Neurological Disorders MCQ | Case-Based Questions #3

Below written are 26 case-type questions for your practice.

Question A 32-year-old female patient with a history of major depressive disorder presents to the pharmacy with a new prescription for fluoxetine. She mentions that she is currently taking ibuprofen for chronic back pain. As a pharmacist, what potential interaction should you discuss with her?

A) Increased risk of hepatotoxicity
B) Increased risk of gastrointestinal bleeding
C) Reduced efficacy of fluoxetine
D) Increased risk of renal toxicity
E) Reduced efficacy of ibuprofen

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Question A 50-year-old male patient with generalized anxiety disorder has been taking sertraline for the past month. He reports feeling more anxious and experiencing difficulty sleeping since starting the medication. As a pharmacist, what advice should you provide?

A) Stop taking sertraline immediately
B) Continue taking sertraline as these side effects will subside
C) Reduce the dose of sertraline
D) Discuss with his doctor about switching to another antidepressant
E) Take sertraline with a sedative

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Question A 28-year-old female patient with a history of major depressive disorder and chronic migraines is prescribed amitriptyline. She expresses concern about potential side effects, particularly weight gain. How should the pharmacist counsel this patient?

A) Amitriptyline does not cause weight gain
B) Weight gain is a common side effect, but lifestyle changes can help manage it
C) Weight gain only occurs with high doses of amitriptyline
D) Recommend discontinuing amitriptyline immediately if weight gain occurs
E) Amitriptyline causes weight loss, not weight gain

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Question A 65-year-old male patient with a history of heart disease is prescribed venlafaxine for depression. What specific monitoring or precautions should the pharmacist recommend?

A) Regular liver function tests
B) Monitoring blood pressure regularly
C) Routine kidney function tests
D) Checking blood glucose levels
E) Monitoring for signs of pulmonary fibrosis

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Question A 35-year-old female patient taking escitalopram for depression reports experiencing sexual dysfunction, which is affecting her relationship. What are possible strategies the pharmacist can suggest to address this issue?

A) Discontinuing escitalopram immediately
B) Switching to another SSRI with a lower incidence of sexual side effects
C) Taking escitalopram only every other day
D) Adding a medication to counteract the sexual side effects
E) Discussing with her doctor about switching to bupropion

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Question A 40-year-old male patient diagnosed with bipolar disorder is prescribed lithium for mood stabilization. He is concerned about potential side effects and asks for your advice as a pharmacist. What common side effects of lithium should you inform the patient about?

A) Hyperglycemia and weight gain
B) Dry mouth and urinary retention
C) Tremors, increased thirst, and frequent urination
D) Hair loss and skin rash
E) Increased appetite and weight loss

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Question A 30-year-old female patient with bipolar disorder is taking valproate. She presents to the pharmacy with a new prescription for warfarin. What potential interaction should you discuss with her?

A) Increased risk of hepatotoxicity
B) Reduced efficacy of valproate
C) Increased risk of bleeding
D) Increased risk of weight gain
E) Reduced efficacy of warfarin

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Question A 45-year-old male patient with bipolar disorder is experiencing weight gain and sedation from his current medication regimen, which includes olanzapine. As a pharmacist, what alternative medication could you discuss with his healthcare provider to potentially reduce these side effects?

A) Lithium
B) Aripiprazole
C) Haloperidol
D) Clozapine
E) Risperidone

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Question A 25-year-old female patient with bipolar disorder is planning to become pregnant. She is currently taking carbamazepine. What important counseling point should you provide regarding the use of carbamazepine during pregnancy?

A) Carbamazepine is safe to use throughout pregnancy
B) Discontinue carbamazepine immediately if pregnancy is detected
C) Discuss with her doctor about switching to a safer alternative due to teratogenic risks
D) Increase the dose of carbamazepine during pregnancy
E) Only use carbamazepine during the first trimester

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Question A 50-year-old male patient with bipolar disorder is taking lamotrigine. He reports a new onset of a rash. As a pharmacist, what is the most appropriate advice to give him?

A) Ignore the rash; it is a common side effect and not harmful
B) Apply a topical steroid cream to the rash
C) Immediately contact his healthcare provider due to the risk of a serious skin reaction
D) Stop taking lamotrigine for a few days to see if the rash improves
E) Take an antihistamine to manage the rash

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Question A 35-year-old male patient diagnosed with schizophrenia is prescribed risperidone. He is concerned about the potential side effects and interactions. As a pharmacist, what common side effects should you inform the patient about?

A) Hypertension and tachycardia
B) Weight gain and increased prolactin levels
C) Dry mouth and constipation
D) Hypoglycemia and hair loss
E) Bradycardia and hypotension

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Question A 45-year-old female patient with a history of psychosis is taking olanzapine. She presents to the pharmacy with a prescription for metformin. What potential reason for this new prescription should you discuss with her?

A) To manage potential hyperlipidemia caused by olanzapine
B) To manage potential hyperglycemia caused by olanzapine
C) To counteract weight loss caused by olanzapine
D) To manage potential hypotension caused by olanzapine
E) To manage potential bradycardia caused by olanzapine

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Question A 60-year-old male patient with schizophrenia has been taking haloperidol for several years. He reports new symptoms of muscle stiffness and tremors. As a pharmacist, what condition should you suspect and discuss with the patient’s healthcare provider?

A) Neuroleptic malignant syndrome
B) Serotonin syndrome
C) Extrapyramidal symptoms
D) Tardive dyskinesia
E) Acute dystonia

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Question A 28-year-old female patient with a history of psychosis is taking clozapine. She presents to the pharmacy with complaints of sore throat and fever. What serious condition should you consider and what action should you take?

A) Agranulocytosis; advise her to seek immediate medical attention
B) Tardive dyskinesia; suggest stopping the medication
C) Neuroleptic malignant syndrome; recommend hydration and rest
D) Serotonin syndrome; suggest taking an antihistamine
E) Hyperprolactinemia; recommend an endocrinology consult

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Question A 50-year-old female patient with schizophrenia is prescribed quetiapine. She is concerned about its impact on her sleep. What is an appropriate counseling point for this patient regarding quetiapine?

A) Quetiapine is likely to cause insomnia
B) Quetiapine may cause drowsiness and should be taken at bedtime
C) Quetiapine does not affect sleep patterns
D) Quetiapine should be taken in the morning to avoid sleep disturbances
E) Quetiapine will not interact with any other medications she is taking

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Question A 70-year-old male patient with Parkinson’s disease is prescribed levodopa/carbidopa. He reports experiencing nausea and dizziness after starting the medication. As a pharmacist, what advice should you provide to manage these side effects?

A) Take the medication with a high-protein meal
B) Take the medication on an empty stomach
C) Take the medication with a small snack or low-protein meal
D) Discontinue the medication immediately
E) Increase fluid intake to prevent dehydration

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Question A 65-year-old female patient with Parkinson’s disease has been taking pramipexole. She reports experiencing sudden episodes of falling asleep during the day. What is the most appropriate action for the pharmacist to recommend?

A) Increase the dose of pramipexole
B) Switch to a different dopamine agonist
C) Advise the patient to take pramipexole only at night
D) Discontinue pramipexole and consult her doctor
E) Add an additional medication to counteract drowsiness

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Question A 72-year-old male patient with Parkinson’s disease is prescribed entacapone as an adjunct to his levodopa/carbidopa therapy. He asks how entacapone will benefit him. What is the correct explanation?

A) Entacapone reduces the side effects of levodopa
B) Entacapone increases the absorption of levodopa
C) Entacapone prolongs the effect of levodopa by inhibiting COMT
D) Entacapone replaces the need for levodopa
E) Entacapone decreases the progression of Parkinson’s disease

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Question A 68-year-old female patient with Parkinson’s disease is experiencing tremors and rigidity despite being on levodopa/carbidopa therapy. Her doctor prescribes selegiline. As a pharmacist, what should you inform the patient about this medication?

A) Selegiline is a dopamine agonist that will replace levodopa
B) Selegiline is a selective MAO-B inhibitor that can be used with levodopa
C) Selegiline must be taken with high-protein meals
D) Selegiline will decrease blood pressure significantly
E) Selegiline has no dietary restrictions

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Question A 75-year-old male patient with Parkinson’s disease is prescribed amantadine for dyskinesia. He asks how this medication will help him. What is the correct response?

A) Amantadine will increase dopamine production
B) Amantadine is an anticholinergic that reduces tremors
C) Amantadine helps reduce dyskinesia and improves motor function
D) Amantadine replaces the need for levodopa
E) Amantadine will slow the progression of Parkinson’s disease

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uestion (Dementia) A 78-year-old female patient diagnosed with Alzheimer’s disease is prescribed donepezil. She expresses concern about potential side effects. As a pharmacist, what common side effects should you inform her about?

A) Hyperglycemia and weight gain
B) Insomnia, nausea, and diarrhea
C) Dry mouth and urinary retention
D) Hypotension and bradycardia
E) Hair loss and skin rash

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Question (Dementia) A 70-year-old male patient with moderate Alzheimer’s disease is prescribed memantine. He asks how this medication will help his condition. What is the correct explanation?

A) Memantine increases acetylcholine levels in the brain
B) Memantine inhibits cholinesterase enzymes
C) Memantine blocks NMDA receptors to reduce glutamate excitotoxicity
D) Memantine increases dopamine levels
E) Memantine decreases the production of beta-amyloid

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Question (ALS) A 65-year-old male patient diagnosed with amyotrophic lateral sclerosis (ALS) is prescribed riluzole. He asks how this medication will help him. What is the correct explanation?

A) Riluzole increases dopamine production
B) Riluzole enhances acetylcholine release
C) Riluzole inhibits glutamate release and prolongs survival
D) Riluzole decreases muscle spasms
E) Riluzole repairs damaged neurons

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Question (ALS) A 58-year-old female patient with ALS is experiencing increased muscle spasticity. Her neurologist prescribes baclofen. As a pharmacist, what should you inform the patient about the common side effects of baclofen?

A) Insomnia and increased appetite
B) Dry mouth and constipation
C) Sedation, dizziness, and muscle weakness
D) Hypertension and tachycardia
E) Nausea and weight gain

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Question (Dementia) A 72-year-old female patient with Alzheimer’s disease is prescribed rivastigmine. She is concerned about administering the medication. What are the available forms of rivastigmine, and what should the pharmacist advise regarding administration?

A) Oral tablet and subcutaneous injection
B) Oral tablet and transdermal patch
C) Oral tablet and intravenous infusion
D) Transdermal patch and nasal spray
E) Subcutaneous injection and nasal spray

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Question (ALS) A 62-year-old male patient with ALS is prescribed edaravone. He asks how this medication will help manage his condition. What is the correct explanation?

A) Edaravone inhibits acetylcholinesterase
B) Edaravone increases dopamine levels
C) Edaravone reduces oxidative stress
D) Edaravone enhances glutamate release
E) Edaravone repairs motor neurons