Chapter 39. Bipolar Disorder

Question 1

1. A history of which of the following is the key feature of bipolar disorder with rapid cycling according to the DSM-5?
   A. A major depressive episode switching to mania
   B. Mania switching to a major depressive episode
   C. More than five manic episodes in 12 months
   D. More than three mood episodes in 12 months

Answer 1

D. More than three mood episodes in 12 months

Question 2

2. Factors that increase risk of suicide in individuals with bipolar disorder include:
   A. A high number of depressive episodes
   B. Late age of onset
   C. Low educational status
   D. Negative family history of bipolar disorder

Answer 2

A. A high number of depressive episodes

Question 3

3. Epidemiologic studies show patients with bipolar I disorder spend:
   A. More time manic than depressed
   B. More time depressed than manic
   C. The same amount of time manic and depressed
   D. More time acutely ill than stable

Answer 3

B. More time depressed than manic

Question 4

4. Another psychiatric illness that can include a history of manic episodes is:
   A. Major depressive disorder
   B. Panic disorder
   C. Schizoaffective disorder
   D. Schizophrenia

Answer 4

C. Schizoaffective disorder

Question 5

5. Which of the following would be the least appropriate initial choice for pharmacologic therapy of a patient with a manic episode?
   A. Divalproex
   B. Lamotrigine
   C. Quetiapine
   D. Risperidone

Answer 5

B. Lamotrigine

Question 6

6. The primary treatment for acute bipolar depression is:
   A. Antidepressant drugs
   B. Family and interpersonal therapy
   C. Electroconvulsive therapy
   D. Mood-stabilizing drugs

Answer 6

D. Mood-stabilizing drugs

Question 7

7. Which of the following second-generation antipsychotic drugs is FDA approved for treatment of acute bipolar depression as monotherapy?
   A. Lamotrigine
   B. Lurasidone
   C. Risperidone
   D. Ziprasidone

Answer 7

B. Lurasidone

Question 8

8. The recommended therapeutic serum concentration range for lithium, inclusive of both acute and maintenance therapy in otherwise healthy, nonelderly adults is:
   A. 0.3 to 0.8 mEq/L (mmol/L)
   B. 0.6 to 1 mEq/L (mmol/L)
   C. 0.6 to 1.5 mEq/L (mmol/L)
   D. 1.1 to 1.5 mEq/L (mmol/L)

Answer 8

C. 0.6 to 1.5 mEq/L (mmol/L)

Question 9

9. Divalproex is more likely than other mood-stabilizing drugs to cause which of the following?
   A. Increased serum creatinine
   B. Leukopenia
   C. Hypothyroidism
   D. Thrombocytopenia

Answer 9

D. Thrombocytopenia

Question 10

10. Which mood stabilizer is most associated with a potentially life-threatening rash?
    A. Carbamazepine
    B. Lamotrigine
    C. Lithium
    D. Divalproex

Answer 10

B. Lamotrigine

Question 11

11. Which of the following drugs classified as a mood-stabilizing drug is FDA approved for the treatment of bipolar disorder in children and adolescents?
    A. Carbamazepine
    B. Divalproex
    C. Lamotrigine
    D. Lithium

Answer 11

D. Lithium

Question 12

12. Which mood-stabilizing drug is associated with neural tube defects?
    A. Clonazepam
    B. Divalproex
    C. Lithium
    D. Lamotrigine

Answer 12

B. Divalproex

Question 13

13. When adding divalproex to the therapy of a patient already taking lamotrigine, the dosage of lamotrigine should:
    A. Stay the same
    B. Be increased by 50%
    C. Be decreased by 50%
    D. Lamotrigine should be discontinued

Answer 13

C. Be decreased by 50%

Question 14

14. Which category of patients is most likely to experience weight gain due to second-generation antipsychotic therapy?
    A. Children and adolescents
    B. Middle-aged adults
    C. Older adults (age greater than 65)
    D. Young adults

Answer 14

A. Children and adolescents

Question 15

15. Which of the following mood-stabilizing drugs induces its own metabolism?
    A. Carbamazepine
    B. Divalproex
    C. Lamotrigine
    D. Lithium

Answer 15

A. Carbamazepine