This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Miscellaneous (Pharmacology), Subject name: Pharmacology
[{'content': 'Gingival hypertrophy and hirsutism are the side effects of following Antiepileptic drug use \nSelect and explain. \nA. Diazepam, B. Primidone, C. Carbamazepine, D. Diphenylhydantoin', 'role': 'user'}, {'content': 'Answer: D \nExplanation: (D) Diphenylhydantoin # Gum hypertrophy: Commonest (20% incidence), more in younger patients, can be minimized by maintaining oral hygiene.> Hirsutism, coarsening of facial features (troublesome in young girls), acne.# Adverse effects These are numerous; some occur at therapeutic plasma concentration after prolonged use, while others are manifestation or toxicity due to overdose.# At therapeutic levels> Gum hypertrophy: Commonest (20% incidence), more in younger patients, can be minimized by maintaining oral hygiene.> Hirsutism, coarsening of facial features (troublesome in young girls), acne.> Hypersensitivity reactions are--rashes, DLE, lymphadenopathy; neutropenia is rare but requires discontinuation of therapy.> Megaloblastic anaemia: phenytoin decreases folate absorption and increases its excretion.> Osteomalacia: phenytoin desensitizes target tissues to vitamin D and interferes with calcium metabolism.> It can inhibit insulin release and cause hyperglycaemia.> Used during pregnancy--can produce foetal hydantoin syndrome (hypoplastic phalanges, cleft palate, hare lip, microcephaly), which is probably caused by its areneoxide metabolite.', 'role': 'assistant'}]