Perinatal and Women's Mental Health (Postpartum Psychosis, PMDD) MCQs

Psychiatry · 15 free questions with answers & explanations.

1. A 26-year-old primiparous woman, 5 days postpartum, presents with acute-onset confusion, bizarre behaviour, auditory hallucinations (hearing her deceased grandmother commanding her), grandiosity, and severe insomnia. She had no prior psychiatric history. This is best classified as:
2. A 32-year-old woman reports that for the past 6 months she experiences severe irritability, depressed mood, hopelessness, and physical symptoms (breast tenderness, bloating) that begin consistently 5–7 days before her period and remit completely within 2–3 days of its onset. Her symptoms significantly impair her work. She has no inter-episode mood disorder. The correct diagnosis per DSM-5 is:
3. Regarding use of antidepressants in pregnancy, which SSRI carries the highest risk of persistent pulmonary hypertension of the newborn (PPHN) when used in the third trimester?
4. A woman with bipolar I disorder is 8 weeks pregnant and was on lithium. Lithium was discontinued at 6 weeks due to teratogenicity concerns. She is now manic. Regarding restarting a mood stabiliser, which statement is most accurate?
5. A 27-year-old primipara develops sudden-onset visual hallucinations, grandiosity, and rapid mood swings on day 4 postpartum. She has a personal history of bipolar disorder. What is the MOST important immediate management concern?
6. A 33-year-old woman has recurrent premenstrual irritability, depressed mood, breast tenderness, and bloating that begin 5–7 days before menses and fully resolve within 2–3 days of onset. Symptoms are severe enough to disrupt work relationships and require prospective charting over 2 cycles. The DSM-5 diagnosis is:
7. A 25-year-old woman in her first trimester of pregnancy has severe OCD. She wishes to continue pharmacotherapy. Which medication is considered safest in terms of fetal risk, with the most data supporting use in pregnancy?
8. Regarding the use of lithium in pregnancy, which specific fetal risk has been documented and should prompt a detailed second-trimester fetal echocardiogram?
9. A 27-year-old primipara presents on day 4 postpartum with confusion, sleep disturbance, auditory hallucinations, and lability. She rapidly shifts between elation and tearfulness. Which diagnosis requires IMMEDIATE inpatient psychiatric admission?
10. A 34-year-old woman reports severe irritability, affective lability, markedly depressed mood, and social withdrawal that begins 1 week before menstruation and resolves completely within a few days of onset of menses, occurring for most cycles over the past year. Her symptoms cause significant occupational impairment. The MOST appropriate diagnosis is:
11. A woman with a previous episode of postpartum psychosis (associated with bipolar disorder) is now planning a second pregnancy. What is the evidence-based recommendation regarding prophylactic pharmacotherapy?
12. A 26-year-old primipara presents on day 4 postpartum with rapid onset confusion, disorganized speech, visual hallucinations, marked mood lability alternating between euphoria and terror, and severe insomnia. She has no prior psychiatric history. The MOST likely diagnosis is:
13. A 32-year-old woman reports severe irritability, mood swings, breast tenderness, and bloating exclusively in the luteal phase of her cycle for the past 6 months, resolving completely within 2-3 days of menses onset. These symptoms significantly impair her work relationships. The DSM-5 diagnosis is:
14. A pregnant woman at 16 weeks with bipolar I disorder is stable on lithium. She wants to know about risks. Which SPECIFIC fetal cardiac anomaly is associated with first-trimester lithium exposure?
15. Which antidepressant is SAFEST for use in the third trimester of pregnancy based on evidence for minimal neonatal adaptation syndrome?