Joint Didactic 22nd

Dopamine Pathways

100

Which dopamine pathway regulates movement and coordination?

 A. Mesolimbic 

 B. Mesocortical 

C. Nigrostriatal 

D. Tuberoinfundibular

C. Nigrostriatal 

200

EPS (tremor, rigidity) occurs from dopamine blockade in which pathway?

A. Mesocortical B. Nigrostriatal 

C. Mesolimbic D. Tuberoinfundibular

B. Nigrostriatal 

300

Which pathway mediates reward and addiction?

A. Mesocortical B. Nigrostriatal

C. Mesolimbic D. Hypothalamic

C. Mesolimbic

400

Hyperactivity in this pathway leads to hallucinations and delusions:

A. Mesolimbic B. Nigrostriatal 

C. Mesocortical D. Tuberoinfundibular

A. Mesolimbic

500

Decreased dopamine activity here causes flat affect and apathy:

A. Nigrostriatal B. Mesocortical 

C. Mesolimbic D. Tuberoinfundibular

B. Mesocortical

Antipsychotic Mechanisms

100

First-generation antipsychotics block which receptor? 

A. 5-HT₂A

 B. D₂ 

C. GABA-A 

D. NMDA

B. D₂ 

200

Atypical antipsychotics affect both dopamine and which receptor? 

A. 5-HT₂A 

B. GABA C. Glutamate D. Muscarinic

A. 5-HT₂A 

300

Clozapine reduces suicide risk in which disorder?

A. PTSD B. Depression C. Schizophrenia D. OCD

C. Schizophrenia

400

Dopamine blockade in this pathway increases prolactin:

A. Mesolimbic B. Mesocortical

C. Tuberoinfundibular D. Nigrostriatal

C. Tuberoinfundibular 

500

Which antipsychotic requires CBC monitoring due to agranulocytosis?

A. Risperidone B. Aripiprazole 

C. Clozapine D. Olanzapine

C. Clozapine

Identifying the Disorder

100

A patient becomes restless six days after starting fluoxetine. Likely cause?

A. Bipolar mania 

B. Activation syndrome 

C. Akathisia D. Panic attack

B. Activation syndrome 

200

Grandiosity, pressured speech, and risky behavior indicate:

A. MDD B. PTSD C. Bipolar I (mania) 

D. OCD

C. Bipolar I (mania)

300

Flashbacks, nightmares, and hypervigilance indicate:

A. Bipolar II B. PTSD C. Panic Disorder 

D. GAD

B. PTSD

400

Hallucinations and delusions result from which pathway’s overactivity?

A. Mesocortical B. Mesolimbic 

C. Nigrostriatal D. Hypothalamic

B. Mesolimbic 

500

Haloperidol-induced tremor and rigidity are due to:

A. EPS B. Mania C. Akathisia D. Sedation

A. EPS

medication Management

100

Which medication treats EPS?

A. Propranolol 

B. Benztropine 

C. Buspirone 

D. Mirtazapine

B. Benztropine 

200

Which antipsychotic causes the greatest weight gain?

A. Aripiprazole B. Lurasidone

 C. Olanzapine D. Ziprasidone

 C. Olanzapine

300

Which mood stabilizer reduces suicide risk in bipolar disorder?

A. Valproate B. Lamotrigine C. Lithium D. Topiramate

C. Lithium

400

Alpha-1 blocker used for PTSD nightmares:

A. Prazosin B. Clonidine C. Trazodone D. Buspirone

A. Prazosin 

500

Hyperprolactinemia with risperidone results from:

A. Serotonin blockade 

B. D₂ blockade in tuberoinfundibular pathway

C. GABA inhibition D. Glutamate excess

B. D₂ blockade in tuberoinfundibular pathway

Clinical Scenarios

100

Which pathway’s underactivity causes negative symptoms?

A. Mesolimbic B. Mesocortical 

C. Nigrostriatal D. Limbic

B. Mesocortical 

200

Early agitation after SSRI initiation—management?

A. Stop immediately 

B. Lower dose/add benzodiazepine

C. Add antipsychotic D. Increase dose

B. Lower dose/add benzodiazepine

300

PTSD + alcohol use disorder—best combination therapy?

A. Naltrexone + SSRI 

B. Benzodiazepine + CBT 

C. Haloperidol + Disulfiram 

D. Lithium + Buspirone

A. Naltrexone + SSRI 

400

Severe psychosis with suicidality—best medication?

A. Risperidone B. Aripiprazole 

C. Clozapine D. Ziprasidone

C. Clozapine

500

Fever, rigidity, and confusion after antipsychotic use indicate:

A. Serotonin syndrome B. EPS 

C. Neuroleptic Malignant Syndrome 

D. Mania

C. Neuroleptic Malignant Syndrome