Chapter 13: Bipolar and Related Disorders

Question 1

bipolar 1 disorder

Answer 1

most severe form
at least 1 manic episode and 1 episode of major depression

Question 2

bipolar 2 disorder

Answer 2

at least 1 hypomanic episode and at least 1 major depressive episode

Question 3

cyclothymic disorder

Answer 3

doesn’t meet criteria for either diagnosis
hypomania alternating with symptoms of mild to moderate depression for at least 2 years
rapid cycling possible

Question 4

rapid cycling possible

Answer 4

more quickly than bipolar 1 and 2
at least 4 times per year

Question 5

hypomanic vs mania

Answer 5

lesser form of mania
mania - lite
more functional
still impactful on brain

Question 6

if mania is euphoric

Answer 6

many people do not want to take meds

Question 7

can cyclothymic disorders can develop bipolar disorder

Answer 7

yes

Question 8

why are substance use disorders common with cyclothymic disorder and bipolar

Answer 8

used to self medicate

Question 9

splitting

Answer 9

breaking apart staff unity to get what they want

Question 10

grandiosity

Answer 10

thinking they are the best at something
big self esteem

Question 11

pressured speech

Answer 11

on-off, stumbling over words

Question 12

circumstantial speech

Answer 12

adding extra detail, will get to the point

Question 13

tangenital speech

Answer 13

on a tangent

Question 14

loose asscoations

Answer 14

ideas loosely connected

Question 15

flight of ideas

Answer 15

fast speach, topic to topic

Question 16

clang associations

Answer 16

rhyming, lyrical, rapping

Question 17

persecutory delusions

Answer 17

paranoid, people are after me

Question 18

what is persecutory normally associated with

Answer 18

grandiose

Question 19

more time in mania or occurences

Answer 19

the harder to pull out of mania

Question 20

normal priority diagnosis

Answer 20

risk for injury
risk for self directed violence
risk for other directed violence

Question 21

acute phase

Answer 21

prevent injury
stablize

Question 22

maintence phase

Answer 22

maintain
prevent future exacerbation of the mania or hypomania

Question 23

bipolar has what 2 sides

Answer 23

mania and depression

Question 24

pharmacologic interventions
two main parts

Answer 24

agitation
mood stabilization

Question 25

medication of depression may push patient into

Answer 25

mania

Question 26

what is the gold standard for bipolar

Answer 26

lithium

Question 27

lithium

Answer 27

first line for bipolar
frequent follow up
monitor kidney and liver

Question 28

lithium therapeutic blood levels

Answer 28

0.8-1.4

Question 29

toxic level of lithium

Answer 29

1.5 and above

Question 30

what is the sign you are moving into toxicity

Answer 30

fine hand tremor

Question 31

early signs of toxicity

Answer 31

GI upset, coarse hand tremor, confusion, hyper irritability of muscles, sedation, incoordination

Question 32

advanced signs of toxicity

Answer 32

ataxia
blurred vision
clonic movements
seizures
stupor
severe hypotension
coma

Question 33

severe toxicity

Answer 33

convulsion, oliguria, death

Question 34

what is key to inform your patient about weight with lithium

Answer 34

in the first week you might gain 5 pounds of water weight

Question 35

3 anticonvulsant drugs

Answer 35

valproate
carbamazepine
lamotrigine

Question 36

carbamazepine

Answer 36

• works well with rapid cyclers
• paranoid thinking
• monitor blood levels

Question 37

valproate sodium

Answer 37

• rapid cycling
• dysphoric symptoms

Question 38

lamotrigine and gabapentin

Answer 38

useful for pateitns refractory to other therapy
lamotrigine does not push patient into mania/depression

Question 39

second generation antipsychotics

Answer 39

olanzapine
risperidone
aripiprazole
asenaprine
cariprazine
lurasidone
quetiapine
ziprasidone

Question 40

why do we use second gen antispychotics in biopolar

Answer 40

get someone out of the manic stage
calm people down

Question 41

first generation antipsychotics

Answer 41

chlorpromazine
loxapine

Question 42

why do we use first generation antipsychotics

Answer 42

acute mania and agitation

Question 43

biggest side effect of ECT is

Answer 43

short term memory loss

Question 44

therapies for bipolar

Answer 44

cognitive behavior therapy
interpersonal and social rythm
- help recognize routine and learn to integrate relationships