Antiepileptics: valproate toxicity: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pharmacology · Antiepileptics: valproate toxicity

Sample item

A 15-year-old girl with juvenile myoclonic epilepsy is on sodium valproate and presents with vomiting, severe epigastric pain and a very high serum amylase. Which adverse effect has occurred?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Acute pancreatitis

Valproate causes dose-related tremor and weight gain, and rarer idiosyncratic hepatotoxicity and pancreatitis, plus neural tube defects when used in pregnancy. It increases GABA and blocks sodium channels and T-type calcium channels.

Option by option

  • A. Acute pancreatitis (correct)

    Correct. Pancreatitis is a recognised valproate adverse effect.

  • B. Stevens-Johnson syndrome

    SJS is more typical of lamotrigine and carbamazepine.

  • C. Gingival hyperplasia

    Gingival hyperplasia is typical of phenytoin.

  • D. Aplastic anaemia

    Aplastic anaemia is more typical of carbamazepine and felbamate.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Acute pancreatitis. Valproate causes dose-related tremor and weight gain, and rarer idiosyncratic hepatotoxicity and pancreatitis, plus neural tube defects when used in pregnancy.

Why is "Stevens-Johnson syndrome" not the answer?

SJS is more typical of lamotrigine and carbamazepine.

Why is "Gingival hyperplasia" not the answer?

Gingival hyperplasia is typical of phenytoin.

Why is "Aplastic anaemia" not the answer?

Aplastic anaemia is more typical of carbamazepine and felbamate.

What concept does this question test?

It tests Antiepileptics: valproate toxicity in Pharmacology. It increases GABA and blocks sodium channels and T-type calcium channels.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antiepileptics: valproate toxicity?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.