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Year 2 Psych exam I > Bipolar, Vertrees > Flashcards

Bipolar, Vertrees Flashcards

1
Q

definition of bipolar

A

refers to group of disorders in which patient has sustained mood episodes in both directions

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2
Q

types of bipolar disorders

A

bipolar I
bipolar II
cyclothymic
substance/medication induced bipolar

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3
Q

mood disorders are based on what episode types

A

manic, depressed, hypomanic, dysthymic persistence

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4
Q

which bipolar type is equal for genders

A

bipolar I

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5
Q

total bipolar affective disorders occur more in W or M

A

W:M 3:2

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6
Q

median age onset BAD

A

earlier in men

usually around 25 yrs

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7
Q

what is criteria for manic episode

A

presence of abnormally elevated, expansive or irritable mood for at least one week (or less if need hospitalization)
+ 3 Sx (on another flash card)

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8
Q

Sx or characteristics of bipolar disorder

A

inflated self esteem or grandiosity
decreased need for sleep
more talkative or pressured
flight o ideas/subjective racing thoughts
distractibility
increased goal directed activity
excessive involvement in pleasurable activities

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9
Q

what will classify episode from anti depressant Tx to be manic

A

if continues past expected physiologic effect

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10
Q

how do manic episodes affect life

A

causes impairment in occupational, social, relationships or results in hospitalization to prevent harm to self or others

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11
Q

clinical findings in mania

A 
mood is either irritable, expansive or euphoric
a lot of emotional outpouring
pressured, trangential speech
more energy
distractible
loss of consideration for consequences
faster thoughts, flighty ideas
fundamental truths become all encompassing
gradiosity
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12
Q

course of mania

A

onset usually abrupt
last week-months
shorter than depressive episodes
preceded or followed by depression

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13
Q

in the course of mania when is highest risk of suicide

A

subsequent depressive episode

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14
Q

hypomanic episode

A

persistent elevated, expansive or irritable with 3+ manic Sx
Does NOT markedly impair social/occupational functioning
no hospitalization needed, no psychotic features

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15
Q

which type mood episodes have high rate of psychotic eatures

A

peri partum

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16
Q

Bipolar I classification

A

al least 1 manic episode

classified as type of most recent episode: manic, depressed, hypomanic

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17
Q

Bipolar II criteria

A

hypomanic episodes and major depressive episodes
relatives have higher rate in Bipolar II than I
higher rate of comorbidity with substance abuse disorders

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18
Q

cyclothymic disorder

A

chronic fluctuating disturbance between periods of hypomanic Sx and periods of depressive Sx
minimum course 2 years

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19
Q

Tx cyclothymic disorder

A

lithium

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20
Q

cyclothymic disorder patients sensitive to what Tx

A

antidepressant induced hypomania

21
Q

catatonia

A

not moving body, very odd

22
Q

what are mixed features of bipolar disorder

A

manic or hypomanic episode with significant depressive Sx
mood and Sx picture alternates rapidly
significantly elevated suicide risk

23
Q

stimulants that can cause bipolar like disorder

A

amphetamine, PCP, cocaine

antidepressants

24
Q

what exogenous steroida can cause bipolar like disorder

A

HRT, testosterone PEDs

25
what endogenous endocrine disorders present like bipolar
hyperthyroidism | pheo
26
neuro presentations like bipolar
fronto temporal dementia
27
bipolar fam Hx increases risk for
major depressive disorder and bipolar affective disorder
28
bipolar in monozygotic twins
70-90%
29
FDA approved mood stabilizers in mania
lithium, valproate, carbamazepine
30
which antipsychotic can be monotherapy in bipolar disorder
olanzapine
31
mood stabilizers in maintenance of bipolar
lamotrigine, adjunctive anti-psychotics | benzos
32
top drug for bipolar BAD II
lamotrigine
33
key in Tx plan for bipolar
psychoeducation
34
depression episode ends but pyschosis continues
schizophrenia
35
male with incident at work took LOA began to feel better than ever, colors have new meanings and he is beyond sleep having true understanding of god and suspected wife poisoning him Dx
bipolar I, MRE manic with psychosis
36
male with incident at work took LOA began to feel better than ever, colors have new meanings and he is beyond sleep having true understanding of god and suspected wife poisoning him wants to kills security gueard
place patient on 72 hr mental health hold | call wife
37
male with incident at work took LOA began to feel better than ever, colors have new meanings and he is beyond sleep having true understanding of god and suspected wife poisoning him Hx from wife: 2 hosp for bipolar managed by valproate and she thinks hes off meds
obtain VPA level and LFTs CBC (CPA cause thrombocytopenia lipid panel BMP and TSH
38
man off his valproate also showing elevated LFTs | Tx plan
start lithium start atypical antipsychotic for psychotic Sx check hepatitis serologies
39
34 y.o F politician withdrawn, sleeps 12 hrs, poor appetite and can't keep up, LOA work blunted, latent in speech and hears voices had 2 prev depressive episodes no psychotic has periods high energy and works excessively little sleep, mother BAD I Dx?
bipolar II, MRE depressed, w/psychosis (voices)
40
34 y.o F politician withdrawn, sleeps 12 hrs, poor appetite and can't keep up, LOA work blunted, latent in speech and hears voices had 2 prev depressive episodes no psychotic has periods high energy and works excessively little sleep, admit and start on lithium SSRI and risperidone and elevated suicide precautions comes back 6 mo later, fight at work, maxed out credit cards, no sleep , singing Dx now?
bipolar I MRE manic(lose job/spent money) with psychosis(spent all money in gamble)
41
``` M surgeon who took baseball bat to car in his spot pressure hyperverbal and very labile agressive and gradiosity new picking at own skin labs to order? ```
BMP CBC urine drug screen LFTs
42
``` M surgeon who took baseball bat to car in his spot pressure hyperverbal and very labile agressive and gradiosity new picking at own skin labs to order? ```
BMP CBC urine drug screen LFTs
43
M 2-3 years high and lows stable employment each type episode lasts 1-2 weeks
cyclothymic
44
Tx for cyclothymic
lithium
45
cyclothymic disorder assoc with +FMH for what
bipolar I
46
45 F with MDD recurrent on venlafaxine has increased energy, talking too much, dec sleep
medication induced bipolar disorder
47
important factors to address for non-adherence to meds in bipolar
potential side effects goals and how difficult it is to achieve them impact on family and friends
48
most effective psychotherpeutic intervention during non-adherence time of illness
psychoeducation and family therapy

Year 2 Psych exam I (15 decks)

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