Diethylstilbestrol (DES) should never be used in pregnant women because it is associated with all of the following EXCEPT:

Correct Answer: A

Rationale: DES, a synthetic estrogen, causes deep vein thrombosis (choice A), feminization of male offspring (choice B), and miscarriages (choice C) in pregnancy, linked to historical congenital anomalies (e.g., vaginal adenocarcinoma). Virilization of female offspring (choice D) isn't reported; DES mimics estrogen, not androgens. This exception highlights its teratogenic risks, banning its use in pregnancy.

Correct Answer: A

Rationale: The correct answer is A. Increased synthesis of adenylyl cyclase. One of the leading hypotheses about the molecular mechanism of action of lithium is its ability to increase the synthesis of adenylyl cyclase. Adenylyl cyclase is an enzyme involved in the production of cyclic adenosine monophosphate (cAMP), which plays a role in cellular signaling pathways. By increasing the synthesis of adenylyl cyclase, lithium may help to regulate intracellular signaling and neurotransmitter release, contributing to its mood-stabilizing effects in bipolar disorder.

Correct Answer: D

Rationale: Desipramine has the least anticholinergic effect and sedation compared to other tricyclic antidepressants.

Correct Answer: B

Rationale: LSD exerts its hallucinogenic effects through serotonin (5-HT) receptor modulation.

Correct Answer: A

Rationale: Aspirin (choice A) is linked to Reye's syndrome, a rare liver/brain disorder in children post-viral infection. Acetaminophen (choice B), Ibuprofen (choice C), and Naproxen (choice D) aren't associated. This contraindication limits aspirin's pediatric use.