Bipolar Jeopardy Flashcards
(45 cards)
In which BD may pts experience delusions?
Bipolar I
In which BD may sx be present for 4-6 days?
Bipolar II
Which BD may present w/mixed sx?
Bipolar I or II
in DSM-4, only Bipolar I presented as a mixed episode
In which BD is a depressive episode not a diagnostic requirement?
Bipolar I
Pts are typically in depressed state 15x’s more than a (hypo)manic state in bipolar I or II?
Bipolar II
- Bipolar I depressed ~2x’s more than manic
Which BD can easily be mistaken for cyclothymia?
Bipolar II
Pts are more likely to have a hypomanic episode with this type of Bipolar disorder.
Bipolar I
Which BD causes significant impairment in social or occupational function or necessitates psychiatric hospitalization.
Bipolar I
The likelihood of a M or F having this form of BD is essentially equal.
Bipolar I
- Data unclear for bipolar II
This sex is more likely to have a first mood disturbance be a manic episode.
Males
If the 1st mood disturbance is a manic episode, the risk of future mood episodes is this %.
80-90%
What % risk does an identical twin have if his or her sibling is dx’d with BD?
~70%
The average age of onset for Bipolar II is later than Bipolar I’s, which is this age.
- What age for bipolar II?
18 y/o
- Bipolar II: mid-20s
With each ensuing episode, the length of time a pt spends in a manic episode does this.
Increases/lengthens
For someone with a family hx of BD, the risk is lower if the affected relative is on this side of the family.
Paternal side
After the first mood disturbance in MDD, the risk of future depression episodes is this.
- After 2 episodes?
- After 3 episodes?
50%
- After 2 episodes, risk is ~70%;
- After 3 episodes, risk is ~90+% (definitely do maintenance treatment)
For patients with BD, as the total # of mood episodes increases, the inter-episode interval does this.
Shortens/decreases
The average lifetime # of manic episodes a pt will have is 9-10 unless the physician does this .
Gives maintenance medication
Lithium
Divalproex/valproic acid (Depakote)
Olanzapine (Zyprexa)
——————————————-
Generally avoided in tx of bipolar pts with liver disease
Divalproex/valproic acid (Depakote)
Lithium
Divalproex (Depakote)
Olanzapine (Zyprexa)
——————————————-
This medication can be rapidly loaded, and pts who respond improve the most in the first 3 days
Divalproex (Depakote)
Lithium or Divalproex (depakote) monotherapy successfully treats manic episodes to resolution in
1 out of this many patients.
3
- Rule of 1/3’s: 1/3 respond well, 1/3 partial respond, 1/3 respond poorly
Lithium’s response rate in treating bipolar pts w/ euphoric mood, family hx of the illness, and/or few lifetime episodes is this:
70% Good/very good
- Lithium
- Lithium + FGA/SGA
- Divalproex (Depakote)
- ## Divalproex (Depakote) + FGA/SGAThe first choice for treating a severe acute manic episode is this:
Lithium + FGA/SGA or divalproex (depakote) + FGA/SGA
Maintenance treatment should always be recommended after this # of manic episodes?
2
- And usually after 1 episode
