Drugs in 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 · Drugs in pregnancy: retinoids

Sample item

A newborn has microtia, cleft palate, hydrocephalus, a ventricular septal defect and thymic hypoplasia. The mother treated her severe acne with an oral retinoid during early pregnancy. Which drug was it?

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

The answer and the reasoning

D. Isotretinoin

Isotretinoin is a potent teratogen causing the retinoic acid embryopathy: craniofacial malformations (microtia or anotia, clefts), central nervous system defects, cardiac outflow and septal defects and thymic abnormalities. Pregnancy must be excluded and effective contraception used before, during and after treatment.

Option by option

  • A. Phenytoin

    Phenytoin causes hypoplasia of the nails and distal phalanges with clefting.

  • B. Methotrexate

    Methotrexate causes skull ossification defects and limb anomalies.

  • C. Carbamazepine

    Carbamazepine is associated with neural tube defects and minor craniofacial features.

  • D. Isotretinoin (correct)

    Correct. Retinoids disrupt neural crest development, giving this pattern.

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 D, Isotretinoin. Isotretinoin is a potent teratogen causing the retinoic acid embryopathy: craniofacial malformations (microtia or anotia, clefts), central nervous system defects, cardiac outflow and septal defects and thymic abnormalities.

Why is "Phenytoin" not the answer?

Phenytoin causes hypoplasia of the nails and distal phalanges with clefting.

Why is "Methotrexate" not the answer?

Methotrexate causes skull ossification defects and limb anomalies.

Why is "Carbamazepine" not the answer?

Carbamazepine is associated with neural tube defects and minor craniofacial features.

What concept does this question test?

It tests Drugs in pregnancy: retinoids in Pharmacology. Pregnancy must be excluded and effective contraception used before, during and after treatment.

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: 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.