Serotonin syndrome

SEROTONIN SYNDROME

1. 
   Which of the following is the correct definition of serotonin syndrome?
   
   1. 
      Signs and symptoms caused by excessive stimulation of the serotonergic system.
      
   2. 
      Signs and symptoms caused by an overdose of serotonergic drugs.
      
   3. 
      A clinical condition that closely resembles neuroleptic malignant syndrome.
      
   4. 
      A clinical condition characterized hyperthermia, clonus, and agitation.
      

2. 
   The basic cause of serotonin syndrome is:
   
   1. 
      Prolonged use of drugs that affect the serotonergic system.
      
   2. 
      Therapeutic use, overdose, or drug interaction involving serotonergic medications.
      
   3. 
      Improper tapering of medications that affect the serotonergic system.
      
   4. 
      It is an inevitable consequence for some people who take serotonergic drugs.
      

3. 
   Which of these classes of drugs that inhibits the reuptake of serotonin?
   
   1. 
      Common analgesics.
      
   2. 
      Illicit drugs.
      
   3. 
      Sympathomimetics
      
   4. 
      SSRIs.
      

4. 
   Drugs that cause the serotonin syndrome by causing excessive release of serotonin are:
   
   1. 
      SSRIs. MAOIs.
      
   2. 
      MAOIs, amphetamines.
      
   3. 
      Opioid analgesics, TCAs.
      
   4. 
      Tryptophan, dextromethorphan.
      

5. 
   Three illicit drugs that may cause serotonin syndrome are:
   
   1. 
      Methamphetamine, heroin, marijuana.
      
   2. 
      Cocaine, LSD, ecstasy.
      
   3. 
      Marijuana, ecstasy, cocaine.
      
   4. 
      Dextromethorphan, LSD, methamphetamine.
      

6. 
   The three categories of signs/symptoms that are diagnostic of serotonin syndrome are:
   
   1. 
      Cardiovascular, autonomic, cognitive.
      
   2. 
      Metabolic, neuromuscular, cognitive.
      
   3. 
      Cognitive, neuromuscular, autonomic,
      
   4. 
      Psychiatric, metabolic, cardiovascular.
      

7. 
   The diagnostic signs that is most reliably noted in cases of serotonin syndrome is:
   
   1. 
      Hyperthermia.
      
   2. 
      Hallucinations.
      
   3. 
      Tremor.
      
   4. 
      Clonus.
      

8. 
   Autonomic, cognitive, and neuromuscular signs of serotonin syndrome include:
   
   1. 
      Hyperthermia, agitation, and clonus.
      
   2. 
      Bradycardia, anxiety, and fasiculations.
      
   3. 
      Tachyarrhythmias, hallucinations, and hyperreflexia.
      
   4. 
      Metabolic acidosis, anxiety, and tremor.
      

9. 
   The criteria used to diagnose serotonin syndrome are:
   
   1. 
      Sternbach’s criteria.
      
   2. 
      Hunter’s criteria.
      
   3. 
      Modified Glasgow scale.
      
   4. 
      Romberg criteria.
      

10. 
    Two clinical conditions that may be mistaken for serotonin syndrome are:
    
    1. 
       Cholinergic syndrome, syndrome, malignant hyperthermia.
       
    2. 
       Anticholinergic syndrome, Stevens-Johnson syndrome.
       
    3. 
       Neuroleptic malignant syndrome, anticholinergic syndrome.
       
    4. 
       Sympathomimetic syndrome, drug-induced hypothermia.
       

11. 
    The usual time of onset of the signs and symptoms of serotonin syndrome is:
    
    1. 
       24 hours.
       
    2. 
       Two-three days.
       
    3. 
       One-two weeks.
       
    4. 
       Six-eight hours.
       

12. 
    Which of the following are serious complications of serotonin syndrome?
    
    1. 
       DIC, rhabdomyolysis, metabolic acidosis.
       
    2. 
       Hepatic failure, renal failure, ventricular arrhythmias.
       
    3. 
       Coma, hypotension, pulmonary embolism.
       
    4. 
       Rhabdomyolysis, renal failure, ischemic stroke.
       

13. 
    The best therapy for serotonin syndrome and three specific treatments include:
    
    1. 
       Supportive care: intubation, fluids, dantrolene.
       
    2. 
       Supportive care: aggressive cooling, neuromuscular paralysis, benzodiazepines.
       
    3. 
       Antidotal therapy: cyproheptadine, chlorpromazine.
       
    4. 
       Discontinuation of the drug: supportive care,
       

14. 
    Which of these drugs may be helpful in treating serotonin syndrome?
    
    1. 
       Bromocriptine, acetaminophen.
       
    2. 
       Propranolol, chlorpromazine.
       
    3. 
       Cyproheptadine, chlorpromazine.
       
    4. 
       Dantrolene, glucagon.
       

15. 
    Four drugs that should not be used to treat serotonin syndrome are:
    
    1. 
       Cyproheptadine, bromocriptine, acetaminophen, propranolol.
       
    2. 
       Dopamine, succinylcholine, epinephrine, chlorpromazine.
       
    3. 
       Olanzapine, tramadol, phenylephrine.
       
    4. 
       Bromocriptine, dantrolene, propranolol, succinylcholine