PQ

Question 1

Mecanismo de ação: benzodiazepínicos x barbitúricos?

Answer 1

Benzodiazepines act by binding to the benzodiazepine binding site, which allosterically modulates the bonding of GABA, resulting in an increased frequency of chloride ion channel opening (they don’t function through direct activation of the GABA A receptor).
Barbiturates act at a separate allosteric site and work by prolonging the duration of channel openings in response to GABA.

Question 2

GABA A x GABA B

Answer 2

GABA A

GABA B receptors mediate their actions using G proteins

Question 3

Ácido valproico: o que faz?

Answer 3

Reduces GABA catabolism

Anticonvulsant

Question 4

Quetiapina é um anti…?

Answer 4

Antipsicótico de 2a geração

Question 5

Preferred medications for bipolar maintenance treatment?

Answer 5

Lithium, valproate, quetiapine

Question 6

Bipolar maintenance treatment should be avoided with which therapy?

Answer 6

Antidepressant monotherapy

They have the potential to precipitate manic episodes

Question 7

Bupropion: contraindications?

Answer 7

Patients with seizure disorders or current or prior diagnosis of bulimia or anorexia nervosa (potential electrolyte imbalances).
Not associated with sexual dysfunction (as other selective serotonin reuptake inhibitors)

Question 8

Clozapine: side effects?

Answer 8

Antipsychotic clozapine related to agranulocytosis.

Carbamazepine and valproate can also be associated with bone marrow abnormalities.

Question 9

Tricyclic antidepressants inhibit…?

Answer 9

The reuptake of norepinephrine and serotonin. They also inhibit fast sodium channel conduction (can cause fatal cardiac arrhythmias in overdose) and hypotension

Question 10

Amphetamines increase the release of … by vesicles in presynaptic neurons

Answer 10

Dopamine and norepinephrine

Question 11

Dopamine binds to D2 receptors on pituitary lactotrophs, resulting in…?

Answer 11

Decreased prolactin secretion from the anterior pituitary gland

Question 12

Dopamine hyperactivity in the mesolimbic pathway is associated with…?

Answer 12

Positive psychotic symptoms (eg hallucinations and delusions)

Question 13

Which are the 4 major dopaminergic pathways in the brain?

Answer 13

Mesocortical
Mesolimbic
Nigrostriatal
Tuberoinfundibular

Question 14

OCD’s first-line treatment?

Answer 14

SSRI (selective serotonin reuptake inhibitor)
They cause an immediate increase in availability of synaptic serotonin and a subsequent cascade of downstream neurobiological effects

Question 15

In the CNS, acetylcholine is involved primarily in… ?

Answer 15

Arousal, memory and learning

Degeneration of cholinergic neurons is associated with Alzheimer dementia

Question 16

Primary excitatory neurotransmitter?

Answer 16

Glutamate

Question 17

Primary inhibitory neurotransmitter?

Answer 17

GABA

Glycine is also an inhibitory neurotransmitter

Question 18

Histamine is a neurotransmitter involved in…?

Answer 18

Maintaining wakefulness

Question 19

Norepinephrine is a catecholamine involved in…?

Answer 19

Mood, anxiety, alertness, learning and memory

Question 20

Second-generation antipsychotics associated with…?

Answer 20

Metabolic adverse effects (eg weight gain, dyslipidemia, hyperglicemia…)
EX. olanzapine, clozapine, risperidone, quetiapine

Clozapine: 1% risk of agranulocytosis

Question 21

Mood stabilizer lithium has the potencial to cause…?

adverse effects

Answer 21

Hypothyroidism and renal function impairment

Blood urea nitrogen, creatinine and thyroid funcion tests should be routinely monitored

Question 22

First-generation antipsychotics associated with…?

Answer 22

Extrapyramidal symptoms due to their potent D2 antagonism

Both FGAs and SGAs have been associated with seizure risk

Question 23

How to differentiate schizoaffective disorder from bipolar disorder with psychotic features or major depression with psychotic features?

Answer 23

Temporal relationship between psychotic symptoms and mood symptoms. In bipolar disorder and major depression with psychotic features, psychotic symptoms occur exclusively during manic or depressive episodes

Question 24

Generalized anxiety disorder (GAT) - treated with … ?

Answer 24

Buspirone

Question 25

Chronic lithium toxicity can be precipitated by volume depletion and drug interactions with … ?

Answer 25

Thiazide diuretics, ACE inhibitors and nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 26

Valproate is used for…?

Answer 26

Bipolar disorder, epilepsy and to prevent migraine headache

Question 27

Trazodone is a … used off-label most often as a hypnotic to treat … associated with depression or antidepressant treatment

Answer 27

Sedating antidepressant
Insomnia

It’s been associated with the rare but serious side effect of priapism (persistent erection of the penis >4h that is not associated with sexual excitement)