Perinatal

Question 1

Define perinatal mental illness

Answer 1

Disorder which occur during pregnancy up to the first year following child birth

Question 2

Risk factors of antenatal depression x5

Answer 2

Genetics
Primigravid
Single mother
Hx of depression
Previous Hx of antenatal depression

Question 3

Signs and symptoms of antenatal depression x5

Answer 3

Loss of interest about self/pregnancy
Worry about giving birth and parenthood
Hopeless about the future
Lack of sex interest
Disturbed sleep

Question 4

Risk to baby x5 of antenatal depression

Answer 4

Infanticide
Health risks
Neglect
Physical harm
Failure to bond

Question 5

Psychological management x2 of antenatal depression

Answer 5

CBT
Psychoeducation

Question 6

Social management x3 of antenatal depression

Answer 6

Support groups
Family support
Financial support

Question 7

In antenatal depression caution is taking with which drug classes x3 and why

Answer 7

MAOIs- cause hypertensive crises
Mood stabilizers - teratogenic
SSRIs- heart defects

Question 8

Pharmacological options for bipolar in pregnancy x2 class and drug

Answer 8

Atypical antipsychotics - olanzapine
Mood stabilizers- lamotrigine

Question 9

Duration of baby blues and management x2

Answer 9

2- 14 days
Reassurance, self limiting
Social and emotional support

Question 10

Symptoms of baby blues x5

Answer 10

Overwhelmed
Crying
Irritable
Sadness
Reduced concentration

Question 11

Symptoms of perinatal anxiety disorder x5

Answer 11

Constant worry
Sleeping disturbances
Appetite changes
Restlessness
Feeling that something bad will happen

Question 12

Baby x3 and maternal x3 risk factors of PDD

Answer 12

Baby- premature, cardiac defects, twins
Maternal- Hx of depression, low income, unemployment

Question 13

Management of PDD x5

Answer 13

Bio: Antidepressants
Sleep disturbance- promethazine
Psychoeducation
Psychotherapy- explore underlying problems
Social : Family support

Question 14

Risk factors of postpartum psychosis x5

Answer 14

Previous history
Primigravida
Personal or Family Hx of bipolar disorder
Sleep loss

Question 15

Symptoms of Postpartum psychosis x6

Answer 15

Insomnia
Confusion
Disorganization
Depersonalization
Abnormal mood
Abnormal thought content

Question 16

Management of postpartum psychosis x5

Answer 16

Antipsychotics
Lithium
Electroconvulsive therapy
Family support
Sleep hygiene

Question 16

Congenital effects of paroxetine -SSRI x2

Answer 16

Neonatal pulmonary HTN
Fetal heart defects

Question 17

Which drug class causes neural tube defects (2xexamples)

Answer 17

Mood stabilizers- carbamazepine, sodium valproate

Question 18

Effects of benzodiazepines on baby x5

Answer 18

Cleft palate
Respiratory depression
Floppy baby syndrome
CNS and Urinary tract malformations

Question 19

Effect of plasma volume on medication during pregnancy

Answer 19

Plasma volume expands hence doses of drugs such as lithium need to be increased

Question 20

Safe antipsychotics in pregnancy x2

Answer 20

Chlorpromazine
Fluphenazine

Question 21

Effects of antipsychotics on baby if taken in third trimester x5

Answer 21

Tremors
Drowsiness
Abnormal tone
Feeding problems
Respiratory distress

Question 22

Pharmacological treatment of depression in pregnancy

Answer 22

Amitriptyline

Question 23

Teratogenic effects of sodium valproate x5

Answer 23

Neural tube defects
Growth retardation
Hepatotoxicity
Heart defects
Limb defects

Question 24

Screening tool for PPD

Answer 24

Edinburg postnatal depression scale