The Anatomy of a Question
A 35-year-old woman presents to the clinic complaining of increased irritability and decreased concentration for the past ten days. She also notes that she feels rested after four hours of sleep for the past ten nights, and has received two speeding tickets in the past week. On exam, the patient is unable to sit still and exhibits pressured speech and easy distractibility. Which of the following additional elements of her history would help lead to a diagnosis of bipolar I disorder?
Answer choice options
- A. She has been married for 12 years and has been employed with the same company for 15 years
- B. She has not been hospitalized for any reason
- C. She is experiencing increased energy and has completed 350 pages of her “memoirs” in the past ten days
- D. Two months ago she felt “down” and stayed in bed for seven days
The incorrect options (distractors) are not totally wrong. These options can be diagramed as follows:
C.She is experiencing increased energy and has completed 350 pages of her “memoirs” in the past ten days Bipolar I is associated with expansive, elevated, or irritable mood and increased energy and goal-directed behavior.
D.Two months ago she felt “down” and stayed in bed for seven days May be a depressive episode, or may just have had an isolated event in the past causing sadness.
B.She has not been hospitalized for any reason Likely rules out a metabolic cause of mania but does not exclude Bipolar I.
A.She has been married for 12 years and has been employed with the same company for 15 years Bipolar I is associated with unstable rather than stable relationships.
The Anatomy of an Explanation
“Its been such a pleasure to use the Rosh Review Qbank. I use the app during downtime at work. I don’t know what I’d do without it!”-Maria Larson, MSN, PMHNP-BC
Crush Your Cert and Earn CE