Bipolar Disorder: Pharmacology Quiz!

21 Questions | Total Attempts: 762

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Bipolar Disorder: Pharmacology Quiz!

Bipolar disorder is a serious mental illness characterized by highs of mania and lows of depression with some mood states in between. There is no known cure for this disorder, but medications can keep the illness from escalating. Take up this quiz on bipolar pharmacology and see how well you know the drugs.


Questions and Answers
  • 1. 
    This drug can both stimulate the release and potentiate the action of ADH:
    • A. 

      Aripiprazole

    • B. 

      Carbamazepine

    • C. 

      Lithium

    • D. 

      Quietapine

    • E. 

      Risperidone

    • F. 

      Valproate

  • 2. 
    This drug can increase the risk of spina bifida in the newborn when given during pregnancy.
    • A. 

      Aripiprazole

    • B. 

      Carbamazepine

    • C. 

      Lithium

    • D. 

      Quietapine

    • E. 

      Risperidone

    • F. 

      Valproate

  • 3. 
    This drug is effective for the treatment of acute mania, tonic-clonic seizure, and absence seizure.
    • A. 

      Aripiprazole

    • B. 

      Carbamazepine

    • C. 

      Lithium

    • D. 

      Quietapine

    • E. 

      Risperidone

    • F. 

      Valproate

  • 4. 
    The hepatic clearance of this drug is zero.
    • A. 

      Aripiprazole

    • B. 

      Carbamazepine

    • C. 

      Lithium

    • D. 

      Quietapine

    • E. 

      Risperidone

    • F. 

      Valproate

  • 5. 
    A 45-year-old man with a long history of bipolar disorder had been stable on a maintenance lithium treatment for the past year. Which of the following statements best describes a current working hypothesis about the molecular mechanism of action of lithium?
    • A. 

      Increased synthesis of adenylyl cyclase

    • B. 

      Increased synthesis of inositol monophosphatase

    • C. 

      Increased serotonin reuptake into serotonergic terminals

    • D. 

      Up-regulation of beta adrenergic receptors

    • E. 

      Decreased synthesis of IP3 and DAG

    • F. 

      Increased glutamatergic activity

  • 6. 
    A 54-year-old man, diagnosed with a bipolar disorder at the age of 34, had had e three manic episodes and two depressive episodes since then. The patient had been suffering from exertional angina for five years and from hypertension for 2 years. The present medication of the patient included lithium, atenolol, lovastatin, losartan, and aspirin. Plasma levels of which of the following psychotropic drugs were most likely determined periodically to assess the effective dosage and to avoid toxicity?
    • A. 

      Atenolol

    • B. 

      Lovastatin

    • C. 

      Aspirin

    • D. 

      Lithium

    • E. 

      Losartan

  • 7. 
    A 30-y/o woman was brought to the hospital by her parents because she had been in bed most of the day for the last two weeks. The woman had had an acute manic episode 4 months ago and was discharged on valproate with a good response. On questioning the patient said she discontinued the therapy two weeks ago because she felt cured, but now she admitted she had a depressed mood most of the time and that she wanted to die. Maintenance therapy was ordered. Which of the following drugs was most likely prescribed?
    • A. 

      Amitriptyline

    • B. 

      Mirtazapine

    • C. 

      Fluoxetine

    • D. 

      Venlafaxine

    • E. 

      Lithium

  • 8. 
    A 55-year-old man suffering from bipolar disorder started a therapy which included lithium, two tablets daily. Which of the following adverse effects might most likely occur during the first days of therapy?
    • A. 

      Constipation

    • B. 

      Weight loss

    • C. 

      Insomnia

    • D. 

      Hypertension

    • E. 

      Edema

  • 9. 
    A 57-year-old woman complained to her physician of tremor, polyuria, mental confusion, and disturbance of speech. The woman had been suffering from a bipolar disorder and had been receiving lithium for seven months. Two weeks ago she was found to have successive high blood pressure readings and her physician started an antihypertensive treatment with hydrochlorothiazide and captopril. Which of the following was most likely the reason for the adverse effects reported by the patient?
    • A. 

      Thiazide-induced dilutional hyponatremia

    • B. 

      Decreased renal elimination of lithium

    • C. 

      Decreased hepatic metabolism of lithium

    • D. 

      Thiazide-induced hypokalemia

    • E. 

      Captopril-induced hyperkalemia

  • 10. 
    A 49-year-old woman visited her physician complaining of a fine hand tremor and of an increasing need to urinate. The woman, recently diagnosed with a psychiatric disorder, had been taking a psychotropic drug for three weeks. Physical examination disclosed cystic acne with folliculitis over the trunk and thorax. Which of the following drugs could have caused the patient’s symptoms and signs?
    • A. 

      Fluoxetine

    • B. 

      Haloperidol

    • C. 

      Lithium

    • D. 

      Fluphenazine

    • E. 

      Valproic acid

    • F. 

      Trazodone

  • 11. 
    A 25-year-old man was accompanied to the clinic by his mother who stated that her son had been exhibiting the most unusual behavior over the last few weeks. He was euphoric most of the day, stayed up later and later at night, and frequently awakened his parents shouting and screaming. Recently he experienced problems at work. Upon arriving at the clinic he had trouble sitting still or listening and became increasingly irritable throughout the examination. He repeatedly said he heard a voice telling him he had a superpower. Which of the following pairs of drugs would be most helpful for the patient’s condition?
    • A. 

      Fluoxetine and risperidone

    • B. 

      Imipramine and lithium

    • C. 

      Fluoxetine and haloperidol

    • D. 

      Imipramine and haloperidol

    • E. 

      Risperidone and lithium

  • 12. 
    A 43-year-old woman recently diagnosed with major depressive disorder had started a therapy with sertraline but one month later her condition did not change appreciably and her psychiatrist decided to add a second medication (augmentation therapy). He ordered a drug with multiple mechanisms of action including an inhibition of glycogen synthase kinase-3. Which of the following drugs was most likely prescribed?
    • A. 

      Bupropion

    • B. 

      Triiodothyronine

    • C. 

      Lithium

    • D. 

      Lamotigrine

    • E. 

      Buspirone

    • F. 

      Olanzapine

  • 13. 
    A 40-year-old woman was discharged from the psychiatric hospital after an episode of acute mania. The patient had had five previous hospitalizations four major manic or depressive episodes during the last two years. Her post-discharge therapy included lithium, two tablets daily. How long should the patient continue to take lithium?
    • A. 

      For three months

    • B. 

      For six months

    • C. 

      For nine months

    • D. 

      For one year

    • E. 

      Indefinitely

  • 14. 
    A 45-year-old woman presented to the psychiatric hospital complaining of depression, hopelessness about her condition, sleep disturbances, and poor appetite. She had had seven previous hospitalizations for manic or depressive episodes and had experienced five mood swings in the past year, including episodes of depression and hypomania. Despite adequate plasma levels, she had not responded to lithium. Which of the following drugs would be appropriate for this patient?
    • A. 

      Haloperidol

    • B. 

      Thioridazine

    • C. 

      Fluoxetine

    • D. 

      Valproate

    • E. 

      Amitriptyline

    • F. 

      Diazepam

  • 15. 
    A 36-year-old woman complained to her physician that she felt tired, suffered from constipation, and had gained weight in recent weeks. She also complained of feeling cold and of the absence of menses during the last three months. The woman had been suffering from a bipolar disorder and had been maintained successfully on lithium therapy for one year. In addition to lithium, her present medication included cimetidine for duodenal ulcer and loratadine for hay fever. Which of the following was the most likely cause of the patient’s symptoms?
    • A. 

      Lithium induced hypothyroidism

    • B. 

      Cimetidine induced decrease in lithium metabolism

    • C. 

      Side effects of cimetidine

    • D. 

      Central depressant effects of loratadine

    • E. 

      Worsening of the disease due to inadequate lithium dosage

  • 16. 
    A 57-year-old man complained to his physician that he was always thirsty and had frequent and profuse micturition. The man recently diagnosed with bipolar disorder had been receiving lithium for three weeks. Which of the following was most likely the cause of the patient’s symptoms?
    • A. 

      Blockade of Na+ reabsorption in the thick ascending loop of Henle

    • B. 

      Blockade of the ADH-induced increase of cAMP in the collecting tubule

    • C. 

      Increased glucose plasma levels

    • D. 

      Stimulation of the thirst center in the hypothalamus

    • E. 

      Blockade of vasopressin secretion from the pituitary

  • 17. 
    A 51-year-old woman was admitted to the psychiatric hospital because of depressive mood, feelings of hopelessness, and suicidal ideation. The woman had a history of alternating episodes of depression and hypomania during the last eight years. An admitting diagnosis of severe bipolar depression was made and appropriate therapy was ordered. Which of the following pairs of drugs were most likely prescribed?
    • A. 

      Lamotigrine and lithium

    • B. 

      Amitriptyline and haloperidol

    • C. 

      Amitriptyline and valproate

    • D. 

      Lithium and ethosuximide

    • E. 

      Lamotigrine and ethosuximide

    • F. 

      Valproate and haloperidol

  • 18. 
    A 33-year-old woman had been maintained successfully on lithium therapy for two years for a bipolar disorder. Now she planned to become pregnant. Her psychiatrist ordered her to stop lithium and to start another medication. Which of the following drugs was most likely prescribed?
    • A. 

      Carbamazepine

    • B. 

      Valproate

    • C. 

      Quietapine

    • D. 

      Haloperidol

    • E. 

      Clozapine

    • F. 

      Amitriptyline

  • 19. 
    A 46-year-old man complained to his physician of a fine hand tremor, diarrhea, and frequent need to urinate. The man had been receiving lithium therapy for one month because of a bipolar disorder. Routine lab tests showed a normal renal function and a plasma lithium level of 3 mEq/L. Lithium has a volume of distribution of about 45 L and a half-life of about 20 hours. How many hours should the physician withhold lithium in order to reach a safer, yet likely therapeutic level of 0.75 mEq/L?
    • A. 

      20

    • B. 

      100

    • C. 

      80

    • D. 

      10

    • E. 

      30

    • F. 

      40

  • 20. 
    A 34-year-old man was admitted to the psychiatric hospital because of an acute panic attack. The man had his first panic attack at the age of 27 and had three other manic attacks since then. A diagnosis of acute mania was made and a therapy was prescribed which included a drug that acts by blocking D2 and 5HT-2 receptors in the brain. Which of the following drugs was most likely prescribed?
    • A. 

      Lamotigrine

    • B. 

      Clomipramine

    • C. 

      Valproate

    • D. 

      Olanzapine

    • E. 

      Lithium

    • F. 

      Trazodone

  • 21. 
    A 24-year-old female was diagnosed with a partial seizure 6 weeks ago. Since then, she has been on an anti-seizure med monotherapy and was instructed to use caution with activities that lead to increased core temperature, such as strenuous exercise or exposure to extreme heat. She has been compliant but comes to your office today complaining of fatigue and weight loss. Additionally, she complains of severe pain on her right side and back, below the ribs. The pain has spread to her groin area and has trouble urinating. Which drug is likely to cause her symptoms?  
    • A. 

      Felbamate

    • B. 

      Topiramate

    • C. 

      Ethosuximide

    • D. 

      Phenytoin

    • E. 

      Carbamazepine

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