EBCOG P1 – 3 month May 2022 – Maternal Medicine Part 2 – Pregnancy after solid organ transplant – Day 5 EMQ

A . advice against breastfeeding
B. advice against pregnancy
C. advice on diet exercise and folic acid
D . antipsychotic drugs
E. cognitive behavioural therapy (CBT)
F. counselling
G counselling the partner and other family members
H. dedicated mother and baby unit admission
I . electroconvulsive therapy
J. interpersonal psychotherapy IPT
K. involve social services
L. involvement of special mental health team/psychiatrist
M. rapid tranquillisation
N. SSRI – fluoxetine
O. tricyclic antidepressants – imipramine
For each of the following questions, choose the single-most appropriate option from the list
A–O. Each option may be chosen once, more than once or not at all.


1. A 21-year-old woman with known bipolar disorder on regular medication attends for preconception counselling. She is on fluoxetine and is on regular follow-up.

2.A 30-year-old woman presents to the delivery suite at 32 weeks gestation with severe backache. She denies any vaginal watery loss or bleeding. On examination, her vital signs are found to be stable, with a soft uterus. Vaginal examination was not performed as she does not consent. Her recent growth scan has been normal. On further questioning, she lacks coherence and says she heard voices the night before, which instructed her to go to the hospital immediately.

3.A 22-year-old primigravida attends the breastfeeding clinic on the 7th day following her delivery. She is tearful due to her inability to feed the baby and feels completely worthless. She lives alone and says life means nothing to her now and talks about harming herself. She looks emaciated and dehydrated.

4.A 34-year-old woman attends the postnatal clinic feeling tired with lack of appetite and feeling unwell on the 4th day following her delivery. She is complaining of severe pain in the episiotomy site and vaginal bleeding. She had a prolonged labour following induction and a forceps delivery. She is very upset about the whole event. Physical examination reveals normal findings and stable vital parameters.

5.A 29-year-old woman is attending the GP surgery for breast engorgement. She was a victim of road traffic accident recently and lost her baby at term due to placental abruption. She was induced and had vaginal delivery and discharged later from the hospital. She was prescribed cabergoline following the delivery. On examination, there is very mild breast tenderness with no engorgement and is extremely tearful.

A. baby blues
B. postnatal depression
C. panic disorders
D. schizophrenia
E. puerperal psychosis
F. bipolar affective disorder
G. depression
H. withdrawal psychosis
I. personality disorder
J. space-occupying lesions
K. acute confusional state
L. metabolic disorder
M. post-traumatic stress disorder
N. none of the above

For each description below, choose the single most appropriate answer from the above list of options. Each option may be used once, more than once, or not at all.
6. A 23-year-old woman who has had a normal delivery 12 hours earlier is noted by the ward staff to be having difficulties sleeping, is overactive and expresses feelings of excitement

7. A 23-year-old woman presents at the booking clinic. She is 7 weeks pregnant in her first pregnancy and has been referred by the community midwife for consultant care. She feels well in herself and says that a specific voice has been speaking to her every morning instructing her to do things. She is not on any medication.

8. A 40-year-old woman presents on the fifth day after a normal delivery. Her husband brought her in to Accident and Emergency after he noticed an abrupt change in her behaviour. He describes her as confused, restless and expressing thoughts of self-harm.

9.its postnatal depression is about 10 per cent, but severe depression with suicidal thoughts is relatively less common

10.post delivery 26 years old female has auditory and visual unexplained imaginations and voices