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Acute mania — MCCQE Part 1 MCQ

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ModerateAltered BehaviourAcute maniaMCCQE Part 1

A 30-year-old woman is brought by her sister after 6 days of sleeping 2 hours per night, spending thousands of dollars and saying she has a special mission from God. She is pressured, irritable and distractible. Urine toxicology is negative. What is the most likely diagnosis?

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Correct answer: D — Acute manic episode

Decreased need for sleep, grandiosity, pressured speech, impulsive spending and functional impairment for nearly a week indicate mania. Generalized anxiety causes worry rather than grandiosity and decreased sleep need. Substance-induced symptoms should be considered, but the provided toxicology is negative.

Reference: CANMAT/ISBD Bipolar Disorder Guidelines