Mehl. bullets: BIPOLAR 03-21 (1)

Question 1

Mehl. Bipolar I and II. you give Tx => increased LFTs + tremor. What medication?

Answer 1

choose valproic acid over lithium.

Question 2

Mehl. Tx for bipolar?

Answer 2

lithium or valproic acid to start.

Question 3

Mehl. What is bipolar I vs II, which worse?

Answer 3

bipolar I is worse than II;

Question 4

Mehl. bipolar I and II, what is the difference and what is the same?

Answer 4

both will have cycling episodes of mania and depression.

bipolar I will often tell you there’s Hx of hospitalization, or losing one’s job, friends, or relationships (socio-occupational dysfunction), or spending lots of money;

bipolar II will tell you patient keeps stable job and/or family life and has never been hospitalized.

Question 5

Mehl. Adverse effects of lithium?

Answer 5

lithium causes Ebstein anomaly in pregnancy (atrialization of right ventricle in fetus); also tremor and thyroid dysfunction;

Question 6

Mehl. Mehl. Adverse effects of valproic?

Answer 6

valproic acid notoriously causes neural tube defects.