Medical disorders in pregnancy: epilepsy: 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 · Medical disorders in pregnancy: epilepsy

Sample item

Which antiepileptic drug is associated with a haemorrhagic disease of the newborn through vitamin K deficiency?

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

The answer and the reasoning

C. Phenytoin

Enzyme-inducing antiepileptics such as phenytoin, phenobarbitone and carbamazepine increase vitamin K catabolism, causing neonatal coagulopathy. Newborns receive 1 mg of vitamin K intramuscularly at birth. Some guidelines also give maternal vitamin K orally in late pregnancy.

Option by option

  • A. Clonazepam

    Clonazepam does not cause vitamin K deficiency.

  • B. Levetiracetam

    Levetiracetam is not an enzyme inducer.

  • C. Phenytoin (correct)

    Correct. Enzyme induction depletes vitamin K dependent clotting factors.

  • D. Lamotrigine

    Lamotrigine is not an enzyme inducer.

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 OBG question

What is the answer to this OBG question?

The best answer is C, Phenytoin. Enzyme-inducing antiepileptics such as phenytoin, phenobarbitone and carbamazepine increase vitamin K catabolism, causing neonatal coagulopathy.

Why is "Clonazepam" not the answer?

Clonazepam does not cause vitamin K deficiency.

Why is "Levetiracetam" not the answer?

Levetiracetam is not an enzyme inducer.

Why is "Lamotrigine" not the answer?

Lamotrigine is not an enzyme inducer.

What concept does this question test?

It tests Medical disorders in pregnancy: epilepsy in OBG. Newborns receive 1 mg of vitamin K intramuscularly at birth. Some guidelines also give maternal vitamin K orally in late pregnancy.

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 Medical disorders in pregnancy: epilepsy?

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.