Postpartum psychosis — MCCQE Part 1 MCQ

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HardPsychiatryPostpartum psychosisMCCQE Part 1

A 26-year-old woman 10 days postpartum believes her baby is possessed, has not slept for 3 nights and hears voices telling her to cleanse the baby. Which of the following is the most appropriate next step?

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Correct answer: E — Arrange emergency psychiatric admission and ensure infant safety

Arrange emergency psychiatric admission and ensure infant safety is the single best answer because the age, timing, examination findings and investigations in the vignette fit Postpartum psychosis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian perinatal mental health guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian perinatal mental health guidance