effect:

5. tardive dyskinesia
6. perioral tremor
7. akathisia
8. pseudoparkinsonism

Ans:3
39. Effective in managing rapidly cycling bipolar diorder in lithium non-responding
patient populations:
1. dexamethasone (Decadron)
2. valproic acid (Depakene, Depakote)
3. all of the above
4. triazolam (Halcion)
Ans: 2

40. Patient treated with fluphenazine presents the following day with a unilateral
stiff , sore neck and back; What was the neurological reaction--which drug
treatments might be appropriate?
1. acute dystonia: diphenhydramine (Benadryl)
2. acute dystonia:L-DOPA
3. acute dystonia: benztropine (Cogentin)
4. tardive dyskinesia: reduce fluphenazine (Prolixin) dosage

Ans: 1

41. A schizophrenic patient has been treated with haloperidol, loxapine, thiothixene
and lithium. If paranoid delusions persist, what other drug might be tried?
1. molindone (Moban)
2. benztropine (Cogentin)
3. clozapine (Clozaril)
4. trifluoperazine (Stelazine)
Ans: 3

42. Neurochemical abnormality most closely associated with schizophrenia:

1. high levels of CNS VMA
2. decreased brain GABA
3. abnormal glycine metabolism
4. dopaminergic abnormality
Ans: 4

43. Side effects include anti-cholinergic, anti-adrenergic and extrapyramidal

1. chloral hydrate (Noctec)
2. lithium
3. haloperidol (Haldol)
4. meprobamate (Miltown)
Ans: 3
44. Neuroleptic malignant syndrome is characterized by all of the following
EXCEPT:
1. hyperpyrexia
 2. increase in serum creatine phosphokinase 3.
3. Catatonia
4. akathisia
Ans: 4

45. Antipsychotic endocrine effect(s):

1. false-positive pregnancy tests
2. increased libido in women
3. decreased libido in men
4. amenorrhea-galactorrhea
5. all the above
Ans: 5