1. The following statements are true:  
A. Drugs must be ionized to be absorbed by passive diffusion F
B. In an acid pH, basic drugs will be poorly absorbed T
C. Gastric emptying is delayed by MAOIs T
D. Food increases the absorption of diazepam T
E. Rectal administration results in extensive 1st pass metabolism F
2. Regarding some aspects of pharmacokinetics:  
A. Diazepam is 99% protein-bound T
B. Ionized drugs cross the blood-brain barrier easily F
C. Phase I reactions convert the drug to non-active metabolites F
D. Phase II reactions include glucuronidation and sulphation T
E. Hydroxylation is autosomal dominant T
3. Regarding Drug interactions:  
A. Carbamazepine can inhibit the metabolism of TCAs F
B. Phenothiazines can induce their own metabolism T
C. Haloperidol inhibits the metabolism of TCAs T
D. Cytochrome P450 inhibition by cimetidine is an important factor in healthy subjects F
E. Slow acetylators predominate in Europe and Japan F
4. The following are true:  
A. In the elderly, there is a reduction in plasma albumin T
B. There is a loss of body weight in the elderly F
C. In pregnancy, the increase in plasma volume results in an increase in the free fraction of a drug F
D. First-order kinetics are exponential T
E. Alcohol and aspirin undergo zero-order kinetics T
5. The following statements about the distribution of neurotransmitters are correct:  
A. Acetylcholine is found in the basal ganglia T
B. Dopamine cell bodies are found in the limbic system F
C. 5-HT predominates in the raphe nuclei in the brainstem T
D. Noradrenaline predominates in the locus coeruleus T
E. GABA is found in the peri-aqueductal grey matter F
6. The following are true statements about receptors:  
A. 5-HT2A antagonists improve slow-wave sleep T
B. 5-HT1A antagonists are anxiolytic F
C. D2 receptors are found in the limbic system T
D. Antagonism of alpha-2 adrenoceptors leads to reduced NA release F
E. Most antipsychotics are D2 agonists F
7. Regarding benzodiazepines (BZDs):  
A. BZDs bind to the gamma-2 subunit of the GABAB supramolecular complex F
B. BZDs can inhibit the effects of other neurotransmitters such as 5-HT T
C. Oxazepam and Lorazepam are short-acting BZDs T
D. The BZ1 receptor mediates the anti-anxiety effect of BZDs T
E. The BZ2 receptor is concentrated in the amygdala and septo-hippocampal pathways T
8. Regarding Benzodiazepines:  
A. Tolerance develops in 4-6 weeks of therapy F
B. Withdrawal can cause rebound insomnia T
C. BZDs are effective in phobic states F
D. Zopiclone and Zolpidem act upon the BZ2 receptor in a similar way to BZDs F
E. Withdrawal symptoms peak at 7-8 days T
9. The following are recognized side effects of BZDs:  
A. Ataxia T
B. Drowsiness T
C. Anterograde amnesia T
D. Nightmares F
E. Insomnia F
10. The following are recognized symptoms of the BZD withdrawal syndrome:  
A. Tremor T
B. Depression T
C. Tinnitus T
D. Blurred vision T
E. Sweating T
11. Factors associated with dependence and withdrawal problems are:  
A. Short duration of treatment F
B. Passive-dependent personality traits T
C. Age < 40 years F
D. Concurrent use of Buproprion T
E. High dose and rapid withdrawal T
12. Regarding Buspirone:  
A. Buspirone is a 5-HT1A agonist T
B. Buspirone has little effect on DA systems F
C. Effects are usually evident after 8-12 hours F
D. It can cause galactorrhoea T
E. Dysphoria has been reported T
13. Regarding the pharmacological treatment of anxiety disorders:  
A. Placebo-response rate is in the region of 20-30 % F
B. CBT is much less effective than drugs for anxiety F
C. Beta-blockers can cause anxiety F
D. Beta-blockers are associated with nightmares T
E. The effect of Beta-blockers usually takes up to a month to develop F
14. The following statements about antidepressants are true:  
A. Mianserin is an SSRI F
B. Reboxetine is a NaSSA F
C. Mirtazapine is a NARI F
D. Trazodone is an SNRI F
E. Nefazodone is an SSRI T
15. Regarding Tricyclic Antidepressants (TCAs):  
A. Treatment results in subsensitivity of NA and 5-HT receptors on cell bodies T
B. Tertiary amines have a higher affinity for the 5-HT uptake site T
C. Tertiary amines are less sedating F
D. Secondary amines have more anticholinergic side effects F
E. Tertiary amines have a quicker peak plasma level T
16. The following are true:  
A. Amoxapine has D2 antagonist properties T
B. Amitriptyline is a secondary amine F
C. Lofepramine is a tertiary amine T
D. Maprotiline is the most selective NA uptake inhibitor of the TCAs T
E. Imipramine is more selective for 5-HT than Nortriptyline T
17. Side effects of TCAs include:  
A. Sinus bradycardia F
B. Impairment of memory T
C. Postural hypotension due to alpha-1 adrenoceptor antagonism T
D. Weight gain due to histamine H1 agonism F
E. Negative inotropism T
18. Side effects of TCAs include:  
A. Prolongation of the PR interval T
B. Flattening of T waves T
C. Coarse tremor F
D. Raising of the seizure threshold F
E. Cholestatic jaundice T
19. Contraindications to TCAs include:  
A. Narrow angle glaucoma T
B. Elderly F
C. Heart block T
D. Previous MI F
E. Prostatic hypertrophy T
20. Regarding SSRIs:  
A. They reach peak levels within 1 hour of ingestion F
B. Long-term use results in reduced 5-HT2 function T
C. Fluoxetine has a half-life of around 7 days F
D. OCD is an indication for their use T
E. They should be avoided in people with cardiac disease F
21. Common side effects of SSRIs include:  
A. Diarrhoea T
B. Constipation T
C. Loss of appetite T
D. Weight gain F
E. Tremor T
22. Common side effects of SSRIs include:  
A. Anorgasmia T
B. Hypertension F
C. Tachycardia F
D. Alopecia F
E. Sweating T
23. Interactions of SSRIs include:  
A. Use with MAOIs can result in the 5-HT toxicity syndrome T
B. Lithium T
C. Diazepam and fluoxetine T
D. Warfarin T
E. Anti-convulsants T
24. Regarding MAOIs:  
A. Most are selective for MAOI-A F
B. Phenelzine has fewer side effects than isocarboxacid F
C. Hypotension is a major problem with tranycypramine F
D. Fast acetylators metabolize MAOIs at the same rate as slow acetylators F
E. It is said that atypical depression responds best to MAOIs T
25. Recognized side effects of MAOIs include:  
A. Mania T
B. Seizures T
C. Blurred vision T
D. Peripheral neuropathy T
E. Alopecia F
26. Important interactions with MAOIs can occur with:  
A. Some cough medicines T
B. Oral hypoglycaemics T
D. Cheese T
E. Calcium antagonists F
27. Contraindications for MAOIs include:  
A. Renal failure F
B. Congestive cardiac failure T
C. Concurrent use of TCAs F
D. Asthma F
E. Phaochromocytoma T
28. Mianserin:  
A. Is a weak NA reuptake inhibitor T
B. Is cardiotoxic F
C. Is an antagonist at histamine receptors and can cause weight gain T
D. Has no effect on the seizure threshold F
E. Can cause agranulocytosis T
29. Mirtazapine:  
A. Has little effect on histamine receptors F
B. Blocks alpha-2 autoreceptors T
C. Is alerting in its profile F
D. Can reduce appetite F
E. Can cause neutropenia T
30. Trazodone:  
A. Is non-sedating F
B. Has 5-HT agonist properties T
C. Should be taken with food T
D. Can cause priapism T
E. Has no effect on cognitive function F
31. Nefazodone:  
A. Has sedating properties due to alpha-1 adrenoceptor antagonism F
B. Dry mouth and dizziness can occur T
C. Has a long half-life F
D. Can affect the action of propanolol T
E. Can increase haloperidol levels T
32. Venlafaxine:  
A. Is an SNRI T
B. Lacks anticholinergic effects T
C. Has no effect on the seizure threshold F
D. Can be given with MAOIs F
E. Can cause hypotension T
33. L-Tryptophan:  
A. Is an effective antidepressant by itself F
B. Should not be used with MAOIs F
C. Can cause agranulocytosis F
D. Peripheral neuropathy may be a rare side effect T
E. Skin sclerosis can occur rarely T
34. Regarding the phenothiazines:  
A. Group one drugs include thioridazine F
B. Group three drugs include trifluoperazine T
C. Group two drugs have high levels of antimuscarinic side effects T
D. Group three drugs have low levels of extrapyramidal side effects F
E. Other classes of drugs tend to resemble group one phenothiazines F
34. Regarding other antipsychotic drugs:  
A. Droperidol is a butyrophenone T
B. Zuclopenthixol is a thioxanthene T
C. Olanzapine is a dibenzodiazepine F
D. Risperidone is a dibenzothiazepine F
E. Sulpiride is a substituted benzamied T
35. The following are true of movement disorders:  
A. Young females are at highest risk of acute dystonic reactions F
B. Extrapyramidal symptoms tend to occur within a few hours of drug administration F
C. Extrapyramidal symptoms are due to blockage of D2 receptors in the basal ganglia T
D. Increasing the dose can sometimes help extrapyramidal side effects F
E. Tardive dyskinesia is due to D2 receptor hypersensitivity T
36. The following are at increased risk of tardive dyskinesia:  
A. Female T
B. Affective disorders T
C. Continuous treatment F
D. Organic brain disease T
E. Increasing age T
37. Recognized side effects of antipsychotics include:  
A. Sedation due to muscarinic blockade F
B. Nasal congestion T
C. Impotence T
D. Psoriasis F
E. Hypertension F
38. Recognized side effects of antipsychotics include:  
A. Retinal pigmentation T
B. Leucocytosis F
C. Prolonged QT interval T
D. Weight loss F
E. Torsade de pointes T
39. Regarding neuroleptic malignant syndrome:  
A. Onset occurs after 1-2 months of treatment F
B. Onset is slow and insidious F
C. Symptoms include hypertonicity, stupor, and autonomic instability T
D. Mortality is 50 % F
E. Secondary conditions include thromboembolism, renal failure, and cardivascular collapse T
40. Risperidone:  
A. Has high affinity for the 5-HT2A receptor T
B. Can cause hyperprolacinaemia T
C. Weight loss is frequent F
D. Is less effective than conventional antipsychotics F
E. Headache and anxiety may occur T
41. Clozapine:  
A. Has low affinity for D2 receptors T
B. Has low affinity for D1 and D4 receptors F
C. Has few effects on adrenoceptors F
D. Can increase blood levels of warfarin and digoxin T
E. Metabolism by the cytochrome P450 system is not significant F
42. Side effects of Clozapine include:  
A. Bradycardia F
B. Weight gain T
C. Hypersalivation T
D. Increase in seizure threshold F
E. Neutropenia and agranulocytosis T
43. Olanzapine:  
A. Has lower affinity for the D2 and 5-HT2A receptors than Clozapine F
B. Has higher affinity for the D1 receptor than Clozapine F
C. Causes negligible weight gain F
D. Has high levels of Extra-pyramidal side effects F
E. Can cause marked sedation T
44. Quetiapine:  
A. Has a similar binding profile to clozapine T
B. Has a high affinity for muscarinic receptors F
C. Has lower affinity for all receptors than clozapine T
D. Causes less weight gain than olanzapine and clozapine T
E. Can cause constipation T
45. Sertindole:  
A. Has low affinity for the 5-HT2A receptor F
B. Specifically targets D2 receptors in the limbic region T
C. Causes high levels of EPS F
D. May cause orthostatic hypotension T
E. Has been linked to sudden cardiac death T
46. Amisulpride:  
A. Is a D2/ D3 agonist F
B. Blocks autoreceptors at low doses and can increase synaptic dopamine levels T
C. Does not increase prolactin levels F
D. Has a similar level of EPS across the whole dose range F
E. Is clinically effective for negative symptoms of schizophrenia at low doses (<300mg/ day) T
47. Lithium:  
A. Has its main effects on noradrenaline systems in the brain F
B. Works by affecting secondary messenger systems in the cell T
C. Increases the rate of formation of cAMP F
D. Works best with rapid-cycling patients F
E. Is reabsorbed from the kidney T
48. Side effects of Lithium include:  
A. Tremor T
B. Muscle weakness T
C. Decreased urine output F
D. Dysgeusia T
E. Weight gain more in men F
49. Side effects of lithium include:  
A. Cranial diabetes insipidus F
B. Hypothyroidism T
C. Shrinkage of the thyroid gland F
D. Hypoparathryoidism F
E. Females have thyroid side effects more commonly than men T
50. Side effects of lithium include:  
A. Leucocytosis T
B. Acne T
C. Alopecia T
D. T wave inversion and QRS narrowing F
E. Memory impairment T
51. The following statements are true:  
A. A rise in plasma sodium results in a rise in plasma lithium levels F
B. Dehydration results in a fall in plasma lithium levels F
C. Although lithium can treat bipolar illness, it has no effect on the number of relapses F
D. Thyroid gland disorders do not respond to thryoxine F
E. Lithium is distributed widely in the body T
52. Regarding lithium toxicity:  
A. Fine tremor is an early sign F
B. GI upset tends to occur early T
C. Neurological signs tend to appear later T
D. Hyporeflexia frequently occurs F
E. Coma may occur at high levels T
53. The following statements are true:  
A. Lithium inhibits the release of iodine, and thyroid hormones T
B. Lithium induces thyroid autoantibodies T
C. Lithium does not cross the placenta F
D. Lithium is excreted in breat milk T
E. Long term treatment does not seem to affect GFR T
54. Increased lithium levels occur with:  
A. Bendrofluazide T
B. Aspirin F
C. Metronidazole T
E. ACE-inhibitors T
55. Carbamazepine:  
A. Is a GABA agonist T
B. Affects calcium channels T
C. Induces its own metabolism T
D. Has a short half life F
E. Affects brain 5-HT function T
56. Side effects of carbamazepine include:  
A. Ataxia T
B. Diplopia T
D. Agranulocytosis T
E. Leucocytosis F
57. Interactions with carbamazepine include:  
A. Increased metabolism of tricyclic antidepressants T
B. Decreased metabolism of other anticonvulsants F
C. Neurotoxicity with lithium T
D. Reduced carbamazepine levels with SSRIs T
E. Higher levels of oral contraceptives F
58. Sodium Valproate:  
A. Is a GABA transaminase inhibitor T
B. Is absorbed slowly from the GI tract F
C. Should be given with caution in patients with liver disease T
D. Has no effects on the foetus F
E. Can increase the levels of phenytoin T
59. Side effects of Valproate include:  
A. GI upset T
B. Weight gain T
C. Ataxia T
D. Thrombocytosis F
E. Impaired platelet function T
60. Side effects of Valproate include:  
A. Acute pancreatitis T
B. Renal failure F
C. Hepatic enzyme changes T
D. Hepatic toxicity and death T
E. Valproate should be stopped if jaundice occurs T