Antipsychotic Drugs MCQ Quiz Questions And Answers

1. A woman, 68 years of age, presents with blunted affect; she seems indifferent to her surroundings and says that she has no sense of pleasure in life. She complains that she hears voices and fears that she is about to be killed. She is admitted to the acute psychiatric ward, where she is given an antipsychotic –Drug A. After treatment, her hallucinations and paranoia resolve, but she complains that she has a tremor and cannot move about quickly. After a change in her medication to Drug B, all of her symptoms improved. She does not need to have weekly blood tests. Which one of the following pairs most likely corresponds to Drug A and Drug B?

Fluphenazine Clozapine

Haloperidol Olanzapine

Risperidone Sertraline

Thioridazine Clozapine

Quetiapine Paroxetine

Drug A likely corresponds to Haloperidol, a typical antipsychotic known for its effectiveness against psychosis but also for causing side effects like tremors and slowed movements due to its dopamine-blocking effects. Drug B corresponds to Olanzapine, an atypical antipsychotic that is generally better tolerated, causing fewer extrapyramidal symptoms and not requiring frequent blood monitoring like Clozapine, another atypical antipsychotic known for its need for regular blood tests due to a risk of agranulocytosis. Olanzapine provides a balance of efficacy and a lower risk of movement-related side effects.

Explanation

Drug A likely corresponds to Haloperidol, a typical antipsychotic known for its effectiveness against psychosis but also for causing side effects like tremors and slowed movements due to its dopamine-blocking effects. Drug B corresponds to Olanzapine, an atypical antipsychotic that is generally better tolerated, causing fewer extrapyramidal symptoms and not requiring frequent blood monitoring like Clozapine, another atypical antipsychotic known for its need for regular blood tests due to a risk of agranulocytosis. Olanzapine provides a balance of efficacy and a lower risk of movement-related side effects.

2. A 35-year-old man with abnormal behavior has been diagnosed with schizophrenia. In schizophrenia, Clozapine is more effective than haloperidol against:

Hallucinations

Bizarre delusions

Delusions

Social withdrawal

Clozapine is more effective than haloperidol against social withdrawal in schizophrenia. Social withdrawal is a common symptom of schizophrenia, characterized by a lack of interest in social interactions and a tendency to isolate oneself. Clozapine, an atypical antipsychotic medication, has been found to be particularly effective in treating negative symptoms of schizophrenia, such as social withdrawal. Haloperidol, on the other hand, is a typical antipsychotic medication that is more effective in treating positive symptoms of schizophrenia, such as hallucinations and delusions. Therefore, Clozapine is the preferred medication for addressing social withdrawal in individuals with schizophrenia.

Explanation

Clozapine is more effective than haloperidol against social withdrawal in schizophrenia. Social withdrawal is a common symptom of schizophrenia, characterized by a lack of interest in social interactions and a tendency to isolate oneself. Clozapine, an atypical antipsychotic medication, has been found to be particularly effective in treating negative symptoms of schizophrenia, such as social withdrawal. Haloperidol, on the other hand, is a typical antipsychotic medication that is more effective in treating positive symptoms of schizophrenia, such as hallucinations and delusions. Therefore, Clozapine is the preferred medication for addressing social withdrawal in individuals with schizophrenia.

3. A 17-year-old male diagnosed with schizophrenia was treated with Fluphenazine. Three days later, he developed a high body temperature and lead-pipe rigidity. The appropriate treatment for this patient would be:

Discontinue Fluphenazine and administer haloperidol

Continue with Fluphenazine and administer an anticholinergic

Continue with Fluphenazine and administer a benzodiazepine.

Discontinue Fluphenazine and administer dantrolene

The patient's symptoms of high body temperature and lead-pipe rigidity are consistent with neuroleptic malignant syndrome (NMS), a potentially life-threatening condition associated with the use of antipsychotic medications like Fluphenazine. The appropriate treatment for NMS is to discontinue the causative medication, in this case Fluphenazine, and administer dantrolene. Dantrolene is a medication that helps to reduce muscle rigidity and hyperthermia. Haloperidol and benzodiazepines may be used for other symptoms associated with schizophrenia but are not the recommended treatment for NMS. Anticholinergics may worsen the symptoms of NMS and are contraindicated.

Explanation

The patient's symptoms of high body temperature and lead-pipe rigidity are consistent with neuroleptic malignant syndrome (NMS), a potentially life-threatening condition associated with the use of antipsychotic medications like Fluphenazine. The appropriate treatment for NMS is to discontinue the causative medication, in this case Fluphenazine, and administer dantrolene. Dantrolene is a medication that helps to reduce muscle rigidity and hyperthermia. Haloperidol and benzodiazepines may be used for other symptoms associated with schizophrenia but are not the recommended treatment for NMS. Anticholinergics may worsen the symptoms of NMS and are contraindicated.

4. A 33-year-old female was brought to the hospital for an acute mental status change by her husband. He reports that she has been taking the same medication to treat symptoms of anxiety and paranoia for the past year. On examination, the woman is diaphoretic, with some rigidity of her extremities. Her blood pressure is 198/109, and her Temperature is 101 0. Blood analyses show grossly elevated creatine kinase. Which of the following medications could have caused her serious condition?

Clozapine

Dantrolene

Asenapine

Quetiapine

Fluphenazine

Fluphenazine is the correct answer because it is a typical antipsychotic medication that can cause neuroleptic malignant syndrome (NMS). The patient's symptoms of diaphoresis, rigidity, elevated blood pressure, and elevated creatine kinase are consistent with NMS. NMS is a potentially life-threatening condition that can occur as a rare side effect of antipsychotic medications, particularly the typical antipsychotics. Clozapine, asenapine, quetiapine, and dantrolene are not typically associated with NMS.

Explanation

Fluphenazine is the correct answer because it is a typical antipsychotic medication that can cause neuroleptic malignant syndrome (NMS). The patient's symptoms of diaphoresis, rigidity, elevated blood pressure, and elevated creatine kinase are consistent with NMS. NMS is a potentially life-threatening condition that can occur as a rare side effect of antipsychotic medications, particularly the typical antipsychotics. Clozapine, asenapine, quetiapine, and dantrolene are not typically associated with NMS.

5. Which would be the most likely diagnosis for this patient?

Tardive dyskinesia

Alzheimer’s dementia

Pseudo-dementia

Huntington’s disease

Parkinsonism

The most likely diagnosis for this patient is Huntington's disease. Tardive dyskinesia is a movement disorder caused by long-term use of certain medications, Alzheimer's dementia is a neurodegenerative disorder characterized by memory loss and cognitive decline, Pseudo-dementia refers to a condition where cognitive symptoms mimic dementia but are actually caused by a different underlying condition, and Parkinsonism is a group of movement disorders similar to Parkinson's disease. However, Huntington's disease is a genetic disorder that causes progressive degeneration of the nerve cells in the brain, leading to movement, cognitive, and psychiatric symptoms, which align with the patient's presentation.

Explanation

The most likely diagnosis for this patient is Huntington's disease. Tardive dyskinesia is a movement disorder caused by long-term use of certain medications, Alzheimer's dementia is a neurodegenerative disorder characterized by memory loss and cognitive decline, Pseudo-dementia refers to a condition where cognitive symptoms mimic dementia but are actually caused by a different underlying condition, and Parkinsonism is a group of movement disorders similar to Parkinson's disease. However, Huntington's disease is a genetic disorder that causes progressive degeneration of the nerve cells in the brain, leading to movement, cognitive, and psychiatric symptoms, which align with the patient's presentation.

6. A patient presented with progressive cognitive decline, an emerging personality disorder, and chorea. He was diagnosed with a neurodegenerative disorder, and his chorea was treated with phenothiazines. A CT scan showed atrophy of the head of the caudate nucleus. Which neurotransmitter is primarily involved in this disorder?

5-hydroxytryptamine

Acetylcholine

GABA

Norepinephrine

Glutamate

The patient's symptoms of cognitive decline, personality disorder, and chorea, along with the atrophy of the caudate nucleus seen on the CT scan, are consistent with Huntington's disease. Huntington's disease is a neurodegenerative disorder characterized by a loss of GABAergic neurons in the caudate nucleus. GABA is an inhibitory neurotransmitter that plays a crucial role in regulating movement, mood, and cognition. The loss of GABAergic neurons in the caudate nucleus leads to an imbalance of neurotransmitters, resulting in the symptoms observed in the patient. Therefore, GABA is primarily involved in this disorder.

Explanation

The patient's symptoms of cognitive decline, personality disorder, and chorea, along with the atrophy of the caudate nucleus seen on the CT scan, are consistent with Huntington's disease. Huntington's disease is a neurodegenerative disorder characterized by a loss of GABAergic neurons in the caudate nucleus. GABA is an inhibitory neurotransmitter that plays a crucial role in regulating movement, mood, and cognition. The loss of GABAergic neurons in the caudate nucleus leads to an imbalance of neurotransmitters, resulting in the symptoms observed in the patient. Therefore, GABA is primarily involved in this disorder.

7. A young patient comes with progressive cognitive decline, a personality disorder, and chorea. He gets diagnosed with a neurodegenerative disorder. A CT scan showed atrophy of the head of the caudate nucleus. Which neurotransmitter is involved in the disorder?

5-hydroxytryptamine

Acetylcholine

Norepinephrine

None of these

The correct answer is "None of these". This is because the symptoms described in the question (progressive cognitive decline, personality disorder, chorea) are characteristic of Huntington's disease, which is caused by a genetic mutation leading to the accumulation of abnormal proteins in the brain. The neurotransmitter involved in Huntington's disease is dopamine, not any of the options provided in the question.

Explanation

The correct answer is "None of these". This is because the symptoms described in the question (progressive cognitive decline, personality disorder, chorea) are characteristic of Huntington's disease, which is caused by a genetic mutation leading to the accumulation of abnormal proteins in the brain. The neurotransmitter involved in Huntington's disease is dopamine, not any of the options provided in the question.

8. A 58-year-old patient was brought to the mental health clinic by his family. They said that for the past three weeks, he had heard voices, dressing in a bizarre manner and behaving strangely. They also mentioned that he was presently being treated for mild symptoms characteristic of early-onset Parkinson’s disease. He was diagnosed with schizophrenia and was given quetiapine. What is the most likely reason for selecting this drug for this patient?

It is an atypical neuroleptic that reduces the positive and negative symptoms ofschizophrenia and will decrease the Parkinson’s symptoms.

It blocks D2 and 5-HT2 receptors and is unlikely to exacerbate the underlyingParkinson’swhile decreasing the positive symptoms.

It is an atypical neuroleptic that reduces positive and negative symptoms withoutexacerbating the underlying Parkinson’s disease.

It blocks D2 and 5-HT2 receptors, thereby potentially exacerbating Parkinson’sbut reducing the negative symptoms of schizophrenia.

The most likely reason for selecting quetiapine for this patient is because it is an atypical neuroleptic that can reduce both the positive and negative symptoms of schizophrenia without exacerbating the underlying Parkinson's disease. This is important because the patient is already being treated for mild symptoms characteristic of early-onset Parkinson's disease. By choosing quetiapine, the patient's schizophrenia symptoms can be addressed without worsening their Parkinson's symptoms.

Explanation

The most likely reason for selecting quetiapine for this patient is because it is an atypical neuroleptic that can reduce both the positive and negative symptoms of schizophrenia without exacerbating the underlying Parkinson's disease. This is important because the patient is already being treated for mild symptoms characteristic of early-onset Parkinson's disease. By choosing quetiapine, the patient's schizophrenia symptoms can be addressed without worsening their Parkinson's symptoms.

9. An elderly female Dominican patient under treatment for schizophrenia is readmitted to the hospital with a history of increasing jaundice over the past four weeks. She reports that her urine has become darker, her stools have become lighter, and her skin is itching. Blood tests show that her alkaline phosphatase and conjugated bilirubin were raised. Which of the following drugs is she most likely taking?

Haloperidol

Chlorpromazine

Clozapine

Risperidone

The patient's symptoms, including increasing jaundice, dark urine, lighter stools, and itching skin, suggest liver dysfunction. The elevation of alkaline phosphatase and conjugated bilirubin levels further support this. Chlorpromazine is known to cause hepatotoxicity, which can manifest as jaundice and liver enzyme abnormalities. Therefore, it is the most likely drug that the patient is taking.

Explanation

The patient's symptoms, including increasing jaundice, dark urine, lighter stools, and itching skin, suggest liver dysfunction. The elevation of alkaline phosphatase and conjugated bilirubin levels further support this. Chlorpromazine is known to cause hepatotoxicity, which can manifest as jaundice and liver enzyme abnormalities. Therefore, it is the most likely drug that the patient is taking.

10. A 28-year-old U.S. Marine recruit has a history of Tourette syndrome, for which he has been taking haloperidol for the past six months. He complains that he has become very restless and that his tongue is in constant motion as if he were constantly chewing gum. Since the emergence of these symptoms, he stopped taking the drug, but the symptoms persist. Which one of the following is the correct statement with respect to the symptoms he describes?

The symptoms are consistent with haloperidol-induced akathisia and tardivedyskinesia and are due to blocked dopamine receptors.

The symptoms are consistent with haloperidol-induced akathisia and tardivedyskinesia and are due to supersensitive dopamine receptors.

These are haloperidol-induced extrapyramidal symptoms and are due to dualantagonism of D2 and- 5-HT2C receptors.

These are haloperidol-induced extrapyramidal symptoms and are due tosupersensitive D2 and 5-HT2C receptors.

The symptoms described by the patient, including restlessness and constant movement of the tongue, are consistent with haloperidol-induced akathisia and tardive dyskinesia. These symptoms are believed to be caused by supersensitive dopamine receptors, which can occur as a result of long-term use of haloperidol.

Explanation

The symptoms described by the patient, including restlessness and constant movement of the tongue, are consistent with haloperidol-induced akathisia and tardive dyskinesia. These symptoms are believed to be caused by supersensitive dopamine receptors, which can occur as a result of long-term use of haloperidol.