Block 13 Mood Disorder Drugs MCQ's
Questions and Answers
- 1.
A 75-year-old woman complained of significant weight loss, forgetfulness, insomnia, and sadness. She also reported that she was discouraged, fearful, very anxious. If the decision is to keep her drug regimen to one drug due to her age, the best pharmacotherapy would be
- A.
Imipramine
- B.
Amitriptyline
- C.
Phenelzine
- D.
Lorazepam
- E.
Sertraline
Correct Answer
E. SertralineExplanation
Sertraline would be the best pharmacotherapy for this 75-year-old woman based on her symptoms. Sertraline is an antidepressant that is commonly used to treat depression, anxiety, and insomnia. It is well-tolerated in older adults and has a lower risk of side effects compared to other antidepressant medications. Additionally, sertraline has been shown to be effective in treating weight loss and forgetfulness associated with depression. Therefore, considering the patient's age and symptoms, sertraline would be the most appropriate choice for her drug regimen.Rate this question:
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- 2.
A 22-year-old man presented to his physician complaining of a distressing and embarrassing behavior. For the past five months he had being experiencing an irresistible urge to disinfect with alcohol any object in his room and to wash his hands again and again. He was distressed by the unreasonable time he spent on such activities and by his behavior he knew to be inappropriate, but he felt that he could not stop. He denied any substance abuse or use of medications. The physician recommended the man to a psychiatrist who suggested cognitive behavioral therapy and pharmacotherapy. Which of the following drugs was most likely prescribed?
- A.
Amitriptyline
- B.
Lithium
- C.
Fluoxetine
- D.
Haloperidol
- E.
Diazepam
- F.
Clozapine
Correct Answer
C. FluoxetineExplanation
The patient's symptoms, including the irresistible urge to disinfect objects and wash hands repeatedly, are consistent with obsessive-compulsive disorder (OCD). The recommended treatment for OCD typically involves a combination of cognitive behavioral therapy (CBT) and pharmacotherapy. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is commonly prescribed for OCD due to its ability to increase serotonin levels in the brain, which can help reduce symptoms of OCD. Therefore, fluoxetine is the most likely drug prescribed in this case.Rate this question:
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- 3.
A 65-year-old woman has been recently diagnosed with endogenous depression. The patient has been suffering from hypothyroidism for 5 years and exertional angina for one year. Which of the following drugs would be most appropriate for this patient?
- A.
Amitriptyline
- B.
Sertraline
- C.
Imipramine
- D.
Lithium
- E.
Lorazepam
- F.
Haloperidol
Correct Answer
B. SertralineExplanation
Sertraline would be the most appropriate drug for this patient because it is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression. Endogenous depression is a type of depression that is believed to be caused by internal factors, such as genetics or biochemical imbalances, rather than external factors. Since the patient has been diagnosed with hypothyroidism and exertional angina, it is important to consider drug interactions and potential side effects. Sertraline is generally well-tolerated and has a low risk of drug interactions, making it a suitable choice for this patient.Rate this question:
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- 4.
A 72-year-old man was brought in for psychiatric evaluation by his daughter, who reported that recently her father showed little interest in usual activities, was irritable, very anxious, and had trouble falling asleep. He also frequently became agitated over insignificant things and was very sad for the past 6 months, since his wife’s death. After doing a history and physical examination, a diagnosis of depression with anxiety symptoms was made. The psychiatrist suggests that cognitive behavioral therapy be started right away along with the pharmacotherapy and which of the following drugs would be appropriate first line therapy for this patient?
- A.
Bupropion
- B.
Amitriptyline
- C.
Escitalopram
- D.
Alprazolam
- E.
Imipramine
Correct Answer
C. EscitalopramExplanation
The correct answer is Escitalopram because it is a selective serotonin reuptake inhibitor (SSRI) which is commonly used as a first-line treatment for depression. The patient in the scenario is experiencing symptoms of depression, including sadness, loss of interest, irritability, anxiety, and trouble sleeping, which are consistent with a diagnosis of depression with anxiety symptoms. Escitalopram is effective in treating both depression and anxiety, making it an appropriate choice for this patient. Bupropion is also commonly used for depression, but it is not the first-line therapy for this patient. Amitriptyline and imipramine are tricyclic antidepressants, which are generally not recommended as first-line therapy due to their side effect profile. Alprazolam is a benzodiazepine, which may be used for short-term relief of anxiety symptoms but is not typically used as a first-line treatment for depression.Rate this question:
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- 5.
A 20-year-old man was accompanied to the clinic by his mother who stated that her son had been exhibiting 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 singing at the top of his lungs. He quit his job and insists he doesn’t need one since he has a plan for big money. Upon arriving at the clinic he has trouble sitting still or listening and becomes increasingly irritable throughout the examination. He has a history of alcohol misuse. What first line pharmacotherapy was likely tried?
- A.
Alprazolam
- B.
Imipramine
- C.
Chlorpromazine
- D.
Valproate
- E.
Phenobarbital
Correct Answer
D. ValproateExplanation
Based on the given information, the 20-year-old man is exhibiting symptoms of mania, such as euphoria, decreased need for sleep, increased energy, impulsivity, and irritability. These symptoms are indicative of bipolar disorder. Valproate is a first-line pharmacotherapy for the treatment of bipolar disorder, specifically for the manic phase. It helps stabilize mood and prevent further episodes of mania. Alprazolam is a benzodiazepine used for anxiety disorders, Imipramine is a tricyclic antidepressant, Chlorpromazine is an antipsychotic, and Phenobarbital is a barbiturate, none of which are commonly used as first-line treatments for bipolar disorder.Rate this question:
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- 6.
A 47-year-old woman presented to the 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 severe 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 for treatment of rapid cycling?
- A.
Clozapine
- B.
Thioridazine
- C.
Fluoxetine
- D.
Lamotrigine
- E.
Amitriptyline
- F.
Diazepam
Correct Answer
D. LamotrigineExplanation
Lamotrigine would be appropriate for this patient for treatment of rapid cycling. Rapid cycling is characterized by frequent and rapid mood swings between mania and depression. This patient has a history of multiple mood swings in the past year, indicating rapid cycling. Lamotrigine is a mood stabilizer commonly used to treat bipolar disorder, including rapid cycling. It has been shown to help reduce the frequency and severity of mood swings in patients with bipolar disorder.Rate this question:
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- 7.
A 67-year-old man complained of polyuria and polydipsia. The man recently diagnosed with manic-depressive illness, has been receiving lithium for three weeks. Which of the following is the most likely cause of the patient’s symptoms?
- A.
Inhibition of Na+ reabsorption in the thick ascending loop of Henle
- B.
Inhibition of the ADH-induced increase of cAMP in the collecting tubule
- C.
Increased ADH-induced water flow across collecting ducts
- D.
Stimulation of the thirst center in the hypothalamus
- E.
Blockade of vasopressin secretion from the pituitary
Correct Answer
B. Inhibition of the ADH-induced increase of cAMP in the collecting tubuleExplanation
The most likely cause of the patient's symptoms is the inhibition of the ADH-induced increase of cAMP in the collecting tubule. This is because lithium is known to interfere with the action of ADH (antidiuretic hormone) in the kidneys, leading to decreased water reabsorption in the collecting tubules. This results in increased urine production (polyuria) and increased thirst (polydipsia).Rate this question:
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- 8.
A 37-year-old man presented to the hospital complaining of persistent, intolerable pain in his left leg. The man, who had suffered from the amputation of his left leg following an accident at work, four months ago, referred that he tried several over the counter pain-killer medications without success. Physical examination revealed that pain could be elicited by a non-noxious stimulus applied to the region of amputation. Which of the following drugs would be appropriate to treat the patient’s pain?
- A.
Phenobarbital
- B.
Acetaminophen
- C.
Fluoxetine
- D.
Venlafaxine
- E.
Diazepam
- F.
Lithium
Correct Answer
D. VenlafaxineExplanation
The patient is experiencing phantom limb pain, which is pain felt in a limb that is no longer there. This type of pain is often difficult to treat with traditional pain medications. Venlafaxine, an antidepressant, has been found to be effective in treating phantom limb pain by altering the levels of certain neurotransmitters in the brain. Therefore, it would be an appropriate choice to treat the patient's pain.Rate this question:
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- 9.
A 16-year-old girl was admitted to an eating disorder clinic because of a three month history of binge eating, vomiting and purging episodes occurring from twice per week to four times a day. After physical examination and lab tests, psychotherapy was started and which pharmacotherapy was recommended?
- A.
Diazepam
- B.
Phenobarbital
- C.
Sertraline
- D.
Haloperidol
- E.
Clozapine
- F.
Lithium
Correct Answer
C. SertralineExplanation
Sertraline is the recommended pharmacotherapy for the 16-year-old girl with binge eating, vomiting, and purging episodes. Sertraline is an antidepressant medication that is commonly used to treat eating disorders, particularly bulimia nervosa. It helps to reduce the frequency of binge eating and purging episodes by regulating serotonin levels in the brain. Psychotherapy is also an important component of treatment for eating disorders, and it is likely that the patient is receiving both medication and therapy to address her symptoms.Rate this question:
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- 10.
A 2-year-old girl was rushed to the ER after she was found to have swallowed a bottle of pills of her mother’s psychotropic medication. She exhibited dry mouth, mydriasis, hot cheeks and palpitations. Within an hour she showed myoclonic jerking. ECG showed prolonged QT intervals. Which of the following drugs most likely caused the patient’s symptoms?
- A.
Zolpidem
- B.
Amitriptyline
- C.
Clozapine
- D.
Fluoxetine
- E.
Diazepam
- F.
Lithium
Correct Answer
B. AmitriptylineExplanation
The symptoms described in the question, such as dry mouth, mydriasis, hot cheeks, palpitations, myoclonic jerking, and prolonged QT intervals on ECG, are consistent with the anticholinergic and cardiotoxic effects of tricyclic antidepressants (TCAs). Amitriptyline is a TCA commonly used for the treatment of depression. Therefore, it is the most likely drug to have caused the patient's symptoms.Rate this question:
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- 11.
A 31-year-old man presented to the hospital complaining of marked sedation, painful and persistent penile erection and dizziness upon standing up rapidly. The man has been suffering from endogenous depression for two years and recently his antidepressant therapy was changed because of failure of the preceding treatment. Which of the following drugs most likely caused the patient’s symptoms?
- A.
Alprazolam
- B.
Mirtazapine
- C.
Bupropion
- D.
Lithium
- E.
Fluoxetine
- F.
Trazodone
Correct Answer
F. TrazodoneExplanation
Trazodone is the most likely drug that caused the patient's symptoms. Trazodone is an antidepressant that can cause sedation, dizziness upon standing up rapidly, and priapism (painful and persistent penile erection) as side effects. These symptoms are consistent with the patient's presentation and are known side effects of trazodone. The other drugs listed do not typically cause these specific symptoms.Rate this question:
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Current Version
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Mar 20, 2023Quiz Edited by
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Sep 08, 2012Quiz Created by
Chachelly
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