Q.1 What is the hallmark feature of bipolar disorder?
Hallucinations
Fluctuations between mania and depression
Memory loss
Phobias
Explanation - Bipolar disorder is characterized by alternating episodes of mania and depression.
Correct answer is: Fluctuations between mania and depression
Q.2 Which of the following is a symptom of mania?
Low energy
Excessive sleep
Inflated self-esteem
Slowed thinking
Explanation - During mania, individuals often experience inflated self-esteem or grandiosity.
Correct answer is: Inflated self-esteem
Q.3 Bipolar I disorder requires the presence of:
At least one depressive episode
At least one manic episode
Only hypomania
Only cyclothymia
Explanation - Bipolar I disorder is defined by the occurrence of at least one manic episode, regardless of depressive episodes.
Correct answer is: At least one manic episode
Q.4 Which neurotransmitter is most implicated in bipolar disorder?
Serotonin
GABA
Dopamine
Acetylcholine
Explanation - Dysregulation of dopamine is strongly implicated in mood swings seen in bipolar disorder.
Correct answer is: Dopamine
Q.5 Lithium is considered a:
Stimulant
Mood stabilizer
Antidepressant
Antipsychotic
Explanation - Lithium is the classic mood stabilizer used in the treatment of bipolar disorder.
Correct answer is: Mood stabilizer
Q.6 Hypomania differs from mania in that:
It lasts longer
It is more severe
It does not cause marked impairment
It always involves psychosis
Explanation - Hypomania is a milder form of mania without significant functional impairment.
Correct answer is: It does not cause marked impairment
Q.7 What is the typical onset age range of bipolar disorder?
Childhood
Adolescence to early adulthood
Middle age
Late adulthood
Explanation - Bipolar disorder commonly begins between late adolescence and early adulthood.
Correct answer is: Adolescence to early adulthood
Q.8 Which of the following is NOT a symptom of mania?
Pressured speech
Racing thoughts
Excessive spending
Psychomotor retardation
Explanation - Psychomotor retardation is more typical of depressive episodes, not mania.
Correct answer is: Psychomotor retardation
Q.9 Rapid cycling bipolar disorder is defined as:
Two episodes per year
Four or more episodes per year
One episode every 5 years
Daily mood swings
Explanation - Rapid cycling is diagnosed when a patient has 4 or more mood episodes within a year.
Correct answer is: Four or more episodes per year
Q.10 Which medical complication is most associated with long-term lithium use?
Liver cirrhosis
Kidney dysfunction
Lung fibrosis
Vision loss
Explanation - Chronic lithium use can impair kidney function and requires regular monitoring.
Correct answer is: Kidney dysfunction
Q.11 Which sleep pattern is often seen in manic episodes?
Hypersomnia
Reduced need for sleep
Insomnia with fatigue
Irregular REM sleep
Explanation - Patients in mania can function with little sleep without feeling tired.
Correct answer is: Reduced need for sleep
Q.12 Which class of medications may trigger mania in bipolar patients?
Antidepressants
Beta-blockers
Antihistamines
Opioids
Explanation - Antidepressants can sometimes trigger manic episodes in bipolar disorder.
Correct answer is: Antidepressants
Q.13 Bipolar II disorder is characterized by:
At least one manic episode
Only depressive episodes
Hypomania and depression
Cyclothymic symptoms only
Explanation - Bipolar II involves hypomanic and depressive episodes, but not full mania.
Correct answer is: Hypomania and depression
Q.14 Cyclothymic disorder involves:
Chronic low-grade mania and depression
Severe psychotic episodes
Only mania
Only depression
Explanation - Cyclothymia is a chronic mood disturbance with mild hypomanic and depressive symptoms.
Correct answer is: Chronic low-grade mania and depression
Q.15 Which lifestyle factor is important in managing bipolar disorder?
High sugar diet
Regular sleep patterns
Irregular exercise
Frequent alcohol use
Explanation - Stable sleep patterns help prevent mood episode triggers.
Correct answer is: Regular sleep patterns
Q.16 Which brain region is most implicated in bipolar disorder?
Hippocampus
Prefrontal cortex
Medulla
Cerebellum
Explanation - The prefrontal cortex shows structural and functional changes in bipolar disorder.
Correct answer is: Prefrontal cortex
Q.17 Which is a first-line treatment for acute mania?
SSRIs
Mood stabilizers
Benzodiazepines
Beta-blockers
Explanation - Mood stabilizers like lithium or valproate are first-line for mania.
Correct answer is: Mood stabilizers
Q.18 Electroconvulsive therapy (ECT) may be used in bipolar disorder when:
Patient refuses therapy
Symptoms are mild
Severe depression or treatment resistance is present
Mania is well controlled
Explanation - ECT is reserved for severe or resistant cases, particularly depression.
Correct answer is: Severe depression or treatment resistance is present
Q.19 Which comorbidity is common with bipolar disorder?
Hypertension
Substance use disorder
Arthritis
Asthma
Explanation - Substance abuse is common in individuals with bipolar disorder.
Correct answer is: Substance use disorder
Q.20 The duration of hypomania must be at least:
1 day
2 days
4 days
7 days
Explanation - DSM-5 requires at least 4 consecutive days for hypomania diagnosis.
Correct answer is: 4 days
Q.21 What is the risk of suicide in bipolar disorder compared to the general population?
Equal
Slightly higher
10-20 times higher
Lower
Explanation - Patients with bipolar disorder have a significantly increased suicide risk.
Correct answer is: 10-20 times higher
Q.22 Which of the following best describes mixed episodes?
Only mania
Only depression
Manic and depressive symptoms simultaneously
Cyclothymic symptoms
Explanation - Mixed episodes include both manic and depressive features.
Correct answer is: Manic and depressive symptoms simultaneously
Q.23 Which antiepileptic drug is used as a mood stabilizer in bipolar disorder?
Valproate
Phenytoin
Topiramate
Levetiracetam
Explanation - Valproate is an effective mood stabilizer commonly used in bipolar disorder.
Correct answer is: Valproate
Q.24 What is the gender distribution in bipolar disorder prevalence?
More common in men
More common in women
Equal in men and women
Only in women
Explanation - Bipolar disorder affects both genders equally, unlike depression.
Correct answer is: Equal in men and women
Q.25 Which sleep disturbance is a prodromal sign of mania?
Nightmares
Reduced need for sleep
Sleep paralysis
Hypersomnia
Explanation - Reduced sleep without fatigue often precedes a manic episode.
Correct answer is: Reduced need for sleep