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Please help answer these questions for me. Ques 1-L. J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts? A . Memantine B . Escitalopra m C . Donepezil D . Risperidone Question 2 : Of the following neurotransmitters, which one(s) are known to be severely disrupted in the disease Dementia with Lewy Bodies? I. Acetylcholine II. Glutamate III. Dopamine IV. GABA V. Norepinephrine A . II only B . III only C . I and II D . I and III Question 3: Choose the correct statement regarding medications used for alcoholism A . Disulfiram: NMDA receptor antagonist & GABAA agonist B . Naltrexone: µ-opioid receptor antagonist that reduces the reinforcement/euphoria produced by alcohol C . Acamprosate: enhances the effect of the inhibitory neurotransmitter gammaaminobutyric acid on the GABA receptors by binding to a site that is distinct from the GABA binding site in the central nervous system. D . Lorazepam: inhibits alcohol dehydrogenase, leading to a buildup of acetaldehyde. Question 4: Patient is a 75-year-old female with a confirmed diagnosis of Alzheimer’s Disease. She is currently on Donepezil 10 mg daily. She is accompanied to your clinic today by her daughter, who informs you that her mother has recently had an increase in depressive symptoms. She has no history of mood disorders. She has a history of hypertension and tonic-clonic seizures, but both are controlled. Assuming this patient will be thoroughly evaluated for the diagnosis of depression, what would you recommend as initial therapy? A . Amitriptyli ne B . Doxepin C . Fluoxetine D . Bupropion Question 5: Which neurotransmitters are likely involved in the pathophysiology of withdrawal seizures? I. Serotonin II. Endorphins III. Glutamate IV. GABA V. Dopamine A . I and II B . II and V C . I and III D . III and IV Question 6: T. C. is an 88-year-old male who is diagnosed at your clinic with Dementia with Lewy Bodies. He currently has some debilitating gait issues, which makes his quality of life very poor. His memory is still intact with minor deficits. Which medication would likely benefit T. C. as his initial therapy? A . Levodopa/carbido pa B . Galantamine C . Memantine D . Benztropine Question 7: What is the difference between Ritalin and Focalin? A . Focalin is a D-isomer B . Ritalin is the D-isomer C . Focalin is the S-isomer D . There is no difference other than the formulations involved. Question 8: The patient is a 16-year-old girl with a past history of substance use disorder. She has been known to abuse prescription opioids and smokes one pack of cigarettes every day. She has been in and out of recovery for the past year. During her last admission into a recovery center, she was diagnosed with ADHD, which may have contributed to her addictive personality. She presents to your clinic today to initiate pharmacotherapy for her new diagnosis. What would you recommend in this patient? Her current weight is 55 kg. A . Ritalin 10 mg twice daily B . Focalin 10 mg twice daily C . Daytrana 30 mg patch worn for 12 hours daily D . Atomoxetine 60 mg once daily. Question 9: Of the following medications, which one is contraindicated with stimulants such as Ritalin or Adderall? A . Atomoxetin e B . Clonidine C . Amitriptyli ne D . Phenelzine Question 10: A new patient presents to your clinic today. The patient is a 13-year-old boy who complains that he has no interest in anything. The patient states, “I just want to sleep more than I normally do, and I don’t care much for playing my video games anymore.” His mother states he cannot focus on anything for more than a few minutes at a time, and that he often gets in trouble at school because he cannot sit still. What would you recommend at this time? A . Recommend doing a full evaluation to distinguish if this patient is presenting with ADHD symptoms or depressive symptoms B . Begin a stimulant at appropriate dose once patient’s weight is known C . Refer to a behavioral counselor D . Begin an SSRI at lowest initial dose and provide counseling on the increased risk of suicide during the first few months of therapy. Question 11: E. B., a 55-year-old female, is a patient at your clinic today who has a past medical history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes, and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She states she is ready to quit drinking but fears the cravings that it may bring. Which medication would you recommend for E. B. to begin? A . Naltrexone B . Acamprosate C . Any benzodiazepine D . Thiamine Question 12: Which of the following drugs is structurally similar to tramadol; thus, its opioid-mediated analgesia can be reversed by naloxone in mice? A . Venlafaxi ne B . Ketorolac C . Duloxetin e D . Gabapentin Question 13: Disorientation, tremor, hyperactivity, fever, hallucinations, marked wakefulness, and increased autonomic tone are all features that are consistent with which part of alcohol withdrawal? A . Alcohol withdrawal seizures B . Korsakoff’s Psychosis C . Wernicke’s encephalopathy D Alcohol withdrawal Question 14: Which of the following drugs is often used in the management of opioid addiction due to its ceiling effect? A . Buprenorphine B . Naloxone C . Clonidine D . Methadone. Question 15: There are many different types of dementia. Which dementia is NOT a direct result of disrupted neurotransmitters, but a result of degeneration of different regions in the brain? Onset of the disease is typically before the age of 60, and very rare after the age of 75. A . Alzheimer’s Disease B . Dementia with Lewy Bodies C . Creutzfeldt-Jakob Disease D . Frontotemporal Dementias Question 16: A 59-year-old male has been admitted to the E. D. due to a methamphetamine overdose. The patient’s friend reported he ingested up to 2 grams because “he thought cops were coming to get him.” The patient’s vitals are all within normal limits, except his blood pressure is 180/110. What is the best recommendation to make at this time? A . Administer a beta-blocker like labetalol to help bring his blood pressure down B . Patient’s blood pressure is considered a hypertension urgency, but it is probably due to the drug overdose. No action is needed at this time until the drug has cleared his system. C . Blood pressure is not a concern right now, but supportive therapy should be provided in the incidence of respiratory depression. D . Administer an alpha-blocker like phentolamine to help bring his blood pressure down. Question 17: Daytrana is the MPH transdermal system of methylphenidate approved for the treatment of ADHD in children aged 6 years and older. What is the difference in terms of the metabolism compared to the other formulations in this class? A . It is mainly metabolized by the enzyme carboxylesterase once absorbed. B . It does not undergo first-pass metabolism by the enzyme carboxylesterase in the liver. C . It can be cut up and sprinkled onto food so it can bypass first-pass metabolism in the liver. D . It uses an osmotic releasing oral system technology to slowly deliver the drug to the enzyme carboxylesterase in order to make the drug last longer. Question 18: T. B. is a 55-year-old male who has diagnosed with type 2 diabetes 10+ years ago. He has since had complications from the disease and is suffering from severe neuropathy. On top of that, T. B. is struggling with his mental health and was recently told he could be depressed but he had refused treatment at that time. Besides getting his blood sugar under control, what medication(s) can we use that may be useful in helping T. B.? I. Nortriptyline II. Venlafaxine III. Duloxetine IV. Fluoxetine A . I, II, and III B . I and II C . II and III D . IV only. Question 19: Which medication is a selective alpha-adrenergic agonist that works by mimicking norepinephrine binding in the pre-frontal cortex, which makes it particularly useful in the treatment of ADHD? A. Guanfacine B. Modafinil C. Lisdexamfetamine D. Bupropion

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