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Psych > bipolar/mania (2) > Flashcards

bipolar/mania (2) Flashcards

1
Q

describe duration of mania for classification

A

lasts at least 1 week for most of the day nearly every day

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2
Q

describe alterations that classify mania?

A

elevated, expansive, irritable, increased activity or energy, goal oriented

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3
Q

what is the hallamrk of mania?

A

flight of ideas

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4
Q

what are some of the signs/sx of mania?

A

-grandiosity
-decreased need for sleep
-more talkative
-flight of ideas
-distractibility
-goal-oriented
-psychomotor agitation
-excessive involvement

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5
Q

how can mania be emeregnt

A

increased suicide risk

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6
Q

can mania be attributed to substances or other conditions?

A

no

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7
Q

describe hypomania

A

less severe than regular/severe mania
-euphoric/increases functioning
-excessive activity
-not severe enough ti impair functioning or require hospitalization
-no psychosis with mania, may be present in depression

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8
Q

what disorders are characterized by mood swings from profound depression to extreme euphoria with intermittent periods of normalcy

A

bipolar disorders

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9
Q

what are the 3 types of bipolar disorders

A

bipolar 1
bipolar 2
cyclothymic

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10
Q

which bipolar disorder has a full syndrome of manic symptoms, alternates depression with anxiety and agitation, psychosis possible

A

bipolar 1

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11
Q

comorbidities with bipolar 1

A

anxiety, ADHD, impulse control, substance use

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12
Q

which bipolar disorder is major depression with episodic occurence of hypomania, has never met criteria for full manic episode

A

bipolar 2

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13
Q

comorbidities with bipolar 2

A

anxiety, eating disorders, subsyances

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14
Q

which bipolar disorder has symptoms of hypomania alternating with mild/moderate depressin for at least 2 years, does not meet other criteria - yet disturbing enough to alternate functioning

A

cyclothymic disorder

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15
Q

comorbidities with cyclothymic disorder

A

substance use disorder, sleep disorder, ADHD

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16
Q

describe rapid cycling in bipoalr disorder

A

4 mood episodes in 12 months, more severe and resistant to treament

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17
Q

bipolar used to be highly diagnosed in kids, but now is not. what is it called in kids now?

A

disruptive mood dysregualtion disorder (DMDD)

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18
Q

what is there a high risk for in undiagnosed bipolar teens?

A

suicide

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19
Q

is bipolar hereditary?

20
Q

biochemical influences of bipolar

A

excess norepi & dopamine, low serotonin
too much acetylcholine in depression, not enough in mania

21
Q

what is lithium carbonate used for

A

antimanic, neuroprotective antisuicidal

22
Q

contraindications of lithium

A

sodium depletion, dehydration, cardiac/renal disease, pregnancy/lactation

23
Q

expected side effects of lithium

A

drowzy/dizzy/headache
dry mouth/GI upset
tremors
polyuria/dehydration
weight gain

24
Q

what is the therapeutic range of lithium

A

0.6-1.2 mEq/L

25
Q

at what level can lithium toxicity begin to be seen

A

1.5 mEq/L (HOLD MED AND CALL DR)

26
Q

at what lithium level should a patient be hospitalized

27
Q

describe fine tremors

A

expected, usually in hands, usually symmetric, can improve spontaneously

28
Q

describe coarse tremors

A

SIGN OF TOXICITY, more irregular and severe, widespread, associated woth other symptoms

29
Q

treatment of tremor

A

reduce caffeine, keep lithium levels low/medium, propranolol (beta blocker, HR/BP), vitamin B6

30
Q

what does a person on lithium need to regularly intake

A

Na (salt) 2g

31
Q

fluid intake for someone on lithium

32
Q

what can anticonvulsants be used for?

A

mood stabilizers

33
Q

what are the 3 main anticonvulsants used for mood stabilizers

A

valproic acid (depakene) / divalproex sodium (depakote)
lamotrigine (lamictal)

34
Q

major side effect of anticonvulsants as mood stabilizers

A

liver failure

35
Q

BBW for anticonvulsants as mood stabilizers

A

increased risk for suicidal thoughts and behaviors

36
Q

therapeutic level of valproic acid

A

50-100 mcg/ml

37
Q

at what level is valproic acid toxic

A

above 100 mcg/ml

38
Q

BBW valproic acid

A

hepatotoxicity (monitor LFT/PLT)

39
Q

what is the life threatening complication that comes from lamotrigine

A

rash, steven johnson syndrome

40
Q

which meds work faster than mood stabilizers, so are used initially until drugs kick in

A

antipsychotics

41
Q

what combo of meds must be given for bipolar depression

A

antidepressant and mood stabilizer

42
Q

when monotherapy fails, what do yo udo?

A

augmentation with second med

43
Q

when is ECT used for mania

A

meds are not tolerated or when life threatening behavior is present, depressive episodes with catatonia

44
Q

what kinds of foods are best for manic patients

A

finger foods

45
Q

what is a good way of controlling manic behavior

A

distraction

Psych (19 decks)

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