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PMH-C Exam: Medications With
Complete Answers
What percentage of women aged 12 years and over have used an antidepressant medication? - ✔✔13%
What percentage of pregnancies in the U.S. are unplanned? - ✔✔~50%
omission bias - ✔✔the tendency for physicians to feel more responsible for causing harm if it results from
something they do (e.g. prescribe a medication) than if it results from something they fail to do
Pregnancy often leads to - ✔✔antidepressant discontinuation.
relational ethics - ✔✔the principle that the well-being of mother/parent and fetus are intertwined rather
than oppositional, and both need to be taken into account in treatment decisions
3 kinds of stress response - ✔✔1. positive, 2. tolerable, 3. toxic
positive stress response - ✔✔-normal and essential part of healthy development
-brief increases in heart rate and mild elevations in hormone levels
-e.g. vaccines, new caregiver
tolerable stress response - ✔✔-activates the body's alert systems
-if time-limited and buffered by relationships with adults, the brain and other organs recover
-from more severe, longer-lasting difficulties
-e.g. loss of a loved one, natural disaster, frightening injury
Katelyn Whitman© 2025, All Rights Reserved.
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toxic stress response - ✔✔-prolonged activation of stress response systems can disrupt the development
of brain architecture and other organ systems and can increase risk for enduring stress-related disease
-from strong, frequent, and/or prolonged adversity
-e.g. physical or emotional abuse or neglect
fetal programming - ✔✔-Through the mother's biochemistry, the fetus "learns" what to expect regarding
resources, pathogens, etc., and develops accordingly.
-Experiences in the womb (e.g. maternal nutrition, stress) influence which genes are turned on or off, and
therefore how brains and bodies develop.
The fetus is well protected from toxic effects of everyday maternal stress because: - ✔✔-Maternal
hypothalamic pituitary adrenal (HPA) axis has reduced baseline activity and reduced responsiveness.
-a placental enzyme (11BHSD2*) inactivates some circulating maternal glucorticoids.
With severe, prolonged maternal distress... - ✔✔-Maternal cortisol level can overwhelm placental
defenses.
-This increases methylation at promoter regions of fetal genes that affect glucorticoid receptors.
-The child's stress response system can become hypersensitive.
-There is an increased risk of preterm birth.
indirect effects of untreated perinatal depressive symptoms (parent) - ✔✔-greater use of alcohol,
cigarettes, and illicit addictive substances
-less healthy nutrition
-higher BMI
-less participation in prenatal care
Katelyn Whitman© 2025, All Rights Reserved.
PMH-C Exam: Medications With
Complete Answers
What percentage of women aged 12 years and over have used an antidepressant medication? - ✔✔13%
What percentage of pregnancies in the U.S. are unplanned? - ✔✔~50%
omission bias - ✔✔the tendency for physicians to feel more responsible for causing harm if it results from
something they do (e.g. prescribe a medication) than if it results from something they fail to do
Pregnancy often leads to - ✔✔antidepressant discontinuation.
relational ethics - ✔✔the principle that the well-being of mother/parent and fetus are intertwined rather
than oppositional, and both need to be taken into account in treatment decisions
3 kinds of stress response - ✔✔1. positive, 2. tolerable, 3. toxic
positive stress response - ✔✔-normal and essential part of healthy development
-brief increases in heart rate and mild elevations in hormone levels
-e.g. vaccines, new caregiver
tolerable stress response - ✔✔-activates the body's alert systems
-if time-limited and buffered by relationships with adults, the brain and other organs recover
-from more severe, longer-lasting difficulties
-e.g. loss of a loved one, natural disaster, frightening injury
Katelyn Whitman© 2025, All Rights Reserved.
, 2|Page
toxic stress response - ✔✔-prolonged activation of stress response systems can disrupt the development
of brain architecture and other organ systems and can increase risk for enduring stress-related disease
-from strong, frequent, and/or prolonged adversity
-e.g. physical or emotional abuse or neglect
fetal programming - ✔✔-Through the mother's biochemistry, the fetus "learns" what to expect regarding
resources, pathogens, etc., and develops accordingly.
-Experiences in the womb (e.g. maternal nutrition, stress) influence which genes are turned on or off, and
therefore how brains and bodies develop.
The fetus is well protected from toxic effects of everyday maternal stress because: - ✔✔-Maternal
hypothalamic pituitary adrenal (HPA) axis has reduced baseline activity and reduced responsiveness.
-a placental enzyme (11BHSD2*) inactivates some circulating maternal glucorticoids.
With severe, prolonged maternal distress... - ✔✔-Maternal cortisol level can overwhelm placental
defenses.
-This increases methylation at promoter regions of fetal genes that affect glucorticoid receptors.
-The child's stress response system can become hypersensitive.
-There is an increased risk of preterm birth.
indirect effects of untreated perinatal depressive symptoms (parent) - ✔✔-greater use of alcohol,
cigarettes, and illicit addictive substances
-less healthy nutrition
-higher BMI
-less participation in prenatal care
Katelyn Whitman© 2025, All Rights Reserved.
