EXAMINATION TEST 2026 COMPLETE
QUESTIONS AND SOLUTIONS GRADED A+
⩥ bipolar meds: depression. Answer: lurasidone (13+), olanzapine +
fluoxetine (10+)(symbyax)
⩥ bipolar acute and mixed mania. Answer: aripiprazole, risperidone,
olanzapine (13+), quetiapine (acute only), asenapine (10+)
⩥ classic mood stabilizers. Answer: Lamotrigine (excellent medication
to use), lithium, Depakote (avoid in females if possible due to PCOS and
Pregnancy), Tegretol, Trileptal (no evidence for true Bipolar disorder)
⩥ anti-depressants. Answer: class not used w/bipolar disorder
⩥ lithium. Answer: Anti-manic, antidepressant, anti-suicidal
⩥ Lithium side effects. Answer: Frequent urination, increased thirst,
weight gain, sedation
,⩥ lithium toxicity. Answer: sudden onset tremors, N/V/D, muscle
weakness, slurred speech, confusion, seizures (slowing down, feel really
out of it)
⩥ Major Depressive Disorder Dx. Answer: 5+ for at least a 2-week
period; either #1 or 2 req
1. Depressed mood most of the day, nearly every day (can be irritability
in children & adolescents)
2. Diminished interest or pleasure in all, or almost all, activities
3. Change appetite/weight; kids not wt goals
Insomnia or hypersomnia nearly every day
4. Up or down Psychomotor
5. Fatigue or loss of energy
6. Worthlessness/excessive or inappropriate guilt
7. Diminished ability to think or concentrate, or indecisiveness (don't
confuse with ADHD, address mood first)
8. Recurrent thoughts of death, thoughts of suicide, or suicidal
plan/intent: if hosp then 2 wk not req.
⩥ SLAP. Answer: Social supports; lethal; access to means; plan and
previous attempt
, ⩥ Suicide risk: IS PATH WARM. Answer: Ideation, substance abuse,
purpose to live gone; anxiety, trapped feeling; hopelessness, w/d from
soc supports, anger w/rage; reckless, dramatic moods
⩥ SIGECAPS. Answer: Sleep, Interest, Guilt, Energy, Concentration,
Appetite, Psychomotor, Suicide
⩥ bipolar vs unipolar: look at bipolar if. Answer: 1. family hx: 1st
degree relatives
2. Substance use: chasing high or low
3. Response to SSRI: no resp to multiple tries or evidence of mania with
use (not diagnostic)
⩥ Bipolar I criteria. Answer: One manic episode required
⩥ Mania. Answer: elevated, expansive, energetic + 3, (unless irritable
mood then requires 4+)
1. SX Lastat least one week-any duration if hosp
2. Inflated self-esteem, grandiosity
3. Decreased need for sleep
4. More talkative, pressure to keep talking
5. Flight of ideas or racing thoughts
6. Distractibility: r/o ADHD (constant) intermit w/BD