A 44-year-old man with schizophrenia is being treated with a low-potency typical antipsychotic. He complains that his medication's side effects are more than he can handle and wants to try another medication. If he was to switch from a low-potency to a high-potency antipsychotic drug, which of the following side effects would likely diminish?

Correct Answer: A

Rationale: High-potency antipsychotics have fewer anticholinergic side effects (e.g., dry mouth, constipation) compared to low-potency antipsychotics, but they are more likely to cause extrapyramidal symptoms like parkinsonism.

Correct Answer: B

Rationale: The decrease in MAC in this case can be attributed to the use of two anesthetics, nitrous oxide and sevoflurane. When two anesthetics are used together, their combined effect can lead to a lower MAC requirement for surgical anesthesia. This phenomenon is known as MAC sparing. In this case, the combination of nitrous oxide and sevoflurane resulted in a lower total MAC requirement of 0.7, compared to the usual 1.3 MAC in most patients. Therefore, the use of two anesthetics is the most likely variable that caused the decrease in MAC in this case.

Correct Answer: D

Rationale: Chloral hydrate (choice D) is metabolized to trichloroethanol, which depresses the CNS, inducing sedation. Morphine (choice A) metabolizes to active compounds like morphine-6-glucuronide, not trichloroethanol. Clorazepate (choice B) becomes desmethyldiazepam, a benzodiazepine. Phenobarbitone (choice C) is a barbiturate, not metabolized to trichloroethanol. This identifies Chloral hydrate's metabolic pathway, key for its hypnotic use.

Correct Answer: B

Rationale: The most likely receptors mediating the adverse effect of olanzapine in the 37-year-old woman are GABAergic and muscarinic receptors. Olanzapine, an atypical antipsychotic, can have side effects such as acute psychotic states and aggression, which may be due to its interaction with these receptors. Blocking GABAergic receptors can lead to disinhibition and agitation, while muscarinic receptor blockade can cause cognitive impairment and confusion, both of which could contribute to the patient's acute psychotic state and aggressive behavior.

Correct Answer: C

Rationale: Acetylsalicylic acid (aspirin) inhibits COX enzymes, reducing prostaglandin synthesis (choice D), yielding analgesic (choice A) and antipyretic (choice B) effects by decreasing pain mediators and hypothalamic heat regulation, respectively. However, it inhibits, not promotes, platelet aggregation (choice C) by blocking thromboxane A2 production, a pro-aggregatory prostaglandin, making it antiplatelet, used in cardiovascular prophylaxis. Promotion of aggregation would contradict its mechanism. This exception tests understanding of aspirin's unique antiplatelet action among NSAIDs, critical for its clinical applications.