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Disciplines Exam 2 SHEA > Bipolar Disorder I, II & Cyclothymic Disorder > Flashcards

Bipolar Disorder I, II & Cyclothymic Disorder Flashcards

1
Q

What is the mean age of onset of Bipolar I?

A

18-20 y/o

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2
Q

What is the one major risk factor of Bipolar Disorder?

A

Family hx of bipolar disorder (10 fold increased risk)

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3
Q

What is the etiology of Bipolar disorder?

A

It is unknown, but likely shares some overlap with depressive disorders

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4
Q

Bipolar I:

Criteria have been met for at least one __________. This could be preceded by and may be followed by ______ or _______ episodes

A

Bipolar I:

Criteria have been met for at least one manic episode. This could be preceded by and may be followed by hypomanic or major depressive episodes.

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5
Q

Are depressive episodes required for Bipolar I diagnosis?

A

No

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6
Q
  • abnormal and persistently elevated, expansive or irritable mood atleast 1 week
  • marked impairment of social/occupational function
A

Manic Episode of Bipolar 1

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7
Q

euphoria, irritable, labile or dysphoric

A

Moods of Bipolar 1

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8
Q
  • racing, flight of ideas, disorganized, easily distracted, expansions or grandiose thoughts (highly inflated self esteem).
  • Judgement is impaired: spendng sprees.
A

THINKING indications that pt has Bipolar Disorder I

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9
Q
  • physical hyperactivity, pressured speech, decreased need for sleep (may go days w/o sleep),
  • increased impulsivity and excessive involvement in pleasurable activities including risk-taking and hypersexuality.
  • Disinhibition, increased goal directed activity.
  • Psychotic symptoms: paranoia, delusions, hallucinations.
A

BEHAVIOR indications that pt has Bipolar I

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10
Q

4 mood episodes in the previous 12 months that meet criteria for manic, hypomanic, or major depressive episode

A

Bipolar I disorder with rapid cycling

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11
Q

Abnormally elevated, expanisive or irritable mood AND abnormally/persistently increased activity/energy lasting at least 1 week and present most of day, nearly every day.

A

Manic Episode

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12
Q
  • Depressed mood or loss of interest or pleasure
  • Clinically significant distress or impairment
A

Major Depressive Episode

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13
Q
  • Abnormally and persistently elevated, expansive, or irritable mood and abnormally persistently increased activity/energy lasting at least 4 consecutive days
  • Episode associated w/ unequivocal change in functioning
  • NOT severe enough to caused marked impairment
A

Hypomanic Episode

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14
Q

Meets criteria for both a manic episode and a major depressive episode

A

Mixed Episode

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15
Q
  • One or more Major Depressive Episodes
  • At least one Hypomanic Episode
  • NEVER been a manic episode
A

Bipolar II Disorder

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16
Q

period of elevated, expansive or irritable mood at least 4 days that is clearly different from the usual nondepressed mood but:

  • DOES NOT CAUSE MARKED IMPAIRMENT,
  • NO PSYCHOTIC FEATURES AND
  • DOES NOT REQUIRE HOSPITALIZATION USUALLY.
  • DOES NOT INCLUDE RACING THOUGHTS OR EXCESSIVE PSYCHOMOTOR AGITATION.
A

Hypomania

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17
Q

Bipolar Disorder Comorbidities

A

anxiety disorders

attention deficit hyperactive disorder (ADHD)

Conduct Disorder

Substance abuse disorder

18
Q

Appropriate medication for managing bipolar affective disorder or manic depressive illness depends on what?

A

The stage of the illness the patient is experiencing

19
Q

What symptoms does the choice of agent depend on?

A

psychotic symptoms

agitation

aggression

sleep disturbance

20
Q

What are the drug categories for Bipolar Disorder?

A

Mood stabilizers

anticonvulsants

antipsychotics

21
Q

Cyclothyma is best managed with_____________

A

psychotherapy

22
Q

What is used for prophylaxis and treatment of manic episodes?

A

Lithium

23
Q

Lithium is a ________

A

mood stabilizer

24
Q

Side effects of Lithium

A

increased risk of urinary concentrating ability

hypothryoidism

hyperparathyroidism

weight gain

risk of end stage renal failure is low but must be kept in mind

25
Q

What drug has anti suicidal action?

A

Lithium

26
Q

What class of medicatios is carbamezepine?

A

Anticonvulsants

27
Q

What kind of patients would you use carbamezapine on?

A

patients who have not had clinical response to lithium and who have rapid cycling bipolar d/o

28
Q

What class of medications do Valproate sodium, valproic acid, divalproex sodium fall into?

A

Anticonvulsants

29
Q

When would you use valproate sodium, valproic acid, divalproex sodium?

A

Valproate treats mania

You can use these alone or in combination with lithium

useful for rapid cycling bipolar d/o

also used to treat aggressive or behavioral d/o

30
Q

What class of meds do Quetiapine and Risperidone fall under?

A

Antipsychotics

31
Q

When would you use Quetiapine?

A

acute treatment of manic or mixed episodes in bipolar I disorder

they come in immediate and extended release

can be used as monotherapy or with lithium or divalproex

32
Q

When would you use Risperidone?

A

short term treatment of acute manic or mixed episodes in bipolar I disorder

can be used alone or in combination with lithium or valproate

can be used in adults and adolescents 10-17 years old with bipolar I

33
Q

Meds used for manic phase of Bipolar

A

Mood stabilizer

  • lithium
  • divalproex
  • carbamazepine

AND/OR

Atypical Antipsychotic

  • risperidone
  • quetiapine
34
Q

Meds used in Depressed phase of BP

A

Mood stabilizer and/or atypical antipsychotic and/or antidepressant

35
Q

Meds used for maintenance

A

Lithium (mood stabilizer)

quetiapine/ risperidone (Atypical Antipsychotics)

36
Q

Define cyclothymic disorder

A

characterized by mood swings between hypomania and dysthmia but without any full manic or major depressive episodes

37
Q

For atleast 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that DO NOT MEET criteria for a hypomanic episode and numerous periods with depressive symptoms that DO NOT MEET criteria for a major depressive episode. What disorder is this?

A

Cyclothymic Disorder

38
Q

Additional criteria for cyclothymic disorder

A

during a 2 year period, hypomanic and depressive periods have been present for atleast half the time and the individual has not been without the symptoms for more than 2 months.

criteria for MDD, manic or hypomanic episodes have never been met.

39
Q

What screens for Bipolar Spectrum Disorder?

A

Mood Disorder Questionnaire

40
Q

Requirements for a positive bipolar screen

A

“yes” to 7 or more of the 13 items under question 1

AND
“yes” to “if you checked YES to more than one of the above, have several of these ever happened during the same period of time?”

AND

“moderate” or “serious” to “how much of a problem did any of these cause you-like being unable to work; having family, money or legal troubles; getting into arguements or fights?”

41
Q

4 comorbidities of Bipolar Disorder

A
  • Anxiety Disorders
  • ADHD
  • Conduct Disorder
  • Substance use disorder
42
Q
  • The occurrence of at least 1 manic or mixed episode.
  • Typically experience major depressive episodes as well, although not necessary for dx
A

Bipolar 1 Disorder

Disciplines Exam 2 SHEA (11 decks)

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