Drugs in pregnancy: teratogens: practice question

A OBG 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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OBG · Drugs in pregnancy: teratogens

Sample item

A woman with a mechanical heart valve took warfarin throughout the first trimester. Which fetal abnormality is characteristic?

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

The answer and the reasoning

A. Nasal hypoplasia and stippled epiphyses (chondrodysplasia punctata)

Warfarin embryopathy, with nasal hypoplasia and stippled epiphyses, occurs with exposure at 6 to 12 weeks. Later exposure can cause central nervous system defects and fetal haemorrhage. Lithium causes Ebstein anomaly, valproate causes neural tube defects, and thalidomide causes phocomelia.

Option by option

  • A. Nasal hypoplasia and stippled epiphyses (chondrodysplasia punctata) (correct)

    Correct. Warfarin crosses the placenta and impairs vitamin K dependent bone proteins.

  • B. Ebstein anomaly

    Ebstein anomaly is associated with lithium.

  • C. Neural tube defect

    Neural tube defects are associated with valproate and carbamazepine.

  • D. Phocomelia

    Phocomelia is the classic thalidomide effect.

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.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Nasal hypoplasia and stippled epiphyses (chondrodysplasia punctata). Warfarin embryopathy, with nasal hypoplasia and stippled epiphyses, occurs with exposure at 6 to 12 weeks.

Why is "Ebstein anomaly" not the answer?

Ebstein anomaly is associated with lithium.

Why is "Neural tube defect" not the answer?

Neural tube defects are associated with valproate and carbamazepine.

Why is "Phocomelia" not the answer?

Phocomelia is the classic thalidomide effect.

What concept does this question test?

It tests Drugs in pregnancy: teratogens in OBG. Later exposure can cause central nervous system defects and fetal haemorrhage. Lithium causes Ebstein anomaly, valproate causes neural tube defects, and thalidomide causes phocomelia.

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: teratogens?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG 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.