Send us Fan Mail Episode 76 PTSD Shoot me any comments or questions @Rotation2ptoh on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Keep it Moving by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS Edited by: Todd Fredricks DO MSS Answers for Episode 75 Bipolar Disorder Question 1 A 22-year-old college student presents to a primary care clinic with a 3-month history of depressed mood, hypersomnia, low energy, impaired concentration, and anhedonia. He reports two prior depressive episodes beginning in adolescence. His mother has a history of bipolar disorder. When previously treated with an antidepressant, he became unusually energetic, slept only 3 hours per night, talked rapidly, and engaged in impulsive spending for several days. He was not hospitalized and did not have psychotic symptoms. Which of the following is the most appropriate next step in management? C. Evaluate for bipolar disorder and avoid antidepressant monotherapy Question 2 A 31-year-old man is brought to the emergency department by his partner because he has not slept for 5 days, has been speaking rapidly, claims he has “special financial powers,” and has spent $18,000 on risky investments. He is euphoric, distractible, and agitated. Urine toxicology is negative. He has no known chronic medical conditions. Which of the following is a first-line monotherapy option for this patient’s acute condition? B. Lithium Question 3 A 29-year-old woman with bipolar I disorder is 30 weeks pregnant and presents for prenatal counseling. She previously had severe manic episodes requiring hospitalization. She stopped her mood stabilizer early in pregnancy because she was worried about fetal effects. She asks about the risk of relapse after delivery. Which of the following counseling statements is most accurate? C. The postpartum period is high risk for relapse, and relapse rates are higher without medication use. Paper for next week: Riemann, Dieter, Colin A. Espie, Ellemarije Altena, Erna Sif Arnardottir, Chiara Baglioni, Claudio L. A. Bassetti, Celyne Bastien, et al. “The European Insomnia Guideline: An Update on the Diagnosis and Treatment of Insomnia 2023.” Journal of Sleep Research 32, no. 6 (2023): e14035. https://doi.org/10.1111/jsr.14035. Rotations 2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS. Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency. Listeners interested in specifics from the paper authors should contact them directly through their respective institutions. Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.
