Psychopharmacology: lithium and pregnancy counselling: practice question

A Psychiatry 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

Psychiatry · Psychopharmacology: lithium and pregnancy counselling

Sample item

A woman stable on lithium for bipolar I disorder plans pregnancy. What is the best advice?

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

The answer and the reasoning

A. Plan pregnancy with specialist input, weigh risk of relapse against fetal risk, and monitor levels closely

Lithium carries a small increased risk of cardiac malformations including Ebstein anomaly, but abrupt stopping risks serious relapse. Decisions are individualised, with specialist planning, fetal echocardiography and more frequent level checks since clearance rises in pregnancy and falls after delivery. Valproate has greater teratogenic risk.

Option by option

  • A. Plan pregnancy with specialist input, weigh risk of relapse against fetal risk, and monitor levels closely (correct)

    Correct. Individualised planning with monitoring is advised.

  • B. Continue lithium with no monitoring

    Lithium levels vary in pregnancy, so no monitoring is unsafe.

  • C. Stop lithium abruptly on finding pregnancy

    Abrupt stopping risks relapse.

  • D. Switch to valproate

    Valproate is more teratogenic.

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 Psychiatry questions

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Plan pregnancy with specialist input, weigh risk of relapse against fetal risk, and monitor levels closely. Lithium carries a small increased risk of cardiac malformations including Ebstein anomaly, but abrupt stopping risks serious relapse.

Why is "Continue lithium with no monitoring" not the answer?

Lithium levels vary in pregnancy, so no monitoring is unsafe.

Why is "Stop lithium abruptly on finding pregnancy" not the answer?

Abrupt stopping risks relapse.

Why is "Switch to valproate" not the answer?

Valproate is more teratogenic.

What concept does this question test?

It tests Psychopharmacology: lithium and pregnancy counselling in Psychiatry. Decisions are individualised, with specialist planning, fetal echocardiography and more frequent level checks since clearance rises in pregnancy and falls after delivery. Valproate has greater teratogenic risk.

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 Psychopharmacology: lithium and pregnancy counselling?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.