Pregnancy: warfarin: 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.

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Pharmacology · Pregnancy: warfarin

Sample item

A woman with a mechanical mitral valve took warfarin throughout the first trimester. Which features are most likely in her newborn?

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

The answer and the reasoning

B. Nasal hypoplasia and stippled epiphyses

Warfarin crosses the placenta and, with exposure at 6 to 12 weeks, causes embryopathy with nasal hypoplasia and stippled epiphyses (chondrodysplasia punctata) because vitamin K-dependent bone proteins are inhibited. Later exposure can cause fetal intracranial bleeding. Heparins do not cross the placenta.

Option by option

  • A. Ebstein anomaly

    Ebstein anomaly is associated with first-trimester lithium.

  • B. Nasal hypoplasia and stippled epiphyses (correct)

    Correct. Warfarin embryopathy is characterised by nasal hypoplasia and stippled epiphyses.

  • C. Neural tube defect

    Neural tube defects are associated with valproate and carbamazepine.

  • D. Phocomelia

    Phocomelia is the classic effect of thalidomide.

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 B, Nasal hypoplasia and stippled epiphyses. Warfarin crosses the placenta and, with exposure at 6 to 12 weeks, causes embryopathy with nasal hypoplasia and stippled epiphyses (chondrodysplasia punctata) because vitamin K-dependent bone proteins are inhibited.

Why is "Ebstein anomaly" not the answer?

Ebstein anomaly is associated with first-trimester lithium.

Why is "Neural tube defect" not the answer?

Neural tube defects are associated with valproate and carbamazepine.

Why is "Phocomelia" not the answer?

Phocomelia is the classic effect of thalidomide.

What concept does this question test?

It tests Pregnancy: warfarin in Pharmacology. Later exposure can cause fetal intracranial bleeding. Heparins do not cross the placenta.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Pregnancy: warfarin?

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.