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Y3 Reproductive > Perinatal Psychiatry > Flashcards

Perinatal Psychiatry Flashcards

1
Q

How are psychiatric problems screen for in pregnancy?

A

Booking visit questions

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2
Q

What percentage of mothers experience the baby blues?

A

50%

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3
Q

How long postnatal do the baby blues occur?

A

3 - 10 days

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4
Q

How long postnatal does postnatal depression occur?

A

2-6 weeks

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5
Q

How long postnatal does puerperal psychosis occur?

A

Less than 2 weeks

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6
Q

How does the baby blues present?

A

Irritable, teary, anxious, lack of sleep

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7
Q

What is the management of the baby blues?

A

Reassure, self-limiting

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8
Q

What percentage of mothers experience postnatal depression?

A

10%

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9
Q

How does postnatal depression present?

A

Anhedonia, concerned for baby, anxious, lack of sleep, weight loss, irritable etc.

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10
Q

What is the management of mild postnatal depression?

A

Self help / counselling

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11
Q

What is the management of moderate - severe postnatal depression?

A

CBT, antidepressant, consider admission

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12
Q

-Rapidly changing mental state
-Suicidal ideation
-Significant estrangement from infant
-Guilt or hopelessness
-Believe inadequate mother
-Psychosis
Are all indications for what?

A

Admission to a mother and baby unit

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13
Q

Preterm births increase the likeliness of postnatal depression. T or F

A

True

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14
Q

What are the risks to the child of untreated postnatal depression?

A

Emotional / conduct / cognitive problems e.g. ADHD

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15
Q

How might puerperal psychosis initially present?

A

Sleep problem, confusion, irrational

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16
Q

What is the management of puerperal psychosis?

A

Admit to mother-baby unit, antidepressant, antipsychotic

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17
Q

Puerperal psychosis has a high recurrence. T or F

A

True

18
Q

Puerperal psychosis has a 5% risk of what?

A

Suicide

19
Q

Facial deformity, low IQ, neurological / developmental delay, epilepsy, hearing problems, hear and kidney defects are all associated with what?

A

Fetal alcohol syndrome

20
Q

Smoking in pregnancy increases the risk of sudden infant death, stillbirths, IUGR, miscarriage and what cause of PV bleeding?

A

Placental abruption

21
Q

Opiate use in pregnancy might cause in the neonate?

A

Withdrawal

22
Q

What is the risk of taking paroxetine in pregnancy?

A

In 1st trimester can cause heart defects

23
Q

What antidepressants should be avoided in pregnancy?

A

Citalopram and doxepin

24
Q

Antidepressants in pregnancy are associate with [low/high birth weight]

A

Low birth weight

25
Q

Name 4 antidepressants that are generally safe in pregnancy?

A

Imipramine, amitriptyline, sertraline, fluoxetine

26
Q

Are benzos safe in the first trimester? If no, why not?

A

Fetal malformation e.g. cleft palate

27
Q

Are benzos safe in the third trimester? If no, why not?

A

Floppy baby syndrome

(hypothermia, resp depression, hypotonia) and neonate withdrawal

28
Q

Are benzos safe in breastfeeding?

A

Avoid

29
Q

Are mood stabilisers safe in pregnancy?

A

All fine except lithium

30
Q

Are mood stabilisers safe when breastfeeding?

A

All fine except lithium

31
Q

Is lithium safe in the first trimester? If no, why not?

A

Fetal abnormality e.g. heart defect

32
Q

Since lithium is unsafe in the first trimester, a patient should immediately stop taking it when they discover they’re pregnant. T or F

A

False, sudden discontinuation has more risks than the risk to pregnancy

33
Q

Lithium toxicity can mimic what syndrome of pregnancy?

A

Pre-eclampsia

34
Q

Is lithium safe in the third trimester? If no, why not?

A

Safe but requires regular monitoring

35
Q

Is lithium safe in breastfeeding?

A

No

36
Q

Which antipsychotic is most associated with GDM?

A

Olanzapine

37
Q

Most antipsychotics are unsafe in pregnancy and when breastfeeding. T or F

A

False, most are safe (especially 1st generation)

38
Q

Is valproate safe in the first trimester? If no, why not?

A

Neural tube and craniofacial defects, intellect, autism

39
Q

When does the neural tube close?

A 
Day 28
(Hence no neural tube defect risk if discover pregnant later)
40
Q

Is valproate safe in breastfeeding?

A

Yes

41
Q

Which antiepileptic drug is associated when Stevens Johnson synd in neonates?

A

Lamotrigine

42
Q

Is lamotrigine safe in the 1st trimester?

A

No

Y3 Reproductive (28 decks)

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