Wattle Pharmacy Prep

CNS and psychiatry
Practice questions with explanations

CNS and psychiatry belongs to Therapeutics and patient care, which makes up about 45% of the Overseas Pharmacist Readiness Assessment (OPRA®). Answer each question yourself before opening the explanation.

1. Which factor most influences the choice of antipsychotic for a first episode of psychosis?

  1. The adverse effect profile matched to the individual, since efficacy between agents other than clozapine is broadly similar
  2. The route of administration only
  3. The cost of the medicine alone
  4. Antipsychotics are interchangeable in every respect
Show answer

A. The adverse effect profile matched to the individual, since efficacy between agents other than clozapine is broadly similar

Because efficacy is comparable, tolerability determines whether a young person stays on treatment, and weight gain, sedation, sexual dysfunction and movement effects all drive discontinuation. Clozapine is the exception, being superior in treatment-resistant illness, but it is reserved because of its monitoring requirements and adverse effects.

2. Which is a recognised risk when an antidepressant is prescribed to a young person?

  1. No specific risks in young people
  2. A small increase in suicidal thinking and behaviour early in treatment, requiring close monitoring in the first weeks
  3. Immediate improvement guaranteed
  4. Antidepressants are contraindicated under 25
Show answer

B. A small increase in suicidal thinking and behaviour early in treatment, requiring close monitoring in the first weeks

The signal is strongest in those under 25 and early in treatment or after dose changes, which is why review is arranged within the first week or two. It does not mean withholding treatment, since untreated depression carries its own substantial suicide risk, but it does mean explaining what to watch for and ensuring access to help.

3. Which factor most increases lithium concentration and the risk of toxicity?

  1. Increasing dietary sodium
  2. Dehydration, or starting a thiazide, ACE inhibitor or NSAID
  3. Drinking more water than usual
  4. Starting an inhaled corticosteroid
Show answer

B. Dehydration, or starting a thiazide, ACE inhibitor or NSAID

Lithium is handled like sodium by the proximal tubule, so anything that reduces sodium and water — vomiting, diarrhoea, fever, hot weather, low-salt diets — increases its reabsorption. Thiazides, ACE inhibitors, sartans and NSAIDs all raise concentrations. Toxicity presents with coarse tremor, vomiting, diarrhoea, ataxia, confusion and eventually seizures, and requires urgent concentration measurement.

These are 3 of the 60 questions on cns and psychiatry in the app.

All 2,200 questions, offline

Wattle Pharmacy Prep has every question with a full explanation, practice by area and topic, timed 120-question mock exams in 150 minutes, and a readiness score that only counts a question once you have answered it correctly twice in a row. One purchase, no subscription, no account, fully offline.

Download on the App StoreGet it on Google Play

More topics in Therapeutics and patient care

Australian pharmacy practice and law · Cardiovascular therapeutics · Counselling, OTC and triage · Dermatology · Diabetes and endocrine therapeutics · Eye, ear, nose and throat · Gastrointestinal therapeutics · Infectious diseases · Musculoskeletal · Older people and polypharmacy · Oncology and supportive care · Paediatrics · Pain and palliative care · Pharmaceutical calculations · Renal and urology · Respiratory therapeutics · Vaccines and immunisation · Women's health