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WorksheetsQuiz on Bipolar Lab 1
Total questions: 15
Worksheet time: 15mins
Which of the following is not a symptom or manifestation of acute mania in this patient?
Less sleep (sleeping at 4:30 AM and waking at 6 AM)
Saying they will give money to everyone, claiming to have millions at home
Talking more
Seeing and hearing spirits
Which drug is least likely to trigger mania in this patient?
Propranolol
Venlafaxine
Levothyroxine
Caffeine
Is it appropriate to give lithium together with risperidone? Why?
Appropriate because the patient has depression as well
Appropriate because there are 1st line combination and patient has psychotic feature
Inappropriate because lithium and risperidone have serious drug interaction
Inappropriate because risperidone can cause acute depression
If the patient is receiving antidepressants, which drug should be avoided the most?
Nortriptyline
Trazodone
Sertraline
Mirtazapine
What is an important parameter to monitor in patients receiving lithium?
CBC
TFT
LFT
ANC
What medication is used to treat tremor from lithium?
Propranolol
Lorazepam
Benztropine
Valbenazine
What medication is used to treat Nephrogenic diabetes insipidus (NDI) from lithium?
Amiloride
Propranolol
Amlodipine
Hydralazine
If the patient has menstrual pain, which medication should be given for treatment?
Sulindac
Ibuprofen
Mefenamic acid
Celecoxib
What is the appropriate documentation of the mental state examination consistent with the symptom 'saying they will give money to everyone, claiming to have millions at home'?
Talkative
Irritable
Flight of idea
Grandiose
Is it appropriate for the patient to receive valproate instead of lithium? Why?
Appropriate because it can be used in acute mania.
Appropriate because the drug has anti-suicide effects.
Inappropriate because the drug level must be monitored.
Inappropriate because lithium has a faster onset.
How should the patient be managed based on the latest thyroid function test results: Free T4 (FT4) 0.6 ng/dL, Free T3 (FT3) 2.0 pg/mL, Thyroid-Stimulating Hormone (TSH) 15.0 µIU/mL?
Reduce the lithium dosage.
Increase the lithium dosage.
Administer propranolol.
Administer levothyroxine.
If the patient is also receiving HCTZ, how should the lithium dosage be adjusted?
Reduce the dosage by 10%.
Reduce the dosage by 40%.
Increase the dosage by 10%.
Increase the dosage by 40%.
What is the appropriate maintenace level of lithium in this patient?
0.2-0.4
0.4-0.6
0.6-0.8
1.0-1.2
Does amlodipine have drug interactions with other medications in this patient? How?
Yes, because lithium is primarily metabolized by CYP3A4.
Yes, because lithium increases blood pressure.
No, because lithium does not go through CYP3A4.
No, because lithium has no drug interactions with any drug.
Which of the following is an adverse effect that should lead to discontinuation of lithium?
Weight gain
Atrial fibrillation
Leukocytosis
Hypothyroidism
