Drugs in pregnancy: valproate neurodevelopment: 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: valproate neurodevelopment

Sample item

A woman with generalised epilepsy on sodium valproate wishes to conceive. Besides neural tube defects, which long-term outcome in the child is linked to in-utero valproate exposure?

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

The answer and the reasoning

C. Lower cognitive scores and higher autism risk

In-utero valproate exposure is dose-related and is associated with lower IQ, language delay and increased risk of autism spectrum disorder as well as major malformations. For this reason it is avoided in women of childbearing potential unless no alternative controls seizures.

Option by option

  • A. Premature ovarian failure

    Premature ovarian failure is not a recognised consequence of valproate exposure in the child.

  • B. Congenital long QT syndrome

    Congenital long QT syndrome is genetic and not caused by valproate exposure.

  • C. Lower cognitive scores and higher autism risk (correct)

    Correct. Prenatal valproate impairs neurodevelopment and raises autism risk.

  • D. Sensorineural hearing loss

    Sensorineural hearing loss is the characteristic fetal effect of aminoglycosides.

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 C, Lower cognitive scores and higher autism risk. In-utero valproate exposure is dose-related and is associated with lower IQ, language delay and increased risk of autism spectrum disorder as well as major malformations.

Why is "Premature ovarian failure" not the answer?

Premature ovarian failure is not a recognised consequence of valproate exposure in the child.

Why is "Congenital long QT syndrome" not the answer?

Congenital long QT syndrome is genetic and not caused by valproate exposure.

Why is "Sensorineural hearing loss" not the answer?

Sensorineural hearing loss is the characteristic fetal effect of aminoglycosides.

What concept does this question test?

It tests Drugs in pregnancy: valproate neurodevelopment in Pharmacology. For this reason it is avoided in women of childbearing potential unless no alternative controls seizures.

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: valproate neurodevelopment?

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.