Chapter 18 Single best answer questions

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. You are a junior doctor working in a GP practice. Peter Wilkes comes to talk to you. His girlfriend Emma gave birth 3 days ago and although she seemed "completely normal" before the birth, he is concerned as she seems very emotional and prone to mood swings. His mother suspects that Emma may be depressed.
Choose the percentage of new mothers affected by this disorder.

Up to 10% correct incorrect

Up to 25% correct incorrect

25 - 50% correct incorrect

50 - 75% correct incorrect

75 - 100% correct incorrect

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. Asuncion Jelinek is a 40 year old single mother who attends your GP surgery, 2 months after giving birth to her son Fernando. She recently separated from her husband and tells you that she has no friends in England, having only moved here recently. Like her mother, Asuncion suffered depression in her thirties.
The risk of postnatal depression is increased by all of the following, EXCEPT:

Personal history of depression correct incorrect

Older maternal age correct incorrect

Family history of depression correct incorrect

Concurrent life events correct incorrect

Poor social support correct incorrect

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. Dominique Smith is a 27 year old woman who gave birth to her son, Bronx-Baloo, a week ago. She now appears to be hearing voices and is terrified of the staff. Her speech is rambling and difficult to follow and she is very restless. The consultant is concerned that she has developed puerperal psychosis.
Regarding puerperal psychosis, which of the following statements is FALSE?

Once present, symptoms tend to be constant correct incorrect

Substance misuse is a differential diagnosis correct incorrect

Pharmacotherapy is indicated correct incorrect

Symptoms rarely last more than 3 months correct incorrect

Electroconvulsive therapy may be indicated correct incorrect

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. You are working in a GP surgery. A 27 year old woman, Sandra Eckhart, attends an appointment made by her husband Josh. With them is their first child, born via emergency caesarean section after a failed ventouse delivery 8 weeks ago. She was a healthy, full-term baby who did not require any specialist input after birth. Josh is concerned about Sandra's mood and sleep disturbance. During the interview she seems tearful and avoids eye contact. She asks to be referred to a paediatrician to 'have the baby checked out.'
Which of the following statements is TRUE?

Post partum 'blues' are the most likely diagnosis correct incorrect

Suicide is a rare cause of death in new mothers correct incorrect

Breastfeeding is an absolute contraindication to pharmacotherapy correct incorrect

An urgent referral to paediatrics should be made to reassure Sandra correct incorrect

It is essential to assess Sandra's interaction with her child correct incorrect

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. Kelly is a 30 year old woman with bipolar affective disorder. She is currently well and concordant with lithium. She presents to you in general practice as she and her husband are planning to start a family.
Which of the following is TRUE?

If Kelly has a baby, she faces an 8-fold increased risk of relapse correct incorrect

Kelly should discontinue her medication to avoid risk of harm to the foetus correct incorrect

Bipolar affective disorder does not increase the risk of puerperal psychosis correct incorrect

Lithium is generally safe in pregnancy and breastfeeding correct incorrect

There is a 30% chance of her child suffering bipolar affective disorder correct incorrect