PMH-C UPDATED COMPREHENSIVE EXAMS
QUESTIONS AND ANSWERS SURE A+
✔✔Neonatal Side Effects of Lithium - ✔✔Flaccidity, cyanosis, lethargy, hypotonia, poor
feeding, abnormal breathing, cardiac arrhythmias, poor myocardial contractillity
Breast feeding:
Toxicity reported
Excretion into breastmilk is variable
✔✔Lamotrigine in pregnancy - ✔✔Lowest risk of malformation
No adverse effects of exposure via breastmilk
✔✔Typical or First Generation Antipsychotics - ✔✔Positive for congenital
malformations, preterm delivery, poor fetal growth, elective termination
✔✔Medications and Psychosis - ✔✔May require multiple medications
Electro Convulsive therapy (ETC) and hospitalization may be necessary
Breastfeeding discouraged with multiple meds
Infant exposure to high doses
Interruption of maternal sleep worsens with illness
, ✔✔Atypical Antipsychotics in Pregnancy - ✔✔Major malformation risk is greater among
those on atypicals compared to others
Higher risk of postpartum complications
Cardiovascular malformations
Higher rate of elective termination
NO difference in miscarriage or stillbirth
Higher risk of preterm birth and low birth weight
✔✔Postpartum Antipsychotics - ✔✔Consider sedation and weight gain
First generation antipsychotics small amounts are in breastmilk
Second generation antipsychotics found that a larger amount is found in breastmilk
✔✔ECT - ✔✔electroconvulsive therapy
Prenatal and postpartum safe
✔✔TMS - ✔✔transcranial magnetic stimulation
Use of strong magnets to briefly interrupt normal brain activity as a way to study brain
regions
Less Studied
Gentler than ECT
✔✔Pharmacogenetic Testing - ✔✔a genetic test that indicates how a patient may
respond to a specific drug
✔✔Breastfeeding and Medications - ✔✔Psychotropic drugs are excreted in small
amounts
A normal, full term infant of average weight, who is breastfeeding exclusively can
handle metabolites without adverse effects
✔✔D-Mer - ✔✔Anxiety with breastmilk letdown
Dysphoric milk ejection reflex (D-MER) is an anomaly of the milk release mechanism in
lactating women. A lactating woman who has D-MER experiences a brief dysphoria just
prior to the milk ejection reflex.
✔✔Stress Responses - ✔✔Positive
- normal part of healthy development
QUESTIONS AND ANSWERS SURE A+
✔✔Neonatal Side Effects of Lithium - ✔✔Flaccidity, cyanosis, lethargy, hypotonia, poor
feeding, abnormal breathing, cardiac arrhythmias, poor myocardial contractillity
Breast feeding:
Toxicity reported
Excretion into breastmilk is variable
✔✔Lamotrigine in pregnancy - ✔✔Lowest risk of malformation
No adverse effects of exposure via breastmilk
✔✔Typical or First Generation Antipsychotics - ✔✔Positive for congenital
malformations, preterm delivery, poor fetal growth, elective termination
✔✔Medications and Psychosis - ✔✔May require multiple medications
Electro Convulsive therapy (ETC) and hospitalization may be necessary
Breastfeeding discouraged with multiple meds
Infant exposure to high doses
Interruption of maternal sleep worsens with illness
, ✔✔Atypical Antipsychotics in Pregnancy - ✔✔Major malformation risk is greater among
those on atypicals compared to others
Higher risk of postpartum complications
Cardiovascular malformations
Higher rate of elective termination
NO difference in miscarriage or stillbirth
Higher risk of preterm birth and low birth weight
✔✔Postpartum Antipsychotics - ✔✔Consider sedation and weight gain
First generation antipsychotics small amounts are in breastmilk
Second generation antipsychotics found that a larger amount is found in breastmilk
✔✔ECT - ✔✔electroconvulsive therapy
Prenatal and postpartum safe
✔✔TMS - ✔✔transcranial magnetic stimulation
Use of strong magnets to briefly interrupt normal brain activity as a way to study brain
regions
Less Studied
Gentler than ECT
✔✔Pharmacogenetic Testing - ✔✔a genetic test that indicates how a patient may
respond to a specific drug
✔✔Breastfeeding and Medications - ✔✔Psychotropic drugs are excreted in small
amounts
A normal, full term infant of average weight, who is breastfeeding exclusively can
handle metabolites without adverse effects
✔✔D-Mer - ✔✔Anxiety with breastmilk letdown
Dysphoric milk ejection reflex (D-MER) is an anomaly of the milk release mechanism in
lactating women. A lactating woman who has D-MER experiences a brief dysphoria just
prior to the milk ejection reflex.
✔✔Stress Responses - ✔✔Positive
- normal part of healthy development
