MRCOG Part 2 – Postpartum Problems EMQ

Option List
A. Generalised anxiety disorder
B. Obsessive–compulsive disorder (OCD)
C. Post-traumatic stress disorder (PTSD)
D. Tocophobia.
E. Schizophrenia
F. Panic disorder
G. Bipolareffective disorder
H. Postpartum psychosis
I. Postpartum blues
J. Alcohol abuse
Choose the most appropriate diagnosis from the list of options provided, each option can be chosen once, more than once and not at all

1. Mrs Liza a 20 year old P1 who had her child few days ago by emergency cesarean section due to failure to progress in 2nd stage of labour , she had an uneventful recovery and she is breast feeding. On 4th post-operative day her husband contact the GP worried about her wife as she c/o flashbacks, nightmares and intrusive memories of her prolonged labour which is a main reason for her psychological distress

2. Mrs Sonia a 25 year old P1 who had her child few days ago by an uneventful spontaneous vaginal delivery. Her husband called GP on her 6th post-partum day because his wife has Fears all the time about the baby that baby may ill shortly, due to this she unable to sleep

3. A woman presents to the GP 3 weeks after delivery with the complaints of elevated mood, overactivity and increased energy followed by poor concentration, distractibility, inflated self-esteem, grandiose ideas, disinhibited behavior. On assessment her family history is positive for mental disorders in reference to her mother

4. A woman comes to the post-natal clinic on her 20thpost delivery day. She tells you that following her previous pregnancy, she was admitted to the MBU for “a few weeks”. She is unable to tell you what her diagnosis was, and is adamant that “she does not want to go back there again”. She declines an outpatient appointment with the perinatal team. On assessment, she has hallucinations, delusions, extremely disordered thinking and behavior and negative symptoms of social withdrawal

5. A woman presents to her general practitioner 2 weeks after delivery. She appears on-edge and says that she is worried about germs in the practice that might affect her baby. She asks to wash her hands as soon as she enters the room and you can see that her hands look red and raw.

Option List
A. Physiologic
B. Haemolytic disease
C. Unconjugated
D. Breast milk
E. Hypothydroidism
F. Breast milk jaundice
G. Bruising
H. Hereditary spherocytosis
I. Congenital infections
J. Polycythaemia
K. Metabolic disorders
L. Liver enzyme defects – Crigler-Najjar syndrome
M. Sepsis
N. Biliary atresia
Choose the most appropriate cause of jaundice according to the day of onset from the list of options provided, each option can be chosen once, more than once and not at all

6. A 24 year old P2 had an uneventful spontaneous vaginal delivery 12 hours ago, her baby developed significant yellowish discoloration of body and sclera. His blood film indicated spherocytes with positive direct Coombs test (DCT) and moderately elevated level of unconjugated bilirubin

7. 30 year old P2 had an uneventful spontaneous full term vaginal delivery 3 weeks ago, she was happy with the baby and the baby was fully active and on exclusive breastfeeding. She presented to her GP with the main concern, baby’s yellowish discoloration of sclera for last 12 days. His lab indicated mildly elevated level of unconjugated bilirubin

8. A 26 year old P1 had a history of fever with flu and rash at 26 weeks of gestation which settle spontaneously, she had an uneventful spontaneous full term vaginal delivery 2 days ago, she presented to her GP and worried about her baby because he has had developed yellowish discoloration of sclera since 1st post-delivery day now severity of jaundice aggravated as it involved his back and body. His lab indicated significantly elevated level of conjugated bilirubin

9. A 24 year old P2 had an instrumental vaginal delivery due to poor maternal effort 2 days ago, her baby developed significant yellowish discoloration of body and sclera. his labs indicated mildly elevated level of unconjugated bilirubin

10. A 35 year old P4 had an history of high grade fever during vaginal delivery 5 days ago which settle after antibiotics and anti-pyretic, she presented to her GP with main concern was baby’s irritable behavior and significant yellowish discoloration baby’s sclera for the last 1 day