32 Questions
What is the typical duration of symptoms required for a diagnosis of mania according to the ICD10 classification?
At least one week
Which neurotransmitter is NOT associated with the monamine theory of mania?
Acetylcholine
What is the typical consequence of treating underlying metabolic disorders that cause manic symptoms?
Resolution of symptoms within a week
What is the primary risk associated with not treating hypomania promptly?
Risk of physical exhaustion
What is the typical course of bipolar disorder?
Chronic and recurrent
What is the primary goal of treating acute hypomania?
To prevent physical exhaustion
What is the primary characteristic of bipolar disorder?
Distinct periods of mania or hypomania accompanied by periods of depression
What is the primary difference between bipolar I and bipolar II?
Presence or absence of full-blown manic episodes
What is the genetic predisposition of bipolar disorder?
Approximately 65% of sufferers have a family member with BPD
What is the role of cortisol in the etiology of bipolar disorder?
Cortisol has a negative feedback on the hypothalamus, reducing CRH release
What is a common symptom of the manic phase of bipolar disorder?
Reduced need for sleep
What is a possible underlying cause of bipolar disorder?
Neurohormonal abnormalities, specifically HPA axis dysfunction
What is the primary concern when using antidepressants in patients with bipolar disorder?
Risk of inducing more switching to mania
Which of the following medications is NOT a mood stabilizer?
Haloperidol
What is the mechanism of action of lithium on second messenger systems?
Inhibits G-proteins
What is the therapeutic range of lithium in terms of plasma levels?
0.4 to 1.0 mmol/l
What is the recommended frequency of blood testing for lithium levels after achieving a stable therapeutic range?
Every 3-6 months
What is a common side effect of lithium therapy?
Fine hand tremor
What is a sign of lithium toxicity?
Blurred vision
What is the primary mechanism of lithium clearance?
Renal excretion
What is the effect of NSAIDs on lithium levels?
Increases lithium levels
What is the ideal dose of lithium in terms of mEq/l?
0.6-0.8 mEq/l
What is the effect of candesartan/irbesartan on lithium levels?
Decreases renal clearance
Which of the following antidepressants are associated with hyponatremia?
SSRIs and Li+
What is the mechanism of action of valproic acid?
Enhances GABA neurotransmission
What is the CSM warning regarding valproic acid?
Women of childbearing age
What is the effect of carbamazepine on NA release?
Decreases NA release
Why is lamotrigine particularly useful in bipolar disorder?
It avoids the need for antidepressants
What is a particular challenge in managing bipolar disorder?
Long term compliance is typically low
What is a risk of using antidepressants in bipolar disorder?
Risk of switching into mania
What is a concern in managing bipolar illness in women of child-bearing age?
Risk of relapse is high
What is an association of valproate?
Increased risk of polycystic ovary disease
Test your knowledge of bipolar disorder, a mood disorder characterized by periods of elation and depression. Learn about the different types of bipolar disorder, including Bipolar I and Bipolar II, and their symptoms.
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