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Psychiatry > Bipolar Jeopardy > Flashcards

Bipolar Jeopardy Flashcards

1
Q

In which BD may pts experience delusions?

A

Bipolar I

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2
Q

In which BD may sx be present for 4-6 days?

A

Bipolar II

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3
Q

Which BD may present w/mixed sx?

A

Bipolar I or II

in DSM-4, only Bipolar I presented as a mixed episode

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4
Q

In which BD is a depressive episode not a diagnostic requirement?

A

Bipolar I

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5
Q

Pts are typically in depressed state 15x’s more than a (hypo)manic state in bipolar I or II?

A

Bipolar II

- Bipolar I depressed ~2x’s more than manic

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6
Q

Which BD can easily be mistaken for cyclothymia?

A

Bipolar II

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7
Q

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

A

Bipolar I

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8
Q

Which BD causes significant impairment in social or occupational function or necessitates psychiatric hospitalization.

A

Bipolar I

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9
Q

The likelihood of a M or F having this form of BD is essentially equal.

A

Bipolar I

- Data unclear for bipolar II

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10
Q

This sex is more likely to have a first mood disturbance be a manic episode.

A

Males

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11
Q

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

A

80-90%

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12
Q

What % risk does an identical twin have if his or her sibling is dx’d with BD?

A

~70%

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13
Q

The average age of onset for Bipolar II is later than Bipolar I’s, which is this age.
- What age for bipolar II?

A

18 y/o

- Bipolar II: mid-20s

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14
Q

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

A

Increases/lengthens

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15
Q

For someone with a family hx of BD, the risk is lower if the affected relative is on this side of the family.

A

Paternal side

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16
Q

After the first mood disturbance in MDD, the risk of future depression episodes is this.

  • After 2 episodes?
  • After 3 episodes?
A

50%

  • After 2 episodes, risk is ~70%;
  • After 3 episodes, risk is ~90+% (definitely do maintenance treatment)
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17
Q

For patients with BD, as the total # of mood episodes increases, the inter-episode interval does this.

A

Shortens/decreases

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18
Q

The average lifetime # of manic episodes a pt will have is 9-10 unless the physician does this .

A

Gives maintenance medication

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19
Q

Lithium
Divalproex/valproic acid (Depakote)
Olanzapine (Zyprexa)
——————————————-
Generally avoided in tx of bipolar pts with liver disease

A

Divalproex/valproic acid (Depakote)

20
Q

Lithium
Divalproex (Depakote)
Olanzapine (Zyprexa)
——————————————-
This medication can be rapidly loaded, and pts who respond improve the most in the first 3 days

A

Divalproex (Depakote)

21
Q

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

A

3

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

22
Q

Lithium’s response rate in treating bipolar pts w/ euphoric mood, family hx of the illness, and/or few lifetime episodes is this:

A

70% Good/very good

23
Q
  • Lithium
  • Lithium + FGA/SGA
  • Divalproex (Depakote)
  • ## Divalproex (Depakote) + FGA/SGAThe first choice for treating a severe acute manic episode is this:
A

Lithium + FGA/SGA or divalproex (depakote) + FGA/SGA

24
Q

Maintenance treatment should always be recommended after this # of manic episodes?

A

2

- And usually after 1 episode

25
Q

For patients with BD, tx w/ this medication appears to decrease the risk of suicide.

A

Lithium

26
Q

Lithium
Divalproex (Depakote)
Olanzapine (Zyprexa)
———————————————
This drug is generally avoided in treating bipolar patients with renal disease

A

Lithium

27
Q

Lithium
Divalproex (Depakote)
Olanzapine (Zyprexa)
———————————————
Generally avoided in treated bipolar patients who are obese.

A

Olanzapine (Zyprexa)

28
Q

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

A

Affective switch to mania.

29
Q

Even though this combination medication contains fluoxetine (prozac), it is effective in treating bipolar depression and has no increased risk of a switch to a manic episode.

A

Olanzapine/fluoxetine (Symbyax)

30
Q

Since these type of antidepressants were introduced, studies have shown an increased switch rate and an increase in the # of rapid cycling cases.

A

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

31
Q

Use of this tx regimen for pts with bipolar I depression is contraindicated.

A

Antidepressant monotherapy

32
Q

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

A

Bupropion (Wellbutrin)

33
Q

Meds that are recommended for treating bipolar depression are lithium, quetiapine (Seroquel), lurasidone (Latuda), and these two meds.

A
  • Lamotrigine (Lamictal)

- Olanzapine/fluoxetine (Symbyax)

34
Q

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

A

Aripiprazole (Abilify)

35
Q

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

A

Discontinue the antidepressant

36
Q

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

A

Lamotragine (Lamictal)

37
Q

Used in the tx of BD, this medication has the narrowest gap between therapeutic and toxic concentration of any drug routinely prescribed in psychiatry.

A

Lithium

38
Q

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

A

1,500mg

39
Q

The % of pts with BD whose life ends by suicide is this.

  • How many times higher is the relative risk vs. the general pop?
  • How many times higher than MDD?
A

~16%

  • 20x’s the relative risk of the general population
  • About the same relative risk as in MDD
40
Q

Lithium toxicity that is so severe as to be life threatening; it is treated with this.

A

Dialysis

41
Q

Jessie Jackson Jr. appears to claim that these two manic symptoms contributed to his illegal misuse of campaign funds.

A
  • Grandiosity

- Dangerous pleasurable activities

42
Q

Often this symptom heralds

the onset of a new manic episode.

A

Decreased need for sleep

43
Q

Mania then depression or
Depression then mania

This happens 60% of the time.

A

Mania then depression

44
Q

Individuals in a manic episode frequently resist efforts to treat them because they do not recognize that they are ill, which is called this.

A

Anosognosia (or lack of insight)

45
Q

A laboratory finding that is diagnostic of a manic episode

is this.

A

None

Psychiatry (16 decks)

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