Question

1) Lithium has been found to be an effective treatment for pregnant and postpartum women

by controlling bipolar disorder symptoms.
by reducing the risk of miscarriage.
because mothers on lithium can breastfeed since the drug is not excreted into breast milk.
by reducing teratogenic risks for the fetus.
2) Exposure to lithium late in pregnancy has been associated with neonatal adaptation syndrome, which may include the following symptom:

hypertonicity.
hyperactivity.
muscle fasciculations.
higher than normal oxygen saturation in the blood.
3) The 2023 guidelines of the American College of Obstetricians and Gynecologists for the treatment and management of mental health during pregnancy and postpartum provide that

pregnant patients NOT take lithium in the first trimester.
all mood stabilizers be discontinued during pregnancy and restarted during the postpartum period.
valproate is the first-line drug to treat mood disorders during pregnancy.
pregnant patients taking lithium in the first trimester receive a detailed ultrasound examination in the second trimester.
4) When women and their clinicians opt to discontinue lithium use during the perinatal period, monitor for the potential risk of

infections.
a relapse of bipolar disorder symptoms
lithium toxicity.
gestational diabetes.
5) An infant who is breastfeeding will take in ________ of the mother’s lithium levels.

100%
up to 1/2
twice the amount
about one-fourth
6) Lithium use at therapeutic levels can cause _________________, which are often associated with the duration of lithium therapy in patients.

dry eyes and chapped lips
T‐wave depressions and sinus node dysfunction
pregnancy-induced type 1 and 2 diabetes
severe constipation and middle ear infection
7) Ebstein’s anomaly is a teratogenic risk associated with taking lithium during pregnancy that is categorized as

a cardiac malformation.
a neurodevelopmental risk.
an adverse event associated with breastfeeding.
a fluctuation in a mother’s serum lithium level.
8) Which response most aligns with childbearing women prescribed lithium for bipolar disorder?

Lithium exposure does not increase the risk of cardiac malformations, neurodevelopmental effects
Lithium is more likely to have adverse effects on the fetus than other drugs such as carbamazepine or valproate
Llithium is less likely to have adverse effects on the fetus than other drugs such as carbamazepine or valproate
Lithium exposure increases the risk of hepatic malformations, not neurodevelopmental effects
9) Which statement is NOT true about lithium in childbearing women?

It can cause diarrhea, has been associated with miscarriage, and can rarely precipitate serotonin syndrome
It has been associated with lower risks of suicide, and it has prevented relapse during pregnancy
The Patorno cohort study revealed with daily dosing between 601 to 900 mg, the cardiac malformation risk was 1.60
The Patorno cohort study revealed with daily doses over 100 mg, cardiac malformation risk increased to 6.0
10) The American College of Obstetricians and Gynecologists noted that holding lithium doses at the onset of labor, or ________ a scheduled birth, may reduce the risk of adverse neonatal events.

one hour before
for 24-48 hours before
for 8 hours
at the time of

Answer 1

1) by controlling bipolar disorder symptoms.
2) hypertonicity.
3) pregnant patients taking lithium in the first trimester receive a detailed ultrasound examination in the second trimester.
4) a relapse of bipolar disorder symptoms
5) up to 1/2
6) T‐wave depressions and sinus node dysfunction
7) a cardiac malformation.
8) Lithium is less likely to have adverse effects on the fetus than other drugs such as carbamazepine or valproate
9) The Patorno cohort study revealed with daily doses over 100 mg, cardiac malformation risk increased to 6.0 (this statement is NOT true)
10) for 24–48 hours before