more anxiety stahl
38-year-old woman was diagnosed with schizophrenia approximately two years ago and after multiple trials of different medications has been maintained on haloperidol for the last several months with good response. Two weeks ago she began exhibiting mild motor symptoms representative of parkinsonism. Which of the following would be the most appropriate adjunct medication for this patient? A. Alpha 1 adrenergic agonist B. Cholinesterase inhibitor C. Histamine 1 antagonist D. Muscarinic 1 antagonist
D. Muscarinic 1 antagonist
Examples of neurotransmitters produced specifically as retrograde neurotransmitters (i.e., those that communicate from postsynaptic neuron to presynaptic neuron) include: A. GABA B. Galanin C. Histamine D. Nitric oxide
D. Nitric oxide
Most Common action of antidepressants, has both therapeutic effects and causes side effects
G-protein Linked receptors
The activation of N-methyl-d-aspartate (NMDA) receptors requires the presence of: A. Glutamate only . Glutamate and glycine C. Glutamate, glycine, and magnesium D. Glutamate and magnesium
Glutamate and glycine
In a G protein-linked signal transduction cascade, the second messenger can be synthesized In the postsynaptic neuron In the synaptic cleft A and B Neither A nor B
In the postsynaptic neuron
The presynaptic reuptake transporter?
Serotonin and GABA
The Excitation Secretion Coupling process causes, VSSC and VSCC by?
Sodium moves into the nerve, electrical charge then opens calcium channels
The reactive reward system signals the immediate prospect of pleasure or pain and triggers drug-seeking behavior. A. True B. False
True
Protein of the CNS that stimulates cell proliferation, aids in cell survival and synaptic restructuring. It is also implicated in the neurotrophic hypothesis of depression A. Brain-derived neurotrophic factor (BDNF) B. Protein Kinase C. Prolactin A. Brain-derived neurotrophic factor (BDNF) (?)
A. Brain-derived neurotrophic factor (BDNF)
A serotonin molecule binds to a 5HT2A receptor causing electrical impulses to be sent down a GABA neuron's axon terminal, eventually releasing GABA to the GABA-A receptor of its postsynaptic neuron. Which type of neurotransmission does this describe? A. Classic Synaptic Neurotransmission B. Retrograde Neurotransmission C. Volume Neurotransmission D. Signal Cascade Transmission
A. Classic Synaptic Neurotransmission
An example of volume neurotransmission is: A. Dopamine in the prefrontal cortex B. Dopamine in the striatum C. Norepinephrine in the prefrontal cortex D. Norepinephrine in the striatum
A. Dopamine in the prefrontal cortex
The activation of AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid) receptors requires the presence of: A. Glutamate only B. Glutamate and glycine C. Glutamate, glycine, and magnesium D. None of the above
A. Glutamate only
During cognitive challenges, individuals with schizophrenia demonstrate: A. Hypoactivation in the DLPFC B. Hyperactivation in the DLPFC C. Normal activation in the DLPFC D. A and B
A. Hypoactivation in the DLPFC B. Hyperactivation in the DLPFC D. A and B
When voltage-sensitive sodium channels are open and activated, the flow of sodium is: A. Into the neuron B. Out of the neuron
A. Into the neuron
In a G protein-linked signal transduction cascade, the second messenger can be synthesized: A. Intracellularly B. Extracellularly C. Either intra- or extracellularly
A. Intracellularly
A 39-year-old patient with major depressive disorder presents to your office after several months of trying various antidepressant drugs. It is suggested that he try augmenting his current regimen with L-methylfolate. Why might L-methylfolate hypothetically boost the therapeutic efficacy of antidepressants? A. It both increases synthesis and inhibits metabolism of monoamines B. It only increases synthesis of monoamines C. It only inhibits metabolism of monoamines
A. It both increases synthesis and inhibits metabolism of monoamines
A 28-year-old woman presents with a depressive episode. She has previously been hospitalized and treated for a manic episode, but is not currently taking any medication.Which of the following have the best evidence of efficacy to treat bipolar depression? A. Lamotrigine, quetiapine B. Quetiapine, olanzapine monotherapy C. Olanzapine monotherapy, lithium D. Lithium, valproate E. Valproate, lamotrigine
A. Lamotrigine, quetiapine
Which of the following is considered the pleasure center of the brain? A. Cortico-striatal-thalamic-cortical loop B. Mesolimbic dopamine pathway C. Mesocortical dopamine pathwayD. None of the above
B. Mesolimbic dopamine pathway
What role does the amygdala play in substance abuse? A. Releases phasic bursts of dopamine to the nucleus accumbens when drugs of abuse are present B. Communicates to the ventral tegmental area when cues related to drugs of abuse are present C. Site of binding for most drugs of abuse D. A and B E. A, B, and C
B. Communicates to the ventral tegmental area when cues related to drugs of abuse are present
A 25-year-old woman with longstanding anxiety is currently experiencing debilitating concerns that her children will be harmed whenever they are aware from her. Such worry is associated with activity in: A. Amygdala-centered circuits B. Cortico-striatal-thalamic-cortical circuits
B. Cortico-striatal-thalamic-cortical circuits
Transport of monoamines requires energy, which is supplied by a: A. Calcium pump B. Potassium pump C. Sodium pump
c. Sodium Pump
A 45-year-old female patient continues to maintain the re-experiencing of her fear of the opposite sex, which began one year ago when she was raped on her way to a parking garage. Which two brain regions are involved in the reciprocal relationship resulting in this symptom? A. Amygdala and hippocampus B. Basal forebrain and amygdala C. Hippocampus and nucleus accumbens D. Hypothalamus and basal foreb
. Amygdala and hippocampus
A 48-year-old patient with depression was recently started on 20 mg/day fluoxetine to combat his presenting symptoms of apathy, fatigue, problems concentrating, and hypersomnia. The patient reports that he is feeling much more energized and can see improvements in his cognition and attention within a day or two of starting fluoxetine. Which of the following properties of fluoxetine is theoretically most likely responsible for this patient's positive response? A. 5HT2C antagonism B. Norepinephrine reuptake inhibition C. Serotonin reuptake inhibition
A. 5HT2C antagonism
A 19-year-old female requires a hospital consultation, after she was admitted following an attempted suicide. Her family reports that she has been suffering from severe depression for the last 3 years. What area of the brain may best be described as hypothetically involved in her feelings of worthlessness and suicidality? A. Amygdala B. Basal forebrain C. Hypothalamus D. Nucleus accumbens
A. Amygdala
A 22-year-old man exhibits a fear response in reaction to unexpectedly encountering a bear while hiking. The various expressions of fear are hypothetically regulated by circuitry centered around the: A. Amygdala B. Hippocampus C. Prefrontal cortex D. Thalamus
A. Amygdala
A 45-year-old female presents with a hand-washing compulsion and an obsession with air fresheners. Based on these symptoms, which of the following is most likely to be true? A. She may have been born with the catechol-O-methyltransferase (COMT) Met genotype, leading to an increased risk of susceptibility to worry and anxiety disorders. B. She may have been born with the COMT Val genotype, leading to an increased risk of susceptibility to worry and anxiety disorders.
A. She may have been born with the catechol-O-methyltransferase (COMT) Met genotype, leading to an increased risk of susceptibility to worry and anxiety disorde
29-year-old patient is morbidly obese and reports that he is "addicted to food". Hunger circuitry is connected to reward circuitry via dopaminergic projections from the hypothalamus to the nucleus accumbens. A. True B. False
A. True
The alpha 2 delta subunit of voltage-sensitive calcium channels is believed to help regulate opening and closing of the voltage-sensitive calcium channel. A. True B. False
A. True
The activation of N-methyl-d-aspartate (NMDA) receptors requires the presence of: A. Glutamate only . Glutamate and glycine C. Glutamate, glycine, and magnesium D. Glutamate and magnesium
B. Glutamate and glycine
receptor with four transmembrane regions changes conformation as GABA binds. Which system is this process describing? A. Presynaptic transporter B. Ligand-gated ion channel C. Voltage-sensitive ion chann
B. Ligand-gated ion channel
Which of the following is considered the pleasure center of the brain? A. Cortico-striatal-thalamic-cortical loop B. Mesolimbic dopamine pathway C. Mesocortical dopamine pathway D. None of the above
B. Mesolimbic dopamine pathway
Which of the following has the secondary property of positive allosteric modulation at nicotinic receptors? A. Donepezil B. Rivastigmine C. Galantamine D. Memantine
C. Galantamine
34-year-old woman with posttraumatic stress disorder has been treated with exposure therapy, with partial success. Her clinician is considering an adjunct medication. The agent d-cycloserine could be efficacious for reducing symptoms in anxiety disorders because it has been shown to: A. Increase glutamate neurotransmission during fear conditioning B. Decrease glutamate neurotransmission during fear conditioning C. Increase glutamate neurotransmission during fear extinction D. Decrease glutamate neurotransmission during fear extinction
C. Increase glutamate neurotransmission during fear extinction
24-year-old man was diagnosed with generalized anxiety disorder 2 years ago, and is now presenting with recurrent and spontaneous panic attacks. These anxiety disorders are hypothetically associated with: A. Unique circuitry for each disorder B. Overlapping circuitry but unique neurotransmitters for each disorder C. Overlapping circuity and neurotransmitters
C. Overlapping circuity and neurotransmitters
A 35-year-old male Army veteran has been experiencing anxiety attacks during which he has difficulty breathing and increased heart rate. His symptom of difficulty breathing is hypothetically related to activation in the: A. Hippocampus B. Hypothalamus C. Parabrachial nucleus D. Periaqueductal gray
C. Parabrachial nucleus
48. A 23-year-old female college student has gotten in significant trouble for her risky and impulsive behavior, stealing a fire extinguisher, driving on the common area lawn, and hostilely addressing a professor. Which of the following monoamine projections may account for her recent behavior? Projections to the: A. Amygdala B. Hypothalamus C. Prefrontal cortex D. Striatum
C. Prefrontal cortex
Which of the following is the most potent property of trazodone? A. Serotonin reuptake inhibition B. Serotonin 2C antagonism C. Serotonin 2A antagonism D. Histamine 1 antagonism
C. Serotonin 2A antagonism
Symptoms of schizophrenia are hypothetically attributable to malfunctioning in the: A. Mesolimbic and nigrostriatal pathways B. Nigrostriatal and tuberoinfundibular pathways C. Tuberoinfundibular and mesocortical pathways D. Mesocortical and mesolimbic pathways
D. Mesocortical and mesolimbic pathways
Which of the following is true? A. Positive allosteric modulation is possible only in the presence of a neurotransmitter, while negative allosteric modulation is possible only in the absence of a neurotransmitter B. Negative allosteric modulation is possible only in the presence of a neurotransmitter, while positive allosteric modulation is possible only in the absence of a neurotransmitter C. Both positive and negative allosteric modulations are possible only in the absence of a neurotransmitter
D. Both positive and negative allosteric modulations are possible only in the presence of a neurotransmitte
Which of the following is true? A. Positive allosteric modulation is possible only in the presence of a neurotransmitter, while negative allosteric modulation is possible only in the absence of a neurotransmitter B. Negative allosteric modulation is possible only in the presence of a neurotransmitter, while positive allosteric modulation is possible only in the absence of a neurotransmitter C. Both positive and negative allosteric modulations are possible only in the absence of a neurotransmitter D. Both positive and negative allosteric modulations are possible only in the presence of a neurotransmitte
D. Both positive and negative allosteric modulations are possible only in the presence of a neurotransmitte
A patient with generalized anxiety disorder is taking a benzodiazepine. What role do benzodiazepines play in GABA neurotransmission? A. Increase it via direct agonist actions B. Increase it via direct antagonist actions C. Increase it via negative allosteric modulation D. Increase it via positive allosteric modulation
D. Increase it via positive allosteric modulation
A clinician has decided to adminster an alpha 2 antagonist to his patient. Alpha 2 antagonists have what effect on neurotransmission? A. Decrease norepinephrine and increase serotonin B. Decrease norepinephrine and decrease serotonin C. Increase norepinephrine and decrease serotonin D. Increase norepinephrine and increase serotonin
D. Increase norepinephrine and increase serotonin
Which of the following statements regarding mood symptoms is true? A. Symptoms related to reduced positive affect are hypothetically linked to serotonergic (and noradrenergic) dysfunction B. Symptoms related to increased negative affect are hypothetically linked to dopaminergic (and noradrenergic) dysfunction C. Symptoms related to reduced positive affect are hypothetically linked to dopaminergic (and serotonergic) dysfunction D. Symptoms related to increased negative affect are hypothetically linked to serotonergic (and noradrenergic) dysfunction
D. Symptoms related to increased negative affect are hypothetically linked to serotonergic (and noradrenergic) dysfunction
A 38 yo presents with depression, anhedonia, decreased energy=Symptoms of Reduced Positive Affect. What neurotransmitters are involved?
Dopamine and Norepinephrine
An example of volume neurotransmission is: A. Dopamine in the prefrontal cortex B. Dopamine in the striatum C. Norepinephrine in the prefrontal cortex D. Norepinephrine in the striatum A. Dopamine in the prefrontal cort
Dopamine in the prefrontal cortex
The Limbic System includes? A. Hypothalamus B. Thalamus C. Hippocampus D. Amygdala E. All of the Above
E. All of the Above
NAM and PAM are?
Either negative or positive depending on..
