Drugs in pregnancy: mycophenolate embryopathy: 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: mycophenolate embryopathy

Sample item

A newborn has microtia with atresia of the ear canal, cleft lip and palate, and hypoplastic nails. His mother had a renal transplant and took an immunosuppressant combination during pregnancy. Which drug is the likely cause?

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

The answer and the reasoning

B. Mycophenolate mofetil

Mycophenolate inhibits inosine monophosphate dehydrogenase and is associated with a characteristic embryopathy of ear malformations, orofacial clefts, and limb and nail hypoplasia, along with a high rate of miscarriage. Women must use contraception, and tacrolimus, prednisolone and azathioprine are considered compatible with pregnancy.

Option by option

  • A. Azathioprine

    Azathioprine is regarded as compatible with pregnancy and is used in transplant recipients.

  • B. Mycophenolate mofetil (correct)

    Correct. Mycophenolate causes ear, orofacial and nail malformations.

  • C. Tacrolimus

    Tacrolimus is generally considered acceptable in pregnancy.

  • D. Prednisolone

    Prednisolone is largely inactivated by placental enzymes and is used in pregnancy.

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, Mycophenolate mofetil. Mycophenolate inhibits inosine monophosphate dehydrogenase and is associated with a characteristic embryopathy of ear malformations, orofacial clefts, and limb and nail hypoplasia, along with a high rate of miscarriage.

Why is "Azathioprine" not the answer?

Azathioprine is regarded as compatible with pregnancy and is used in transplant recipients.

Why is "Tacrolimus" not the answer?

Tacrolimus is generally considered acceptable in pregnancy.

Why is "Prednisolone" not the answer?

Prednisolone is largely inactivated by placental enzymes and is used in pregnancy.

What concept does this question test?

It tests Drugs in pregnancy: mycophenolate embryopathy in Pharmacology. Women must use contraception, and tacrolimus, prednisolone and azathioprine are considered compatible with pregnancy.

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 Drugs in pregnancy: mycophenolate embryopathy?

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.