Q.1 Which neurotransmitter is primarily implicated in the rewarding effects of most addictive substances?
Serotonin
Dopamine
GABA
Acetylcholine
Explanation - Dopamine release in the mesolimbic pathway, particularly the nucleus accumbens, is central to the reinforcing and rewarding effects of addictive substances.
Correct answer is: Dopamine
Q.2 Which of the following is considered a common physiological withdrawal symptom of alcohol?
Hyperthermia
Bradycardia
Tremors
Miosis
Explanation - Alcohol withdrawal commonly presents with autonomic hyperactivity including tremors, sweating, anxiety, and nausea.
Correct answer is: Tremors
Q.3 Which screening tool is specifically designed to assess alcohol use disorders?
PHQ-9
AUDIT
GAD-7
CAGE
Explanation - The Alcohol Use Disorders Identification Test (AUDIT) is a validated 10-item questionnaire designed to detect hazardous and harmful alcohol consumption.
Correct answer is: AUDIT
Q.4 Which of the following is a long-acting opioid used in maintenance therapy for opioid use disorder?
Morphine
Methadone
Fentanyl
Buprenorphine
Explanation - Methadone is a long-acting opioid agonist used in maintenance therapy to prevent withdrawal and reduce cravings in opioid use disorder.
Correct answer is: Methadone
Q.5 Which substance is most likely to cause paranoid psychosis when used chronically?
Cannabis
Cocaine
Alcohol
Nicotine
Explanation - Chronic cocaine use, especially in high doses, can lead to stimulant-induced psychosis characterized by paranoia and hallucinations.
Correct answer is: Cocaine
Q.6 Which medication is an opioid antagonist used to prevent relapse in alcohol and opioid dependence?
Naltrexone
Disulfiram
Acamprosate
Methadone
Explanation - Naltrexone blocks opioid receptors, reducing the rewarding effects of both alcohol and opioids and helping prevent relapse.
Correct answer is: Naltrexone
Q.7 Which brain region is most strongly associated with craving and relapse in substance use disorders?
Amygdala
Prefrontal cortex
Hippocampus
Nucleus accumbens
Explanation - The nucleus accumbens, part of the mesolimbic dopamine system, plays a central role in reward, reinforcement, and craving.
Correct answer is: Nucleus accumbens
Q.8 Which of the following is considered a hallucinogen?
Heroin
LSD
Methamphetamine
Benzodiazepines
Explanation - LSD (lysergic acid diethylamide) is a potent hallucinogen that alters perception, mood, and cognition.
Correct answer is: LSD
Q.9 Which of the following is a benzodiazepine used to manage acute alcohol withdrawal?
Diazepam
Flumazenil
Buspirone
Clonidine
Explanation - Diazepam, a long-acting benzodiazepine, is commonly used to reduce withdrawal symptoms and prevent seizures during alcohol detoxification.
Correct answer is: Diazepam
Q.10 Which of the following is the primary mechanism of action of nicotine?
Dopamine reuptake inhibition
Activation of nicotinic acetylcholine receptors
GABA receptor antagonism
Opioid receptor agonism
Explanation - Nicotine binds to nicotinic acetylcholine receptors in the brain, increasing dopamine release and producing its reinforcing effects.
Correct answer is: Activation of nicotinic acetylcholine receptors
Q.11 Which substance withdrawal can be life-threatening if not managed properly?
Caffeine
Alcohol
Cannabis
Nicotine
Explanation - Alcohol withdrawal can lead to severe complications like seizures and delirium tremens, which can be fatal without medical management.
Correct answer is: Alcohol
Q.12 Which of the following medications is used to deter alcohol consumption by causing unpleasant reactions when alcohol is ingested?
Disulfiram
Naltrexone
Methadone
Acamprosate
Explanation - Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation and unpleasant symptoms when alcohol is consumed, discouraging drinking.
Correct answer is: Disulfiram
Q.13 Which class of drugs is primarily associated with euphoria, increased energy, and risk of cardiac complications?
Opioids
Stimulants
Hallucinogens
Benzodiazepines
Explanation - Stimulants like cocaine and amphetamines increase dopamine and norepinephrine levels, causing euphoria and increased sympathetic activity, which can affect the heart.
Correct answer is: Stimulants
Q.14 Which of the following is a common psychiatric comorbidity in patients with substance use disorders?
Depression
Autism
Schizophrenia
Obsessive-compulsive disorder
Explanation - Depression is frequently comorbid with substance use disorders, and it can both contribute to and result from substance misuse.
Correct answer is: Depression
Q.15 Which of the following opioids is a partial agonist used in opioid maintenance therapy?
Methadone
Buprenorphine
Fentanyl
Heroin
Explanation - Buprenorphine is a partial opioid agonist that reduces withdrawal symptoms and cravings with a lower risk of respiratory depression compared to full agonists.
Correct answer is: Buprenorphine
Q.16 Which substance is most commonly associated with 'flashbacks'?
Alcohol
Cannabis
LSD
Heroin
Explanation - LSD can cause hallucinogen persisting perception disorder, characterized by visual disturbances or 'flashbacks' after acute intoxication.
Correct answer is: LSD
Q.17 Which of the following is a key feature of stimulant intoxication?
Slurred speech
Hypotension
Hyperactivity
Depressed mood
Explanation - Stimulant intoxication commonly manifests as increased energy, hyperactivity, agitation, and sometimes psychosis.
Correct answer is: Hyperactivity
Q.18 Which of the following is the most appropriate first-line treatment for cannabis use disorder?
Benzodiazepines
Behavioral therapy
Methadone
Disulfiram
Explanation - Behavioral interventions such as cognitive-behavioral therapy (CBT) are first-line treatments for cannabis use disorder; there is no approved pharmacotherapy.
Correct answer is: Behavioral therapy
Q.19 Which of the following substances is associated with the highest risk of overdose death in the U.S.?
Alcohol
Cocaine
Fentanyl
Nicotine
Explanation - Fentanyl, a potent synthetic opioid, has a high risk of fatal overdose even in small amounts due to respiratory depression.
Correct answer is: Fentanyl
Q.20 Which of the following is true regarding dual diagnosis in psychiatry?
It refers to the coexistence of two psychiatric disorders unrelated to substance use.
It refers to the coexistence of a substance use disorder and another psychiatric disorder.
It refers to the coexistence of two substance use disorders only.
It refers to the presence of a psychiatric disorder without substance use.
Explanation - Dual diagnosis describes patients who have both a substance use disorder and another mental health disorder, requiring integrated treatment approaches.
Correct answer is: It refers to the coexistence of a substance use disorder and another psychiatric disorder.
Q.21 Which of the following is a common complication of chronic alcohol use?
Hepatitis C
Liver cirrhosis
Renal failure
Hyperthyroidism
Explanation - Chronic alcohol consumption can lead to liver cirrhosis due to progressive hepatocellular injury and fibrosis.
Correct answer is: Liver cirrhosis
Q.22 Which of the following is an example of a sedative-hypnotic substance?
Cocaine
Alcohol
MDMA
Nicotine
Explanation - Alcohol is a central nervous system depressant that acts as a sedative-hypnotic, producing relaxation and sedation.
Correct answer is: Alcohol
Q.23 Which of the following behavioral therapies is commonly used to prevent relapse in substance use disorders?
Exposure therapy
Motivational interviewing
Psychoanalysis
Electroconvulsive therapy
Explanation - Motivational interviewing helps patients enhance motivation for change, set goals, and reduce ambivalence, making it effective in relapse prevention.
Correct answer is: Motivational interviewing
Q.24 Which of the following opioids has the highest potential for abuse and rapid onset of euphoria?
Methadone
Heroin
Buprenorphine
Codeine
Explanation - Heroin is rapidly converted to morphine in the brain, producing intense euphoria and high abuse potential.
Correct answer is: Heroin