PMH-C Psychopharmacology 3

Question 1

Neonatal adaptation syndrome (NAS) following SSRI exposure near delivery most commonly includes which cluster of symptoms?

Accepted Answer

Jitteriness, irritability, feeding difficulties, and respiratory distress

Answer

NAS from SSRIs presents with jitteriness, irritability, feeding difficulties, and mild respiratory distress, typically self-resolving within days.

Question 2

Which factor most significantly increases the risk of postpartum psychosis in a patient with bipolar disorder?

Accepted Answer

Abrupt discontinuation of mood stabilizer peripartum

Answer

Abrupt discontinuation of mood stabilizers peripartum substantially increases relapse risk, particularly postpartum psychosis in bipolar disorder.

Question 3

A pregnant patient with schizophrenia requires antipsychotic medication. Which risk is most associated with first-generation antipsychotics in pregnancy?

Accepted Answer

Neonatal extrapyramidal symptoms and withdrawal

Answer

First-generation antipsychotics, especially haloperidol near delivery, are associated with neonatal extrapyramidal symptoms and withdrawal.

Question 4

Why is lamotrigine dosing particularly complex during pregnancy?

Accepted Answer

Estrogen strongly induces glucuronidation, reducing lamotrigine serum levels

Answer

Elevated estrogen during pregnancy induces UGT enzymes that glucuronidate lamotrigine, reducing serum levels by up to 50-65% and requiring dose increases.

Question 5

A patient on bupropion for depression wants to conceive. What perinatal consideration is most critical to discuss?

Accepted Answer

Some studies suggest a possible small increased risk of cardiac defects and miscarriage

Answer

Some studies suggest a small increased risk of congenital cardiac defects and spontaneous abortion with bupropion, though evidence is mixed and absolute risks remain low.

(PMH-C) Perinatal Mental Health Certification Practice Test

(PMH-C) Perinatal Mental Health Certification Practice Test

PMH-C Psychopharmacology 3