Pregnancy: retinoids: 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: retinoids

Sample item

A 22-year-old woman with severe nodulocystic acne asks for isotretinoin. Which requirement is essential?

ABaseline lipid and liver tests, since teratogenicity is avoided with a low doseBA negative pregnancy test and effective contraception continued for one month after stoppingCContraception only when she is sexually active during the courseDFolic acid supplementation, which prevents the teratogenic effect

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

The answer and the reasoning

B. A negative pregnancy test and effective contraception continued for one month after stopping

Isotretinoin is a potent teratogen causing craniofacial, cardiac, thymic and CNS malformations, and there is no safe dose or trimester. Pregnancy must be excluded before starting, monthly during therapy, and contraception must continue for at least one month after stopping. Lipids and liver tests are monitored separately.

Option by option

A. Baseline lipid and liver tests, since teratogenicity is avoided with a low dose
No dose is safe, and monitoring of lipids does not prevent teratogenic risk.
B. A negative pregnancy test and effective contraception continued for one month after stopping (correct)
Correct. Strict pregnancy prevention is mandatory during therapy and for a month afterwards.
C. Contraception only when she is sexually active during the course
Contraception must be reliable throughout treatment, not conditional on sexual activity.
D. Folic acid supplementation, which prevents the teratogenic effect
Folic acid does not prevent retinoid embryopathy.

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.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, A negative pregnancy test and effective contraception continued for one month after stopping. Isotretinoin is a potent teratogen causing craniofacial, cardiac, thymic and CNS malformations, and there is no safe dose or trimester.

Why is "Baseline lipid and liver tests, since teratogenicity is avoided with…" not the answer?

No dose is safe, and monitoring of lipids does not prevent teratogenic risk.

Why is "Contraception only when she is sexually active during the course" not the answer?

Contraception must be reliable throughout treatment, not conditional on sexual activity.

Why is "Folic acid supplementation, which prevents the teratogenic effect" not the answer?

Folic acid does not prevent retinoid embryopathy.

What concept does this question test?

It tests Pregnancy: retinoids in Pharmacology. Pregnancy must be excluded before starting, monthly during therapy, and contraception must continue for at least one month after stopping. Lipids and liver tests are monitored separately.

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 Pregnancy: retinoids?

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.