Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psyc Test 2 > Bipolar > Flashcards

Bipolar Flashcards

1
Q

Bipolar epidemiology

A

25% of all mood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bipolar

Risk factors

A

*majority first episode BEFORE 25
*mean onset 18 years
Old
*mixed episodes more in younger than older
*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Bipolar in women

A
  • 1st mood is depressive = women, in men its mania
  • women more rapid cycling
  • possible: hypothyroid, hormones, more antidepression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Consequences of Bipolar

A
  • suicide = 15x
  • Bipolar = 1/4 all suicides
  • co-existing anxiety disorder
  • divorce = 2-3x normal
  • more likely unemployed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Bipolar etiology

A
  • shares genetic origin with Schizophrenia
  • twins = 50-75% chance
  • chaotic childhood events
  • HPA axis/cortisol
  • HPituitaryThyroid dysfunction = bluented TSH response / hypothryoidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bipolar 1 vs 2

A

1 = full blown mania/depression

2 = not full mania

Cyclothymia = each extreme not full

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

DSM 5

A 
Abnormally Elevated/irritable mood + persistently increased goal-directed activity/energy MIN 1 WEEK
W/
3+:
*inflated self esteem/grandiosit
*decreased need for sleep
*pressured speech/talkative
*flight of ideas
*distractibility
*UP goal-directed activity
*excessive involvement in risky behavior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

DSM 5 hypomania

A
  • same as mania but 4 DAYS
  • not severe enough for marked impairment
  • need family member to help
  • less AGITATION
  • HAVE CYCLES
  • typically dx monopolar depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How to Dx

BP 1
BP2
Cyclothymia

A

1 = just one manic episode

2= one hypomanic + one major depressive

Cyclothymia = chronic, bipolar-like condition, not meeting threshold (days severity) for major depression at least 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Grandiosity

Personality vs. bipolar

A

Never leaves in personality disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Medication-induced bipolar

A

Right after med use

  • cocaine
  • corticosteroids
  • stimulants

NOT if s/s prior to use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Other bipolar related syndromes

A

Other condition : thyroid, SLE, excess cortisol, TBI, MS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Depressed : mania

A

BP 1 = 3:1
BP 2 = 37:1

Often misdiagnosed as major depressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Best dx strategy

A

Ask family

Specifiers

  • w/ anxious distress
  • w/ mixed features

*rapid cycling = 4 more episodes per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

BP differents

A
  • unipolar major depressive
  • schizoaffective
  • schiz
  • adhd
  • Borderline
  • substance abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

BP comorbidities

A
  • 1 other axis 1 usually (major spyc)
  • substance use
  • anxiety
  • personality disorder
  • ADHD
17
Q

Mania vs depression

A

Mania abrupt, depression gradual

18
Q

BP

Tx themes

A
  • Aggressive
  • Long term
  • S/s every 9-12 months
  • recurrence = rx non-adherence, environmental stress, sleep disruption
  • acute episodes + mainenance of euthymia
19
Q

Kindling Theory of Bipolar Disorder

A
  • Treat early

* cycles get worse as time goes on

20
Q

BP/Depression most dangerous time

A

When physical s/s gone , mood still remains (increased suicide)

21
Q

Tx acute mania w/o psychosis

A
  • SAFETY = admit if unsafe
  • on anti-depressant? Lower/stop
  • 1st line = valproate (no female able to get pregnant)
  • Lithium = slower onset than valproate
  • Benzo short-term for agitation
  • Carbamezipine/gabapentine, lamotrigine/topiramate NOT FOR ACUTE MANIA
22
Q

Acute mania w/ Psychosis

A
  • SAFTEY FIRST
  • lithium/valproate + antipsych
  • olanzapine/quetiapine/risperidone
  • lower anti-depressant
23
Q

Hospitalization options

A
  • inpatient - ALL suicidal/homicidal/hallucinations/inability to care (live alone)
  • Partial hospitalization = moderately ill, family (if don’t come you are inpatient)
  • outpatient = less acute, family, good w/ meds
24
Q

Maintenance

A

*goal: monotherapy w/ mood stabilizer

1st Line (in order:

  • Lithium (reduces suicide)
  • Valproate
  • Quetiapine
  • Lamotrigine (not getting out of acute)
25
Q

Rxs

A

*lithium/valproate = must monitor toxicity

Monitor for :

  • tx failure (live event change? New other med?)
  • suicidality
  • incipient depression/mania
  • bone marrow toxicity
  • inadequate serum levels
  • excess serum levels
26
Q

Bipolar Disorder = psychotherapy

A
  • goal = med adherence
  • ID recurrence
  • promote regular sleep/social patterns
  • group therapy, CBT, family therapy

Psyc Test 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions