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Psychiatry Year 3 Dundee > Bipolar Affective Disorder > Flashcards

Bipolar Affective Disorder Flashcards

1
Q

How does the DSM break up Bipolar affective disorder?

A

By course and severity

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2
Q

DSM Bipolar Type 1

A

Meets the criteria for mania with previous episodes of hypomania and depression.

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3
Q

DSM Bipolar Type 2

A

Current of past hypomanic episode with a current or past depression, but never met criteria for mania

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4
Q

How does ICD10 divide Bipolar affective disorder?

A

Describes episode severity

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5
Q

What is the ICD 10 definition of Bipolar Affective Disorder?

A

Two or more episodes of either hypomania or mania alongside depression.

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6
Q

Hypomania

A

Level of disturbance below mania
Mood is abnormally elevated for the individual that last for four days
At least the symptoms that interfere with normal function.

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7
Q

What are the core symptoms of Hypomania?

A 
Physical restlessness
Talkativness
Difficulty in concentration 
Increased sexual energy
Mild spending sprees
Reckless behaviour
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8
Q

Mania

A

Abnormally elevated and expansive mood for individual
Mood change is prominent and sustained for over a week.
Severe interference with life

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9
Q

What are the core symptoms of Mania?

A 
Same as hypomania +
Increased talkativeness
Monologues
Loss of social inhibitions 
Inflated self esteem
Foolhardy reckless risk taking
Marked sexual energy and indiscretion
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10
Q

How does someone with hypo/mania appear or behave?

A

Bright clothes
Distractabilty
Over familiarity

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11
Q

How does someone with hypo/mania speak?

A

Increased talkativeness
Difficult to get a word in
Punning and clanging associations

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12
Q

What is the form flow and content of a patients thoughts with hypo/mania?

A

Increased flow
Flight of ideas - loose associations
Ideas of grandiosity

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13
Q

Epidemiology of Bipolar Affective disorder

A

Late teens early 20’s

Family history can lead to earlier onset and increased severity

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14
Q

If an elderly patient presents with bipolar affective disorder what is usually the cause?

A

Organic cause

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15
Q

What are some comorbid conditions?

A 
Anxiety 
Alcohol and drug misuse
Personality disorders
Eating disorders
Schizoaffective disorders
Schizophrenia
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16
Q

What are some predictors of poor outcome in a patient with Bipolar Affective disorder?

A 
Early onset
Low socioeconomic output
Long duration
Rapid mood fluctuations
Psychosis
Comorbid disorders
17
Q

What is the gold standard treatment for Bipolar Affective Disorder?

A

Lithium Carbonate

18
Q

What is the desired Lithium 12 hour post dose blood level ?

A

0.4 - 1.0

19
Q

What other classes of drugs can be used in Bipolar Affective Disorder?

A

Anticonvulsants

Antipsychotic

20
Q

What Anticonvulsants can be used in Bipolar Affective Disorder?

A

Valproic Acid
Lamotragine
Carbezamapine

21
Q

What Antipsychotics can be used in Bipolar Affective Disorder?

A

Olanzapine
Aripiprazole
Quetiapine

22
Q

What genetic mutation has a mild association with Bipolar Affective Disorder?

A

Short Allele of Serotonin Transporter Gene

23
Q

If someone presents with Acute Mania what are the 1st line drugs?

A

Antipsychotics e.g.
Olanzapine
Quetiapine
Risperidone

24
Q

What can be used alongside the antipsychotic drugs in the treatment of acute mania?

A

Lithium
Sodium Valproate
Carbamezapine
ECT

25
Q

How should medication be administered in Acute Mania?

A

Orally

IM if non compliant need Mental Health Act

26
Q

When are benzodiazepines used in acute mania?

A

To treat symptoms like extreme agitation

Short term use

27
Q

When should antidepressants not be used in Bipolar Affective Disorder?

A

Recent history of mania

Or evidence or rapid cycling bipolar

28
Q

What is the 1st line drug for acute Bipolar ?

A

Quetiapine - Antipsychotic

29
Q

When can Antidepressants be used in Bipolar Affective disorder?

A

Alongside Lithium or Sodium Valproate

If primary complaint is depression in Bipolar

30
Q

What Antidepressant is used in Bipolar Affective Disorder?

A

Lamotrigine - Slowly titrate

31
Q

What must be monitored if patient is on long term maintenance Lithium?

A

U and Es
ECG
Calcium

Psychiatry Year 3 Dundee (21 decks)

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