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20 Cards in this Set
- Front
- Back
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101. What is the most common cause of progression to rapid cycling bipolar?
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a. Use of antidepressants.
b. Do not give antidepressants prophylactically, unless the question describes previous severe depressive episodes. c. In that case. Antidepressants are only given for a few weeks. |
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102. How she manages rapid cycling bipolar?
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a. Gradually stop all antidepressants stimulants caffeine benzodiazepines and alcohol.
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103. One other medical conditions predispose a patient to rapid cycling bipolar?
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a. Hypothyroidism
b. check TSH in any patient with rapid cycling bipolar and replace thyroid hormones. If needed. |
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104. What drug is been shown to prevent suicidal ideation in bipolar disorder?
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a. Lithium.
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105. A 32-year-old bipolar patient who is undergoing maintenance therapy with lithium presents with a positive pregnancy test. How will you manage this patient bipolar disorder?
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a. Discontinue lithium (to avoid heart abnormalities)
b. choose electroshock therapy for first trimester patients with manic episodes. c. Using lamotrigine in second or third trimester. |
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106. First line treatment of acute mania?
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a. Monotherapy with lithium, lamotrigine, or risperidone.
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107. Second line treatment for acute mania?
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a. Aripiprazole, divalproex, quetiapine, and olanzapine.
b. Patients with multiple recurrences require combination therapy c. always plan psychotherapy in cognitive and neural therapy. |
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108. What three drugs used for the treatment of acute mania should be avoided in women of childbearing age?
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1. Lithium
2. valproate 3. carbamazepine. |
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109. Cyclothymia?
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a. Recurrent episodes of depressed mood and hypomanic mood for at least two years.
b. It resembles a milder form of bipolar affective disorder. |
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110. Treatment of cyclothymia?
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a. Psychotherapy is the first step in management.
b. Many people function without medications and learn to manage their hypomanic dispositions (especially artists). c. Start divalproex, when functioning is impaired. d. Divalproex is more effective in cyclothymia than lithium. |
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111. Features of both grief and depression?
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a. Sadness
b. tearfulness c. decreased sleep d. decreased appetite e. decreased interest in the world. |
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112. Symptom specific to grief?
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a. Symptoms wax and wane
b. shame and guilt are less common c. suicidal ideation is less common d. symptoms can last up to one year e. patient usually returns to baseline level of functioning within two months. |
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113. Treatment of grief?
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a. Supportive therapy.
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114. Symptom specific to depression?
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a. Symptoms are pervasive and unremitting
b. shame and guilt are common c. suicidal ideation is more common d. symptoms and continue for more than one year e. patient does not return to baseline functioning. |
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115. Treatment of depression?
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a. Antidepressant medications.
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116. A 32-year-old woman who gave birth four months ago was brought in by her husband because of depressed mood. The husband reports that she has been depressed since the birth of her child refuses to eat has trouble sleeping and is unable to concentrate. The woman reports that she has lost interest in everything and sometimes can't get out of bed hurried to reports that she's recently had visions of seeing her deceased mother talking to her in criticizing her skills as a new mother. She also admits that she hears her voice talk to her constantly to read. She denies homicidal or suicidal ideation. Which of the following is the best initial treatment?
a. Psychotherapy b. behavioral therapy c. sertraline d. risperidone e. phenelzine |
1. answer: D. Patients with both mood and psychotic symptoms respond to both antidepressants and antipsychotic medication. However, you must treat the worst symptom first. In this case, the antipsychotic would be most indicated to reduce her psychotic symptoms
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117. a 45-year-old woman presents two months after the sudden loss of her son in a car accident. She reports not being able to cope well. She is constantly teary, has lost her appetite has decreased 2 dress sizes. She finds herself laying out dinner plate every night for him. Recently she believes she is heard his voice every nation is nightmares about the car accident. She denies suicidal ideation. Which of the following is the most appropriate next up in management?
a. Group therapy b. amitriptyline c. fluoxetine d. zolpidem e. supportive therapy |
1. answer: E this patient is undergoing normal grief reaction. Auditory hallucinations without other psychotic symptoms are normal in grief reaction. Antidepressants are indicated when symptoms last longer than six months in the patient symptoms can be classified as major depression.
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118. Onset of postpartum blues?
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a. After any birth.
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119. Onset of postpartum depression?
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a. Usually after second birth
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120. onset of postpartum psychosis?
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a. Usually after first birth
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