Bipolar - 4

Question 1

Klerman bipolar I

Answer 1

Mania with depression

Question 2

Klerman bipolar type II

Answer 2

Hypomania with depression

Question 3

Klerman bipolar type III

Answer 3

Cyclothymic disorder /personality

Question 4

Klerman bipolar type IV

Answer 4

Hypomania or Mania peecipitared by antidepressants

Question 5

Klerman bipolar type V

Answer 5

Depression with a family history of bipolar

Question 6

Klerman bipolar type VI

Answer 6

Mania without depression

Question 7

Contemporary application of Klerman classification

Answer 7

Klerman’s classification is limited; modern psychiatry favours individualized care.

Question 8

Akiskal classification 1999

Answer 8

Bipolar I
Bipolar I 1/2
Bipolar II
Bipolar II 1/2
Bipolar III
Bipolar III 1/2
Biplar IV

Question 9

Akiska 1999 Bipolar I

Answer 9

Full Blown Mania

Question 10

Akiska 1999 Bipolar I 1/2

Answer 10

Depression with protracted hypomania

Question 11

Akiska 1999 Bipolar II

Answer 11

depression with hypomania

Question 12

Akiska 1999 Bipolar II 1/2

Answer 12

Cyclothymic depressions

Question 13

Akiska 1999 Bipolar III

Answer 13

antidepressant associated hyomania

Question 14

Akiska 1999 Bipolar III 1/2

Answer 14

Bipolarity unmasked/masked by substance abuse

Question 15

Akiska 1999 Bipolar IV

Answer 15

Hyperthymic depression

Question 16

Main differences between bipolar and borderline personality disorders

Answer 16

-Psychomotor activation in BD
-Self destructive behaviours in BPD
-Hx of sexual trauma in BPD
-Characteristic features of BPD
-Genetic

Question 17

What are psychomotor activations in BD

Answer 17

-Decrease need for sleep
-Higher energy
-Increased goal-directed activities
- Pressured speech

Question 18

Prevalence of self-disctructive cutting behaviours in Borderline vs Bipolar

Answer 18

Borderline ===>50-80%
Bipolar ===> Very Uncommon

Question 19

Hx of sexual trauma in Borderline PD VS bipolar

Answer 19

Borderline 40-70%
Bipolar 20-40%

Question 20

Hx of sexual trauma in general population

Answer 20

13-17% females
2.5-5% in males

Question 21

Borderline characteristic that rarely seen in bipolar

Answer 21

• Abandonment
• Identity disturbance
• Recurrent suicidal or self mutilating behaviours
• Dissociative symptoms

Question 22

Heritability of bipolar

Answer 22

80-90%

Question 23

Overal risk of postpartum biplar relapse

Answer 23

37%

Question 24

Postpartum replace % on prophylactic bipolar vs off prophylactic bipolar

Answer 24

23% vs 66%

Question 25

Bipolar medications that should be stoped in pregnant bipolar patients

Answer 25

Valproate
Lithium
Carbamazepine
Lamotrigine

Question 26

What do NICE and Maudsley offer for pregnant patient with bipolar

Answer 26

Antipsychotics

Question 27

What is a pregnant patient with bipolar is on lithium?

Answer 27

Stop slowly over 4 weeks to avoid relapse
Then start antipsychotics

Question 28

What if

a patient with bipolar gets pregnant and cannot come off lithium?

Answer 28

Check the level of lithium every 4 weeks until week 36, then every week

Question 29

What happens to lithium level in pregnancy

Answer 29

Drops

Question 30

How to manage a bipolar pregnant women with mild depression

Answer 30

-Self help (computerised cbt)
-Brief psychological interventions
-Antidepressants

Question 31

Average brief psychological intervention

Answer 31

5-8 sessions

Question 32

Pregnant patient develops actue mania, Rx is

Answer 32

Antipsychotic

Question 33

Moderate to severe depression in pregnant women with bipolar

Answer 33

CBT ====>Moderate
CBT + Medication ===> severe