Drugs in pregnancy: diethylstilbestrol: 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 · Drugs in pregnancy: diethylstilbestrol

Sample item

A 19-year-old woman has a clear cell adenocarcinoma of the vagina. Her mother took a synthetic non-steroidal oestrogen during pregnancy to prevent miscarriage. Which drug was it?

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

The answer and the reasoning

B. Diethylstilbestrol

In-utero exposure to diethylstilbestrol causes vaginal clear cell adenocarcinoma, vaginal adenosis, cervical and uterine structural anomalies (T-shaped uterus) and infertility in female offspring, and genital anomalies in males. Its use in pregnancy was abandoned for these reasons.

Option by option

  • A. Clomiphene citrate

    Clomiphene is used to induce ovulation and is not linked to this tumour.

  • B. Diethylstilbestrol (correct)

    Correct. Prenatal diethylstilbestrol exposure is the classic cause of vaginal clear cell carcinoma.

  • C. Misoprostol

    Misoprostol is a prostaglandin E1 analogue linked to limb and cranial nerve defects.

  • D. Medroxyprogesterone acetate

    Medroxyprogesterone is a progestin and is not the cause of vaginal clear cell carcinoma.

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.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Diethylstilbestrol. In-utero exposure to diethylstilbestrol causes vaginal clear cell adenocarcinoma, vaginal adenosis, cervical and uterine structural anomalies (T-shaped uterus) and infertility in female offspring, and genital anomalies in males.

Why is "Clomiphene citrate" not the answer?

Clomiphene is used to induce ovulation and is not linked to this tumour.

Why is "Misoprostol" not the answer?

Misoprostol is a prostaglandin E1 analogue linked to limb and cranial nerve defects.

Why is "Medroxyprogesterone acetate" not the answer?

Medroxyprogesterone is a progestin and is not the cause of vaginal clear cell carcinoma.

What concept does this question test?

It tests Drugs in pregnancy: diethylstilbestrol in Pharmacology. Its use in pregnancy was abandoned for these reasons.

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 Drugs in pregnancy: diethylstilbestrol?

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.