Chapter 13: Bipolar and Related Disorders Flashcards

1
Q

bipolar 1 disorder

A

most severe form
at least 1 manic episode and 1 episode of major depression

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2
Q

bipolar 2 disorder

A

at least 1 hypomanic episode and at least 1 major depressive episode

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3
Q

cyclothymic disorder

A

doesn’t meet criteria for either diagnosis
hypomania alternating with symptoms of mild to moderate depression for at least 2 years
rapid cycling possible

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4
Q

rapid cycling possible

A

more quickly than bipolar 1 and 2
at least 4 times per year

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5
Q

hypomanic vs mania

A

lesser form of mania
mania - lite
more functional
still impactful on brain

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6
Q

if mania is euphoric

A

many people do not want to take meds

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7
Q

can cyclothymic disorders can develop bipolar disorder

A

yes

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8
Q

why are substance use disorders common with cyclothymic disorder and bipolar

A

used to self medicate

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9
Q

splitting

A

breaking apart staff unity to get what they want

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10
Q

grandiosity

A

thinking they are the best at something
big self esteem

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11
Q

pressured speech

A

on-off, stumbling over words

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12
Q

circumstantial speech

A

adding extra detail, will get to the point

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13
Q

tangenital speech

A

on a tangent

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14
Q

loose asscoations

A

ideas loosely connected

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15
Q

flight of ideas

A

fast speach, topic to topic

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16
Q

clang associations

A

rhyming, lyrical, rapping

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17
Q

persecutory delusions

A

paranoid, people are after me

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18
Q

what is persecutory normally associated with

A

grandiose

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19
Q

more time in mania or occurences

A

the harder to pull out of mania

20
Q

normal priority diagnosis

A

risk for injury
risk for self directed violence
risk for other directed violence

21
Q

acute phase

A

prevent injury
stablize

22
Q

maintence phase

A

maintain
prevent future exacerbation of the mania or hypomania

23
Q

bipolar has what 2 sides

A

mania and depression

24
Q

pharmacologic interventions
two main parts

A

agitation
mood stabilization

25
medication of depression may push patient into
mania
26
what is the gold standard for bipolar
lithium
27
lithium
first line for bipolar frequent follow up monitor kidney and liver
28
lithium therapeutic blood levels
0.8-1.4
29
toxic level of lithium
1.5 and above
30
what is the sign you are moving into toxicity
fine hand tremor
31
early signs of toxicity
GI upset, coarse hand tremor, confusion, hyper irritability of muscles, sedation, incoordination
32
advanced signs of toxicity
ataxia blurred vision clonic movements seizures stupor severe hypotension coma
33
severe toxicity
convulsion, oliguria, death
34
what is key to inform your patient about weight with lithium
in the first week you might gain 5 pounds of water weight
35
3 anticonvulsant drugs
valproate carbamazepine lamotrigine
36
carbamazepine
- works well with rapid cyclers - paranoid thinking - monitor blood levels
37
valproate sodium
- rapid cycling - dysphoric symptoms
38
lamotrigine and gabapentin
useful for pateitns refractory to other therapy lamotrigine does not push patient into mania/depression
39
second generation antipsychotics
olanzapine risperidone aripiprazole asenaprine cariprazine lurasidone quetiapine ziprasidone
40
why do we use second gen antispychotics in biopolar
get someone out of the manic stage calm people down
41
first generation antipsychotics
chlorpromazine loxapine
42
why do we use first generation antipsychotics
acute mania and agitation
43
biggest side effect of ECT is
short term memory loss
44
therapies for bipolar
cognitive behavior therapy interpersonal and social rythm - help recognize routine and learn to integrate relationships
45