Teratogenic Exposure – 25 Hard Case-Based MCQs

1. A 22-year-old pregnant woman (7 weeks) with epilepsy is on valproate. Her ultrasound at 18 weeks shows a severe neural tube defect. What is the most likely mechanism?

2. A 30-year-old woman accidentally undergoes CT abdomen delivering 15 mGy exposure at 5 weeks gestation. What is the MOST expected fetal outcome?

3. A newborn has nasal hypoplasia and stippled epiphyses. Mother used a drug during 8–10 weeks of pregnancy. Which drug is responsible?

4. A pregnant woman with lupus (anti-Ro positive) presents at 28 weeks. Fetal heart rate is persistently 55 bpm. What structural condition is most likely?

5. A mother with uncontrolled PKU gives birth to a baby with microcephaly and congenital heart disease. What caused the anomaly?

6. A 19-year-old pregnant woman uses isotretinoin unknowingly. Baby born with microtia and conotruncal heart defects. Which developmental process was disrupted?

7. A pregnant woman experiences fever of 39.5°C at 4 weeks gestation. Which malformation risk increases?

8. A baby has periventricular calcifications and microcephaly. Which infection is responsible?

9. A baby of a cocaine-abusing mother presents with limb defects and placental infarcts. Major mechanism?

10. A woman using methimazole in early pregnancy gives birth to a baby with choanal atresia. What is the condition?

11. A fetus exposed to ACE inhibitors during 2nd trimester shows oligohydramnios. Likely cause?

12. A baby with cataracts, PDA, and deafness is born. At what gestational week was infection likely acquired?

13. A fetus exposed to lithium shows apical displacement of the tricuspid valve. Diagnosis?

14. A pregnant woman exposed to 600 mGy radiation at 10 weeks. Likely effect?

15. A baby has limb reduction defects (phocomelia). Mother used a sedative during pregnancy. Identify the drug.

16. Characteristic finding of fetal alcohol syndrome?

17. A baby has diffuse intracranial calcifications and hydrocephalus. Mother had exposure to cats. Diagnosis?

18. A baby has microcephaly, calcifications, and arthrogryposis after mother had mosquito infection. Which virus?

19. Hyperthermia during organogenesis causes which defect?

20. A baby with hearing loss, microcephaly, and jaundice is born. Which infection is most likely?

21. Fetal hydantoin syndrome is seen with which drug?

22. A fetus exposed to misoprostol shows facial paralysis. Mechanism?

23. A neonate has aplasia cutis on scalp. Which maternal drug?

24. A baby with growth restriction, limb hypoplasia, and cicatricial skin lesions—mother infected at 12 weeks. Identify the infection.

25. Baby with IUGR, hepatosplenomegaly, snuffles, and periostitis. Diagnosis?