Bipolar

Question 1

What is the first line psychotherapy in maintenance BP tx?

Answer 1

Psychoeducation

Question 2

What is the first line psychotherapy in acute mania?

Answer 2

None

Question 3

What is the first line psychotherapy in acute depression?

Answer 3

Trick question– only second line (CBT + family based)

Question 4

What is characteristic of a depressed mood that predicts bipolar? (three answers)

Answer 4

Rapid onset and offset of short duration (< 3mo), mixed state, loss of efficacy of AD after initial response

Question 5

What is the risk of a recurrent manic episode after hospitalization?

Answer 5

1/2 (50%), will have a 2nd manic episode, within 2 years

Question 6

which gender has a worse prognosis in bpI?

Answer 6

male

Question 7

compare bipolar to depression heritability

Answer 7

60-80% vs 30-40%

Question 8

mixed features bipolar responds best to?

Answer 8

valproic

Question 9

which episode does BP most commonly start with?

Answer 9

MDD (75% in F, 67% in M)

Question 10

which mood stabilizer is Health Canada approved for maintenance tx for BP?

Answer 10

valproic acid

Question 11

Lesions to which side of the brain cause mania and depression?

Answer 11

Right- mania, left- depression

Question 12

Is rapid cycling associated with hyper or hypothyroidism?

Answer 12

hypo

Question 13

which genes are involved in BP?

Answer 13

chromosome 5, 11, 18, 22, X (but 18 and 22 most evidence)

Question 14

Rapid cycling is more common in which type of BP

Answer 14

I

Question 15

Which BP type spends more time in depression/

Answer 15

II

Question 16

Higher rate of suicide during which episode of BP

Answer 16

mixed features

Question 17

During which mood state are cognitive deficits present?

Answer 17

all three (mania, depression, euthymia)

Question 18

safest AP to breastfeed with?

Answer 18

olz

Question 19

which gender is more likely to rapid cycle

Answer 19

female

Question 20

what percentage of MDD will have a manic episode in 2 yrs?

Answer 20

5-10%

Question 21

what kind of rash does lithium cause?

Answer 21

psoriasis

Question 22

two most common co-morbidites of BP?

Answer 22

1. SUD 2. anxieties (OCD, PD, SAD)

Question 23

How many episodes does one need to be considered for the rapid cycling specifier?

Answer 23

at least 4 within a 12 mo period

Question 24

Does rapid cycling have a familial pattern of inheritance?

Answer 24

No

Question 25

Criterion A for BPI/II is…

Answer 25

Expansive, elevated or irritable mood with increased activity/energy

Question 26

Who is more likely to experience hypomanic sx? BP I or II?

Answer 26

I

Question 27

Which type of BP has greatest genetic heritability?

Answer 27

BP II

Question 28

Carbamazepine is best in what kind of BP

Answer 28

comorbid anxiety, scza with mood incongruent psychosis, neg FHx

Question 29

Best tx for mixed feature episodes?

Answer 29

atypical AP or DVP

Question 30

stroke in which hemisphere can cause mania

Answer 30

R

Question 31

percentage of bpI who achieve remission with lithium

Answer 31

60%

Question 32

first line tx for mania and Mdd in youth

Answer 32

lithium and lurasidone respectively