PMH C TEST FINAL EXAM AND
PRACTICE EXAM QUESTIONS
CURRENTLY TESTING EXAM
QUESTIONS WITH 100% VERIFIED
DETAILED AND CORRECT ANSWERS
ACTUAL BRAND-NEW EXAM
ALREADY GRADED A+
what tricyclic antidepressants are used in perinatal
period? - ....ANSWER...-desipramine (norpramin) and
nortriptyline (pamelor) are preferred bc theres less
anticholinergic side effects and less likely to increase
orthostatic hypotension
-amitriptyline (elavil) can be used for insomnia
guidelines on using antidepressants during pregnancy? -
....ANSWER...-if pt becomes pregnant while on meds,
don't stop or change if its effective and she's doing well-
-> theres a high risk of relapse if meds are stopped
during preg
-meds should NOT be tapered or stopped before
delivery--> theres no shown benefit, it increases risk
of relapse and sets them up for PP illness at height of
vulnerability
1
,-at least 50% of women w/PP dep were symptomatic
during preg
-many women require increased dose as preg progresses
bc of blood changes that happen in 2nd and 3rd
trimester
-meds can be started during preg if symptoms are
mod-severe
research on anti-anxiety meds during pregnancy? -
....ANSWER...-not a ton of info on buspar in preg or
lactation
-buspar increases serum prolactin: its unclear whether
this effect would be sufficient enough to impair fertility
-hydroxyzine (vastaril):
-was used for decades to reduce anx during labor
without affecting contractions and there was no bad
infant effects from short term use
-long term use during preg isn't well studied--> theres
some examples of neonatal seizures after long term use
in high doses during preg
-not a ton of info on safety during breastfeeding and
how much secretes into milk; some case reports suggest
sedation in infants but is uncommon
what is quetiapine (seroquel) used for in pregnancy?
- ....ANSWER...-low doses effective for insomnia and
2
,anxiety
-orthostatic hypotension common the first few mornings
what are the risks of exposure to meds at diff points in
preg? - ....ANSWER...1st trimester: congenital
anomalies
2nd trimester: behavioral issues, learning challenges,
attention, cognitive issues
3rd: physiologic development (changes in body and
brain), effects on growth, effects on labor timing,
neonatal side effects
what is the idea of fetal programming? -
....ANSWER...-through mom's biochemistry, the fetus
"learns" what to expect regarding resources, pathogens,
etc and develops accordingly
-experiences in the womb (maternal nutrition, stress, etc)
influence which genes are turned on or off and therefore
how brains and bodies develop
-severe, prolonged exposure to maternal distress can
make child's stress response system hypersensitive and
increase risk of preterm birth
what is relational ethics? - ........ ANSWER...-the
principle that the wellbeing of mom and fetus are
intertwined rather than oppositional and both need to be
considered in treatment decisions
3
, what are the top voiced concerns by patients regarding
meds in preg? - ........................ ANSWER...-miscarriage
-congenital malformation
-preterm delivery/low birth weight
-neonatal adaptation syndrome
-long term neurobehavioral effects
-autism
-persistent pulmonary hypertension of newborn (baby
doesnt get enough oxygen after birth)
risk of miscarriage/still birth with meds during preg?
- ....ANSWER...-not a true risk
-risk is elevated for women who stopped SSRIs prior to
conception and for those who remained on SSRIs in first
trimester
-risk was due to underlying illness, not med exposure
risk of PPHN (persistent pulmonary hypertension of
newborn (baby doesn't get enough oxygen after birth))?
- ....ANSWER...-very low risk
-other risk factors include prematurity, dom violence, c-
section delivery, smoking, NSAIDs, obesity, black race,
cardiac malformations, lung abnormalities, untreated
maternal dep
4
PRACTICE EXAM QUESTIONS
CURRENTLY TESTING EXAM
QUESTIONS WITH 100% VERIFIED
DETAILED AND CORRECT ANSWERS
ACTUAL BRAND-NEW EXAM
ALREADY GRADED A+
what tricyclic antidepressants are used in perinatal
period? - ....ANSWER...-desipramine (norpramin) and
nortriptyline (pamelor) are preferred bc theres less
anticholinergic side effects and less likely to increase
orthostatic hypotension
-amitriptyline (elavil) can be used for insomnia
guidelines on using antidepressants during pregnancy? -
....ANSWER...-if pt becomes pregnant while on meds,
don't stop or change if its effective and she's doing well-
-> theres a high risk of relapse if meds are stopped
during preg
-meds should NOT be tapered or stopped before
delivery--> theres no shown benefit, it increases risk
of relapse and sets them up for PP illness at height of
vulnerability
1
,-at least 50% of women w/PP dep were symptomatic
during preg
-many women require increased dose as preg progresses
bc of blood changes that happen in 2nd and 3rd
trimester
-meds can be started during preg if symptoms are
mod-severe
research on anti-anxiety meds during pregnancy? -
....ANSWER...-not a ton of info on buspar in preg or
lactation
-buspar increases serum prolactin: its unclear whether
this effect would be sufficient enough to impair fertility
-hydroxyzine (vastaril):
-was used for decades to reduce anx during labor
without affecting contractions and there was no bad
infant effects from short term use
-long term use during preg isn't well studied--> theres
some examples of neonatal seizures after long term use
in high doses during preg
-not a ton of info on safety during breastfeeding and
how much secretes into milk; some case reports suggest
sedation in infants but is uncommon
what is quetiapine (seroquel) used for in pregnancy?
- ....ANSWER...-low doses effective for insomnia and
2
,anxiety
-orthostatic hypotension common the first few mornings
what are the risks of exposure to meds at diff points in
preg? - ....ANSWER...1st trimester: congenital
anomalies
2nd trimester: behavioral issues, learning challenges,
attention, cognitive issues
3rd: physiologic development (changes in body and
brain), effects on growth, effects on labor timing,
neonatal side effects
what is the idea of fetal programming? -
....ANSWER...-through mom's biochemistry, the fetus
"learns" what to expect regarding resources, pathogens,
etc and develops accordingly
-experiences in the womb (maternal nutrition, stress, etc)
influence which genes are turned on or off and therefore
how brains and bodies develop
-severe, prolonged exposure to maternal distress can
make child's stress response system hypersensitive and
increase risk of preterm birth
what is relational ethics? - ........ ANSWER...-the
principle that the wellbeing of mom and fetus are
intertwined rather than oppositional and both need to be
considered in treatment decisions
3
, what are the top voiced concerns by patients regarding
meds in preg? - ........................ ANSWER...-miscarriage
-congenital malformation
-preterm delivery/low birth weight
-neonatal adaptation syndrome
-long term neurobehavioral effects
-autism
-persistent pulmonary hypertension of newborn (baby
doesnt get enough oxygen after birth)
risk of miscarriage/still birth with meds during preg?
- ....ANSWER...-not a true risk
-risk is elevated for women who stopped SSRIs prior to
conception and for those who remained on SSRIs in first
trimester
-risk was due to underlying illness, not med exposure
risk of PPHN (persistent pulmonary hypertension of
newborn (baby doesn't get enough oxygen after birth))?
- ....ANSWER...-very low risk
-other risk factors include prematurity, dom violence, c-
section delivery, smoking, NSAIDs, obesity, black race,
cardiac malformations, lung abnormalities, untreated
maternal dep
4
