BPAD QUIZ- 19/6/25

When should sample be collected to test for Serum Lithium if patient is on Extended release formulation

• 10-12 hours

• 12-16 hours

• 21-25 hours

• any time after the morning dose

Which of the following is considered a first-line pharmacological treatment for acute mania according to IPS guidelines?

• Selective Serotonin Reuptake Inhibitors (SSRIs)

• Lithium

• Benzodiazepines

• Selective Serotonin Reuptake Inhibitors (SSRIs)

What is the recommended approach for treating mild depressive episodes in BPAD as per IPS guidelines?

• Initiate antidepressant monotherapy

• Start mood stabilizer therapy

• Employ psychological therapies without medication

• Hospitalization with electroconvulsive therapy (ECT)

Which of the following is NOT a guiding principle in the pharmacological management of BPAD per IPS guidelines?

• Start with the lowest effective dose

• Prefer monotherapy when possible

• Allow an adequate trial period before changing medications

• Use multiple medications simultaneously from the outset

What is the IPS guideline's stance on the use of antidepressants in BPAD?

• They are first-line treatments for all depressive episodes

• They should be used cautiously, preferably in combination with mood stabilizers

• They are contraindicated in all cases

• They can be used without any mood stabilizer

Standard monitoring protocols for bipolar disorder, at which intervals should serum lithium levels and thyroid/kidney function be monitored once a patient is stable on maintenance therapy?

• Serum lithium levels every 12 months, thyroid/kidney function every 24 months

• Serum lithium levels every 3 months, thyroid function every 3–6 months, and renal function every 3–6 months

• Serum lithium levels every 5 days, thyroid/kidney function never needed after stabilization

• Serum lithium levels every week, thyroid function every month, renal function every year

• Patient A: 35 years old, bipolar II. Over the past 3 weeks, she’s shifted between hypomanic and depressive moods every 2–4 days.

• Patient B: 30 years old, bipolar I. Over the last 10 days, his mood swings occur within the same day—sometimes irritable in the morning, elated by evening—multiple mood shifts daily. Which statement correctly classifies their cycling patterns?

• Patient A: Ultra‑rapid cycling; Patient B: Ultradian cycling

• Patient A: Ultradian cycling; Patient B: Ultra‑rapid cycling

• Patient A: Rapid annual cycling; Patient B: Ultra‑rapid cycling

• Patient A: Ultradian cycling; Patient B: Ultradian cycling

Which of the following is considered a favorable prognostic factor in Bipolar Affective Disorder

• Early age of onset (< 25 years)

• Presence of rapid cycling

• Episodic (classical) course of illness

• High number of lifetime hospital admissions

Which statement is most accurate about the use of lamotrigine (LTG) in BPAD?

• It is first-line for acute mania and prevents manic relapses.

• It is ineffective for preventing depressive relapses in maintenance therapy.

• It requires slow titration to reduce the risk of severe rash and is best reserved for preventing depressive relapse.

• It rapidly reaches therapeutic levels in 1–2 weeks, making it ideal for acute depressive episodes.

Which of the following statements about the use of antipsychotics in BPAD is most accurate?

• Typical antipsychotics are preferred for maintenance therapy due to their lower metabolic side effects.

• Atypical antipsychotics are first-line treatment for acute mania and are also effective for long-term mood stabilization, including relapse prevention.

• Antipsychotics are only indicated in BPAD if psychotic symptoms are present.

• Atypical antipsychotics are equally effective in preventing depressive relapse as they are for manic relapse.

Answer explanation

only quetiapine and some olanzapine combinations show proven benefit in preventing depressive relapse