Background:

Emily, a 23-year-old female college student, has recently experienced her first episode of mania. She presented to the emergency department with symptoms such as elevated mood, decreased need for sleep, racing thoughts, increased energy, and impulsivity. Emily's friends reported that she had been acting unusually over the past week, engaging in risky behaviors and demonstrating poor judgment. Emily denies any substance use or recent significant stressors.

Multiple Choice Questions:

1. What is the most likely diagnosis for Emily's current presentation?

A. Major Depressive Disorder

B. Bipolar I Disorder

C. Generalized Anxiety Disorder

D. Schizophrenia

2. Which of the following symptoms is commonly associated with a manic episode?

 A. Excessive sleep

B. Decreased energy

C. Dysthymia

D.Impulsivity

3. What initial intervention is most appropriate for Emily in the acute management of her manic episode?

 A. Prescribe an antipsychotic medication

B. Provide psychoeducation on stress management

C. Refer her to a long-term outpatient therapy program

D. Admit her to an inpatient psychiatric unit for stabilization

Answers:

1. B. Bipolar I Disorder

Explanation: Emily's symptoms, including elevated mood, decreased need for sleep, racing thoughts, increased energy, and impulsivity, are indicative of a manic episode. The combination of these symptoms is consistent with the criteria for a diagnosis of Bipolar I Disorder. This disorder is characterized by the occurrence of manic episodes, often followed by depressive episodes.

2. D. Impulsivity

Explanation: Impulsivity is a characteristic symptom of manic episodes. Individuals experiencing mania often engage in impulsive and risky behaviors without considering the potential consequences. This impulsivity, along with other symptoms like increased energy and racing thoughts, contributes to the clinical picture of a manic episode.

3. A. Prescribe an antipsychotic medication

Explanation: Antipsychotic medications are commonly used in the acute management of manic episodes. They help regulate neurotransmitters in the brain, particularly dopamine, which is implicated in the manifestation of manic symptoms. Prescribing an antipsychotic medication is a standard intervention to stabilize Emily's mood and address the acute symptoms of mania.