1. MDMA (3,4 methylenedioxymethamphetamine) is: ?
Available for psychiatric research purposes only.
A schedule I drug and has no legitimate use.
A schedule II drug, with a legitimate uses but with a risk of abuse
An appetite suppressant available under the name Ecstasy ®
Not a scheduled drug

2. Common themes associated with MDMA abuse are all of the following EXCEPT: ?
High school and college age users
Rave (or “house” ) dance parties
Infant pacifiers and glow sticks as drug-use associated paraphernalia
Baggy pants

3. MDMA has been referred to as all of the following EXCEPT: ?
A hallucinogenic amphetamine
An entactogen
Ecstasy/biscuit/disco
A dopaminergic agonist
A serotenergic neurotoxin

4. MDMA causes an increase of serotonin in the synapse by: ?
Reversing the normal inward flow of the seortonin reuptake transport channel
Rapid exocytosis of serotonin containing vesicles
Inhibiting the breakdown of serotonin by inhibiting monoamine oxydase (MAO)
Stimulating increased serotinin production
Mimics the effects of serotonin

5. A key feature of MDMA-induced serotonergic syndrome is: ?
Tachycardia
Hyperthermia
Hallucinations
Good dance moves
Elevated liver enzymes

6. Reported clinical effects from a severe MDMA-induced serotonin syndrome case have included all of the following EXCEPT: ?
DIC (disseminated intravascular coagulopathy)
Seizures
Hypotension
Metabolic acidosis
Ischemic bowel

7. MDMA-induced hyponatremia has been associated with all of the following EXCEPT: ?
Decreased serum osmolality
Cerebral edema
Coma
Elevated vasopressin levels
Renal failure

8. The pathogenisis of hyperthermia in an “ecstasy” patient includes all of the following potentiators EXCEPT: ?
Serotonin-related disregulation of the body’s thermostat in the hypothalamus
Increased ambient temperature
Sustained physical activity
Increased vasopressin release
Inadequate fluid intake

9. The probable cause of the hepatotoxicity and liver failure secondary to MDMA use may include all of the following EXCEPT: ?
Idiosyncratic reaction
Ischemic injury secondary to hyperthermia and shock
Possible contaminants from poorly controlled drug manufacture
Increased production of toxic metabolite in large overdose cases

10. The long term toxic effects of MDMA use are probably secondary to: ?
Decreased sensitivity (i.e. down regulation) of serotonin receptors
Structural serotonergic nerve terminal damage and loss of serotonergic synapses
Cutting too many classes after late night Rave parties
“Aging” of the serotonergic neuron
Slowing of the connection between cerebral hemispheres

11. The well documented long term effects reported after MDMA use have been: ?
Impaired memory function (verbal and non-verbal recall, learning)
Drug-induced Parkinson’s disease
Global cognitive deficit
Killer dance moves
Impaired heat tolerance

12. All of the following may be recommended in the management of MDMA-induced serotonin syndrome EXCEPT: ?
External cooling
Benzodiazepines (e.g diazepam)
Selective serotonin re-uptake inhibitors (e.g. fluoxetine)
Adequate fluid replacement
Lidocaine for ventricular arrhythmias

13. The primary intervention for MDMA induced hepatic failure is removal of the drug and supportive care: ?
True
False

14. MDMA is a safe drug if taken in moderate amounts: ?
True
False