Jeopardy Bipolar

Question 1

Bipolar I or Bipolar II:
Patients may experience
delusions in this

Answer 1

What is Bipolar I disorder?

Question 2

Bipolar I or Bipolar II:
Symptoms of this may be
present for 4-6 days

Answer 2

What is Bipolar II disorder?

Question 3

Bipolar I or Bipolar II:

May present with mixed features

Answer 3

What is Bipolar I or II disorder?

In DSM4, only Bipolar I presented as a mixed episode

Question 4

Bipolar I or Bipolar II:

A depressive episode is not a diagnostic requirement

Answer 4

What is Bipolar I disorder?

Question 5

Bipolar I or Bipolar II:
Patients are typically in depressed 
state 15 x’s more than a 
(hypo)manic state 
in this

Answer 5

What is Bipolar II disorder?

Bipolar I depressed ~2x’s more than manic

Question 6

Bipolar I or Bipolar II:
This can easily be mistaken
for cyclothymia

Answer 6

What is a Bipolar II diosrder?

Question 7

Bipolar I or Bipolar II:
Causes significant impairment in social or occupational function
or necessitates psychiatric hospitalization

Answer 7

What is Bipolar I?

Question 8

Bipolar I or Bipolar II:
The likelihood of a male or
female having this illness
is essentially equal

Answer 8

What is Bipolar I?

Bipolar II-data is unclear

Question 9

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

Answer 9

What are males?

Question 10

If the 1st mood disturbance is
a manic episode the risk of
future mood episodes is
this percentage

Answer 10

What is 85%? (80-90%)

Question 11

If this relative is diagnosed with Bipolar Disorder, your

risk is ~70%

Answer 11

What is your identical twin?

Question 12

The average age of onset for Bipolar II is later than

Bipolar I’s which is this age

Answer 12

What is 18 y/o?

Bipolar II: mid 20’s

Question 13

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

Answer 13

What is lengthens/increases?

Question 14

For someone with a family history of bipolar disorder, the risk is lower if the affected relative is
on this side of the family

Answer 14

What is paternal side (father)?

Question 15

After the first mood disturbance in Major Depression, the risk of future depression episodes
is this

Answer 15

What is 50%?
(After 2 episodes, risk is ~70%;
After 3 episodes, risk is ~90+%–definitely do maintenance treatment)

Question 16

For patients with bipolar disorder, as the total number of mood episodes increases, the interepisode
interval does this

Answer 16

What is shortens/decreases?

Question 17

The average lifetime number of manic episodes a patient will
have is 9-10 unless the physician
does this

Answer 17

What is give maintenance medication treatment?

Question 18

Generally avoided in treatment of
Bipolar pts with liver disease

Answer 18

What is divalproex (depakote)??

Question 19

This medication can be rapidly loaded and patients who respond improve the most in the first 3 days

Answer 19

What is divalproex (depakote)?

Question 20

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

Answer 20

What is 3?

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

Question 21

Lithium’s response rate in treating bipolar patients with euphoric mood, family history of the illness, and/or few lifetime episodes is this

Answer 21

What is 70% (good/very good)

Question 22

Lithium       		
		Lithium + FGA/SGA
		Divalproex (Depakote)
		Divalproex (Depakote) + FGA/SGA
-------------------------------
The first choice for treating a severe 
acute manic episode is this

Answer 22

What is Lithium + FGA/SGA or divalproex (depakote) + FGA/SGA?

Question 23

Maintenance treatment should always be recommended after this number of manic episodes

Answer 23

What is two? (And most of the time after one episode)

Question 24

For patients with bipolar disorder, treatment with this medication appears to decrease the risk
of suicide

Answer 24

What is Lithium?

Question 25

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

Answer 25

What is Lithium?

Question 26

Lithium          Depakote (Depakote)      Olanzapine (Zyprexa)
---------------------------------------
Generally avoided in treated bipolar patients who are obese

Answer 26

What is Olanzapine (Zyprexa)?

Question 27

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

Answer 27

What is an affective switch to mania?

Question 28

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

Answer 28

What is olanzapine/fluoxetine (symbyax)

Question 29

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

Answer 29

What are tricyclic antidepressants (TCAs) and serotonin-norepinephrine reuptake inhibitors (SNRI’s)?

Question 30

Use of this treatment regimen for patients with bipolar I depression is contraindicated

Answer 30

What is antidepressant monotherapy?

Question 31

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

Answer 31

What is bupropion (wellbutrin)?

Question 32

Medications that are recommended for treating bipolar depression are lithium, quetiapine (seroquel), lurasidone (latuda) and these two medications

Answer 32

What are lamotrigine (lamictal) & olanzapine/fluoxetine (symbyax)?

Question 33

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

Answer 33

What is aripiprazole (abilify)?

Question 34

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

Answer 34

What is discontinue the antidepressant?

Question 35

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

Answer 35

What is lamotrigine (lamictal)?

Question 36

Used in the treatment of bipolar disorder, this medication has the narrowest gap between therapeutic & toxic concentration of any drug routinely prescribed in psychiatry

Answer 36

What is lithium?

Question 37

To rapidly load a patient weighing

150 pounds with 20 mg/kg of divalproex (depakote), this amount of the medication is prescribed

Answer 37

What is 1,500 mg?

Question 38

The percentage of patients with bipolar disorder whose life ends by suicide is this

Answer 38

Correction: What is ~16%

(Is 20x’s the relative risk of the general population; about the same as major depression)

Question 39

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

Answer 39

What is dialysis?

Question 40

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

Answer 40

What are grandiosity & dangerous pleasurable activities?

Question 41

Often this symptom heralds

the onset of a new manic episode

Answer 41

What is decreased need for sleep?

Question 42

Mania then depression or
Depression then mania

This happens 60% of the time

Answer 42

What is Mania then depression?

Question 43

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

Answer 43

What is anosognosia? (or lack of insight)

Question 44

A laboratory finding that is diagnostic of a manic episode

is this

Answer 44

What is none?