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Endocrine > 181. Fetal Origins of Disease > Flashcards

181. Fetal Origins of Disease Flashcards

1
Q

Type of fuel-mediated teratogenesis

Occurs when:
- mother’s insulin decreases –> increase in plasma glucose, AA’s, lipids which cross the placenta –> Increase in mixed nutrients in placenta –> increased insulin of fetus –> macrosomia, hypoglycemia, obesity, IGT –> diabetes mellitus

A

Developmental over-nutrition

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2
Q

Thin-fat baby phenomenon:
- fetal undernutrition leads to small babies that are at an increased risk for __ __

Low birth weight => catch-up growth (preferential to fat tissue instead of lean tissue)
- increased metabolic load

A

Insulin resistance

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3
Q

All are part of the __:

  • fetal origins of adult disease
  • thrifty phenotype
  • fuel-mediated teratogenesis
  • developmental overnutrition
A

Developmental Origins of Health and Disease Paradigm

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4
Q

Intrauterine growth restriction (IUGR) can occur in the setting of infection, preeclampsia, pregnancy-induced HTN, smoking, and multiples. What is the common mechanism of these conditions that leads to IUGR?

A

Placental insufficiency

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5
Q

Developmental adaptation by the fetus

Biological programming may induce a survival advantage
- fetus responding to environment

A

Plasticity

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6
Q

All of the following maternal fuels cross the placenta to the developing fetus except: (which one?)

  • insulin
  • glucose
  • AA’s
  • lipids
A

Insulin

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7
Q

Environmental exposures influence the development of the __ and __ systems

Can lead to abnormal development
- asthma risk

A

Respiratory

Immune

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8
Q

Most common type of congenital anomalies seen d/t mothers being diabetics

A

Cardiac

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9
Q

Who is more likely to develop gestational diabetes (2 types)

A
  1. Obese mothers w/ an increased metabolic load

2. Fam hx of diabetes

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10
Q

At what time period in pregnancy do mothers need to start producing more insulin than normal in order to avoid gestational diabetes
- time when fetus really starts to grow

A

Weeks 24-28

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11
Q

__, __, and __ may influence fetal neurodevelopment
- psych conditions

Could be more likely to have boys w/ ADHD

A

Anxiety
Depression
Stress

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12
Q

What is the mechanism underlying excessive fetal growth in pregnancies complicated by gestational diabetes mellitus?

Fetal insulin binds __ receptors with high affinity

A

IGF-1

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13
Q

Mother symptoms:

  • possible fetal demise d/t hypoxia
  • preeclampsia/HTN
  • preterm labor
  • operative delivery
  • c-section
  • future risk of type 2 DM
A

Gestational diabetes

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14
Q

Growth factor in utero

A

Insulin

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15
Q

Baby symptoms:

  • macrosomia
  • shoulder dystocia
  • hypoglycemia
  • jaundice d/t hyperbilirubinemia from increase erythropoeitin d/t hypoxia d/t increased tissue oxygen consumption
  • respiratory distress syndrome from decreased surfactant synthesis
A

Gestational diabetes

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16
Q

The study of changes in gene function without changes to DNA sequence
- done through methylation and acetylation

Causes variance in susceptibility to adult diseases

A

Epigenetics

17
Q

Maternal or Placental abnormalities –> fetal malnutrition (especially amino acids) –> decreased B-cell mass or islet function –> decreased fetal growth –> infant malnutrition –> decreased adult B-cell function –> non-insulin dependent diabetes –> metabolic syndrome

Also develop HTN and other organ malfunction from fetal malnutrition

A

Thrifty Phenotype Hypothesis

18
Q

Correlation was found between small size at birth and increased death rate from __

A

CAD

19
Q

Developmental disruption causing harm to the fetus
- no advantages from this

Ex: fetal alcohol syndrome, drugs, infections

A

Teratogenesis

20
Q

Only source of nutrition to the fetus

A

Placental blood flow

21
Q

Relationship between low birth weight and increased risk of __ and __

A

HTN

DM2

22
Q

Prenatal factors that can leads to adult health risk factors and adult health outcomes (2 things)

A

Maternal nutrition

Placental insufficiency

23
Q

Increased insulin in the fetus neonate causes an increase in size called..
- d/t insulin being a growth factor in insulin

A

Macrosomia

24
Q

Leads to an increased adult risk for diabetes, CVD, obesity of the fetus

Developmental programming of glucose and insulin metabolism:
- adaptations to adverse intrauterine conditions

A

Intrauterine Growth Restriction (IUGR)

Endocrine (26 decks)

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