Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Laura MRCOG Part 2 > 9) Maternal Medicine - Psychiatry > Flashcards

9) Maternal Medicine - Psychiatry Flashcards

1
Q

What percentage of women will develop mental health problems during or after pregnancy?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common mental health problem in pregnancy

A

Anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Incidence of depression in pregnancy

A

12%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Incidence of anxiety in pregnancy

A

13%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which questionnaires should be used as initial screening tools for anxiety/depression?

A

GAD-2 and Whooley questions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Incidence of postpartum psychosis

A

1-2 in 1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If concern is raised on the depression screening Qs what further assessment tools could be used?

A

Edinburgh PND Scale

PHQ-9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If concern is raised on the anxiety screening Qs what further assessment tools could be used?

A

GAD-7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How quickly should women be seen after referral with sudden onset symptoms suggesting of postpartum psychosis?

A

4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How quickly should a woman be seen after referral to secondary care?

A

Assess for treatment within 2 weeks and psychological interventions within 1 month.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment of mild–>moderate depression

A

Facilitated self help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment of moderate–>severe depression

A
  • CBT
  • TCA/SNRI/SSRI
  • CBT in combination with medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of mild anxiety

A

Facilitated self help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment of anxiety disorder

A
  • Low or high intensity psychological intervention

- High intensity recommended for PTSD and social anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What to measure in women on antipsychotics planning a pregnancy?

A

Prolactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What screening test to offer in pregnancy for women on antipsychotics?

A

GTT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When to use depot antipsychotics?

A

Only if stable on them and previous non-compliance with oral antipsychotics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which drugs should not be used for mental health problems in pregnancy?

A

Valproate/Carbemazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What to do with antipsychotics in pregnancy?

A

If stable and likely to relapse without it then continue.

20
Q

When to use lithium?

A

Only if antipsychotics have not been effective

21
Q

What to do with lithium in pregnancy?

A
  • Can stop gradually over 4 weeks if well
  • If not well or high risk of relapse then can consider gradually switching to an antipsychotic, stopping lithium and restarting in 2nd trimester or continuing with lithium.
22
Q

Risk of relapse in women with bipolar disorder who stop medication

A

2 x increased risk

23
Q

How often to measure lithium plasma levels?

A

Every 4 weeks and then weekly from 36th week

24
Q

What to do with lithium in labour?

A

Stop during labour and check plasma lithium levels 12 hours after last dose

25
Q

What percentage of women with a mental health problem require inpatient treatment?

A

4%

26
Q

When does postpartum psychosis occur?

A

Frequently occurs early - 50% within first 3 days postpartum.

27
Q

Risk of postpartum psychosis in a woman with bipolar disorder

A

> 25%

28
Q

Risk of postpartum psychosis in a woman with bipolar disorder and a family history of postpartum psychosis

A

50%

29
Q

Recurrence risk of postpartum psychosis

A

50%

30
Q

Risk of suicide with postpartum psychosis

A

2%

31
Q

Incidence of suicide

A

1 in 100,000

32
Q

What percentage of women who committed suicide had a diagnosis of a severe affective illness?

A

60%

33
Q

What percentage of women who develop postpartum psychosis have no risk factors?

A

50%

34
Q

Incidence of chronic serious mental illness (bipolar/schizophrenia)

A

2 in 1000

35
Q

Incidence of severe depressive illness

A

30 in 1000

36
Q

Incidence of PTSD

A

30 in 1000

37
Q

Incidence of adjustment disorders and distress

A

150-300 in 1000

38
Q

Incidence of postpartum blues

A

50-80%

39
Q

When do postpartum blues occur?

A

D3-D10, lasting 48 hours

40
Q

Risk of postnatal depression if you have history of depression

A

15%

41
Q

Risk of postnatal depression if you have a history of depression and FHx of postpartum depression

A

40%

42
Q

What proportion of women with PND develop depression before or during pregnancy?

A

1/2

43
Q

When does PND occur?

A

Gradual onset during first 2 weeks after birth, with two peak presentations 2-4 and 10-14 weeks postnatal.

44
Q

Risk of recurrence of PND

A

2-3 x increased

45
Q

What percentage of women take antidepressants in pregnancy?

A

3%

46
Q

Criteria for referral to specialised perinatal mental health service:

A
  • Current severe psychiatric symptoms
  • Hx severe postpartum illness/schizophrenia/bipolar
  • Complex psychotropic medications

Referral should be considered for those with moderate symptoms developed late in pregnancy/early postpartum, or mild symptoms and a family history of BP/PP.

Laura MRCOG Part 2 (56 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions