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Psychiatry Jeopardy Boards > Bipolar Disorder > Flashcards

Bipolar Disorder Flashcards

1
Q

Patients may experience ________ in bipolar I disorder.

A

delusions

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2
Q

How long do symptoms last in bipolar II disorder?

A

4 - 6 days

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3
Q

Mixed features may be present in which type of bipolar disorder?

A

Bipolar I or Bipolar II disorder

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4
Q

A depressive episode is NOT a diagnostic requirement for which type of bipolar disorder?

A

Bipolar I disorder

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5
Q

Patients are typically in depressed state 15 x’s more than a (hypo)manic state
in which type of Bipolar disorder?

A

Bipolar II disorder

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6
Q

Patients are typically in depressed state 2x’s more than a (hypo)manic state
in which type of Bipolar disorder?

A

Bipolar I disorder

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7
Q

Which type of bipolar disorder is easily mistaken for cyclothymia?

A

Bipolar II Disorder

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8
Q

Patients are more likely to have a hypomanic episode with this type of Bipolar disorder.

A

Bipolar I disorder

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9
Q

Which type of bipolar disorder causes significant impairment in social or occupational function or necessitates psychiatric hospitalization?

A

Bipolar I disorder

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10
Q

The likelihood of a male or
female having this illness
is essentially equal.

A

Bipolar I disorder

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11
Q

Which sex is more likely to have a first mood disturbance be a manic episode?

A

Males

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12
Q

If the 1st mood disturbance is
a manic episode the risk of
future mood episodes is
this percentage.

A

85% (80 - 90%)

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13
Q

If this relative is diagnosed with Bipolar Disorder, your

risk is ~70%

A

Your identical twin

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14
Q

The average age of onset for Bipolar II is what age?

A

mid-20’s

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15
Q

The average age of onset for Bipolar I is what age?

A

18 years old

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16
Q

With each ensuing episode, the length of time a patient spends in a manic episode does this

A

lengthens/increases

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17
Q

For someone with a family history of bipolar disorder, the risk is lower if the affected relative is on this side of the family.

A

Paternal side (father)

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18
Q

After the 1st, 2nd, or 3rd mood disturbance in Major Depression, the risk of future depression episodes
is what percentages?

A

After 1 episode: risk is 50%
After 2 episodes, risk is ~70%
After 3 episodes, risk is ~90% (definitely do maintenance treatment)

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19
Q

For patients with bipolar disorder, as the total number of mood episodes increases, the interepisode interval does this

A

shortens/decreases

20
Q

The average lifetime number of manic episodes a patient will have is 9-10 unless the physician does this

A

give maintenance medication treatment

21
Q

What medication is generally avoided in the treatment of

Bipolar patients with liver disease?

A

divalproex (depakote)

22
Q

This medication can be rapidly loaded and patients who respond improve the most in the first 3 days

A

divalproex (depakote)

23
Q

Lithium or Divalproex (depakote) monotherapy successfully treat manic episodes to resolution in
1 out of this many patients

A

Rule of 1/3’s:
1/3 respond well
1/3 partial respond
1/3 respond poorly

24
Q

What is Lithium’s response rate in treating bipolar patients with euphoric mood, family history of the illness, and/or few lifetime episodes?

A

70% (good/very good)

25
Q

What medication is the first choice for treating a severe acute manic episode?

A 
Lithium + FGA/SGA
or                                               Divalproex (depakote) + FGA/SGA
26
Q

Maintenance treatment should always be recommended after how many manic episodes?

A

2 (most of the time after 1 episode)

27
Q

For patients with bipolar disorder, treatment with which medication appears to decrease the risk of suicide?

A

Lithium

28
Q

Which medication is generally avoided in treating bipolar patients with renal disease?

A

Lithium

29
Q

Which medication is generally avoided in treating bipolar patients who are obese?

A

Olanzapine (Zyprexa)

30
Q

The risk of this adverse outcome is lower if lithium is discontinued gradually over months rather abruptly over days.

A

risk of an affective switch to mania

31
Q

This combination medication contains fluoxetine (prozac) and is effective in treating bipolar depression with no increased risk of a switch to a manic episode.

A

Olanzapine/Fluoxetine (symbyax)

32
Q

Since these types of antidepressants were introduced, studies have shown an increased switch rate & an
increase in the number
of rapid cycling cases

A

tricyclic antidepressants (TCAs) and serotonin-norepinephrine reuptake inhibitors (SNRI’s)

33
Q

Use of this treatment regimen for patients with bipolar I depression is contraindicated

A

antidepressant monotherapy

34
Q

Of all the antidepressants, using this one appears to carry the least risk of inducing a manic episode.

A

bupropion (wellbutrin)

35
Q

Name the 5 medications that are recommended for treating bipolar depression:

A

lithium
quetiapine (seroquel)
lurasidone (latuda)
lamotrigine (lamictal) olanzapine/fluoxetine (symbyax)

36
Q

While often used as an adjunct treatment of major depression,
this SGA is NOT shown to be beneficial in the treatment of bipolar depression

A

aripiprazole (abilify)

37
Q

When using an antidepressant to treat bipolar depression, this should be done after the episode has remitted

A

discontinue the antidepressant

38
Q

This medication can be used to treat acute bipolar depression and for maintenance treatment, but NOT for an acute manic episode

A

lamotrigine (lamictal)

39
Q

Used in the treatment of bipolar disorder, this medication has the narrowest gap between therapeutic & toxic concentration of any drug routinely prescribed in psychiatry

A

lithium

40
Q

To rapidly load a patient weighing 150 pounds with 20 mg/kg of divalproex (depakote), this amount of the medication is prescribed

A

1500 mg

41
Q

What is the percentage of patients with bipolar disorder whose life ends by suicide?

A

16% (20x’s the relative risk of the general population and about the same as major depression)

42
Q

How is life-threatening lithium toxicity treated?

A

Dialysis

43
Q

Often this symptom heralds

the onset of a new manic episode

A

decreased need for sleep

44
Q

Which happens 60% of the time?

Mania then depression or
Depression then mania

A

Mania then depression

45
Q

Which happens 40% of the time?

Mania then depression or
Depression then mania

A

Depression then mania

46
Q

Individuals in a manic episode frequently resist treatment efforts because they do not recognize that they are ill, which is called _______.

A

anosognosia (lack of insight)

47
Q

What laboratory finding is diagnostic of a manic episode?

A

There is no diagnostic finding associated with mania

Psychiatry Jeopardy Boards (7 decks)

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