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The categories for today’s Jeopardy on Bipolar Disorder will be:

Bipolar I vs II

Course of Illness

Bipolar Depression

Treatment

Miscellaneous

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I vs II Treatment Miscellaneous

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Bipolar Depression

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Course of Illness

Row 1, Col 1

Patients may experience delusions in this

What is Bipolar I disorder?

1,2

Symptoms of this may be present for 4-6 days

What is Bipolar II disorder?

1,3

In DSM4, this may present as a mixed episode of illness

What is Bipolar I disorder?(In DSM5, Bipolar I & II may present as a mixed episode)

1,4

Must make diagnosis of past/present episodes of Major Depression

for this

What is Bipolar II disorder?

1,5

Patients are typically in depressed state 15 x’s more than a

(hypo)manic state in this

What is Bipolar II disorder? Bipolar I depressed ~2x’s more than manic

1,6

This can easily be mistaken for cyclothymia

What is a Bipolar II diosrder?

1,7

A depressive episode is not a diagnostic requirement

What is Bipolar I?

1,8

Psychiatric hospitalization eliminates the diagnostic time requirement for this

What is Bipolar I?

1,9

The likelihood of a male or female having this illness

is essentially equal

What is Bipolar I?Bipolar II F > M

2,1

This sex is more likely to have a first mood disturbance be a

manic episode

What are males?

2,2

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

is this

What is 85%? (80-90%)

2,3

If this relative is diagnosed with Bipolar Disorder, your

risk is ~70%

What is your identical twin?

2,4

The risk for completed suicide is highest when a patient

experiences depression or this type of mood disturbance

What is depressed & mixed

2,5

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

episode does this

What is lengthens/increases?

2,6

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

on this side of the family

What is paternal side (father)?

2,7

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

is this

What is 50%?(After 2 episodes, risk is ~70%;

After 3 episodes, risk is ~90+%--definitely do maintenance treatment)

2,8

For patients with bipolar disorder, as the total number of mood episodes

increases, the interepisode interval does this

What is shortens/decreases?

2,9

The average lifetime number of manic episodes a patient will

have is 9-10 unless the physician does this.

What is give maintenance medication treatment?

3,1

The response rate for Lithium is ~30% (poor) in treating bipolar

patients with dysphoric (irritable) mania and this type(s)

What is rapid cycling & mixed mania?

3,2

This medication can be rapidly loaded and patients who

respond improve the most in the first 3 days

What is divalproex (depakote)?

3,3

33% of patients treated for an acute manic episode with these

2 meds respond so well that all symptoms resolve

What is Lithium and Divalproex (depakote)?

3,4

Good or poor:

Lithium’s response rate in treating bipolar patients with a family history

of the illness or who have had few lifetime episodes is this

What is 70% (good/very good)

3,5

The first choice for treating an acute mixed manic episode of bipolar

disorder is this

What is divalproex (depakote)?

3,6

Maintenance treatment should always be recommended after this number

of manic episodes

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

3,7

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

of suicide

What is Lithium?

3,8

Good or poor:

Lithium’s response rate in treating bipolar patients with a history

of substance abuse or a mood episode sequence of depression

then mania is this

What is 30% (fair/poor)?

3,9

Carbamazepine (Tegretol) may be more effective than lithium

in treating bipolar disorder patients who present

with this

What is rapid cycling or mixed mania?

4,1

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

rather abruptly over days

What is an affective switch to mania?

4,2

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

What is olanzapine/fluoxetine (symbyax)

4,3

Since these type of antidepressants were introduced, studies have shown

an increased switch rate & an increase in the number of rapid cycling cases

What are tricyclic antidepressants (TCAs)?

4,4

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

contraindicated

What is antidepressant monotherapy?

4,5

Of all the antidepresants, using this one appears to carry the least risk

of inducing a manic episode

What is bupropion (wellbutrin)?

4,6

Medications that are recommended for treating bipolar depression are

lithium, quetiapine (seroquel), lurasidone (latuda) and these two

medications

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

4,7

This medication can be used to treat acute bipolar mania or depression,

maintenance treatment & to decrease the risk of suicidal

behavior

What is lithium?

4,8

When using an antidepressant to treat bipolar depression, this should be

done after the episode has remitted

What is discontinue the antidepressant?

4,9

This medication can be used to treat acute bipolar mania or depression, for maintenance

treatment, but does NOT lower the risk for suicidal behavior

What is quetiapine (seroquel)?

5,1

Used in the treatment of bipolar disorder, this medication has the

narrowest gap between therapeutic & toxic concentration of any drug routinely prescribed in psychiatry

What is lithium?

5,2

To rapidly load a patient weighing 150 pounds with 20 mg/kg of

divalproex (depakote), this amount of the medication is prescribed

What is 1,500 mg?

5,3

The percentage of patients with bipolar disorder whose life

ends by suicide is this

Correction: What is ~16% (Is 20x’s the relative risk of the general population;

about the same as major depression)

5,4

Lithium toxicity that is so severe as to be life threatening is

treated with this

What is dialysis?

5,5

Jessie Jackson Jr. appears to claim that these two symptoms of Bipolar

disorder contributed to his illegal misuse of campaign funds

What are grandiosity & dangerous pleasurable activities?

5,6

When a manic person is continually and unceasingly enthusiastic for interpersonal,

sexual, or occupational interactions, the mood is described as this

What is expansive?

5,7

If a manic person’s speech is marked by complaints, hostile comments,

and angry tirades, the mood would most likely be this

What is irritable?

5,8

Individuals in a manic episode frequently resist efforts to treat

them because they do not recognize that they are ill which is called this

What is anosognosia? (or lack of insight)

5,9

A laboratory finding that is diagnostic of a manic episode

is this

What is none?