Bipolar Disorder: Understanding Mood Swings

What is the typical duration of symptoms required for a diagnosis of mania according to the ICD10 classification?

At least one week (correct)
At least four weeks
At least 24 hours
At least two weeks

Which neurotransmitter is NOT associated with the monamine theory of mania?

GABA
Serotonin
Dopamine
Acetylcholine (correct)

What is the typical consequence of treating underlying metabolic disorders that cause manic symptoms?

Resolution of symptoms within a month
Resolution of symptoms within a week (correct)
No resolution of symptoms
Resolution of symptoms within three months

What is the primary risk associated with not treating hypomania promptly?

Risk of physical exhaustion (C) Signup and view all the answers

What is the typical course of bipolar disorder?

Chronic and recurrent (D) Signup and view all the answers

What is the primary goal of treating acute hypomania?

To prevent physical exhaustion (B) Signup and view all the answers

What is the primary characteristic of bipolar disorder?

Distinct periods of mania or hypomania accompanied by periods of depression (A) Signup and view all the answers

What is the primary difference between bipolar I and bipolar II?

Presence or absence of full-blown manic episodes (C) Signup and view all the answers

What is the genetic predisposition of bipolar disorder?

Approximately 65% of sufferers have a family member with BPD (A) Signup and view all the answers

What is the role of cortisol in the etiology of bipolar disorder?

Cortisol has a negative feedback on the hypothalamus, reducing CRH release (D) Signup and view all the answers

What is a common symptom of the manic phase of bipolar disorder?

Reduced need for sleep (A) Signup and view all the answers

What is a possible underlying cause of bipolar disorder?

Neurohormonal abnormalities, specifically HPA axis dysfunction (C) Signup and view all the answers

What is the primary concern when using antidepressants in patients with bipolar disorder?

Risk of inducing more switching to mania (A) Signup and view all the answers

Which of the following medications is NOT a mood stabilizer?

Haloperidol (B) Signup and view all the answers

What is the mechanism of action of lithium on second messenger systems?

Inhibits G-proteins (D) Signup and view all the answers

What is the therapeutic range of lithium in terms of plasma levels?

0.4 to 1.0 mmol/l (A) Signup and view all the answers

What is the recommended frequency of blood testing for lithium levels after achieving a stable therapeutic range?

Every 3-6 months (B) Signup and view all the answers

What is a common side effect of lithium therapy?

Fine hand tremor (B) Signup and view all the answers

What is a sign of lithium toxicity?

Blurred vision (B) Signup and view all the answers

What is the primary mechanism of lithium clearance?

Renal excretion (B) Signup and view all the answers

What is the effect of NSAIDs on lithium levels?

Increases lithium levels (D) Signup and view all the answers

What is the ideal dose of lithium in terms of mEq/l?

0.6-0.8 mEq/l (A) Signup and view all the answers

What is the effect of candesartan/irbesartan on lithium levels?

Decreases renal clearance (B) Signup and view all the answers

Which of the following antidepressants are associated with hyponatremia?

SSRIs and Li+ (A) Signup and view all the answers

What is the mechanism of action of valproic acid?

Enhances GABA neurotransmission (A) Signup and view all the answers

What is the CSM warning regarding valproic acid?

Women of childbearing age (A) Signup and view all the answers

What is the effect of carbamazepine on NA release?

Decreases NA release (A) Signup and view all the answers

Why is lamotrigine particularly useful in bipolar disorder?

It avoids the need for antidepressants (C) Signup and view all the answers

What is a particular challenge in managing bipolar disorder?

Long term compliance is typically low (C) Signup and view all the answers

What is a risk of using antidepressants in bipolar disorder?

Risk of switching into mania (B) Signup and view all the answers

What is a concern in managing bipolar illness in women of child-bearing age?

Risk of relapse is high (B) Signup and view all the answers

What is an association of valproate?

Increased risk of polycystic ovary disease (A) Signup and view all the answers