Development and Teratogenesis

Question 1

Teratogens

Answer 1

Come from the outside

Question 2

4 classes of teratogens and examples

Answer 2

Maternal illness (PKU, diabetes)
INfectious agents (TORCH) 
Physical agents (radiation or heat exposure)
Drugs (thalidomide, antiepileptic drugs)

Question 3

Response ot teratogens

Answer 3

Highly individual and could have to do with a lot of different things such as route, timing, dose

Question 4

All or nothing theory

Answer 4

In enough cells die, spontaneous abortion

If only a few cells die, others can compensate

Question 5

Significant exposure to teratogens during days ________ post-conception may result in cell death

Answer 5

10-14

Question 6

Day 27

Answer 6

Closure of neural tube

Question 7

Day 30

Answer 7

Appearance of limb buds

Question 8

Weeks 4 and 5

Answer 8

Branchial arches, clefts, piuches, and optic vesicle

Question 9

Week 5 to 7

Answer 9

HEart and kidneys

Question 10

Week 8

Answer 10

Mature limb architecture

Question 11

Weeks 7 to 10

Answer 11

Internal and external genitalia

Question 12

Week 10

Answer 12

Rotation into abdominal cavity

Question 13

Teratogenesis occurs _______

Answer 13

After fertilization

Question 14

Toxic mutagenesis

Answer 14

Exposure prior to conception causing mutations

Question 15

Toxic mutagenesis females vs. males

Answer 15

Females - DNA replication occurs during oogenesis years before ovulation
Males - continous spermatogensis makes males more susceptible

Question 16

Infectious agents mechanisms

Answer 16

Usually direct invasion of fetal tissues…lead to inflammation and cell death

Question 17

Infectious teratogenic agents

Answer 17

TORCH, varicella, and parvovirus B19

Question 18

TORCH infection

Answer 18

Toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis

Question 19

Maternal illnesses mech

Answer 19

Diffusion of teratogenic metabolite or antibody across the placenta

Question 20

Insulin-dependent diabetes mellitus birth defect

Answer 20

2-3 fold increase…hyperglycema can cause diabetic embryopathy resulting in major birth defects and spon abortions…glucose acts as teratogen

Question 21

PKU (in short)

Answer 21

Inability ot make tyrosin from Phe…microceph, intellectual, cong heart disease

Causes phenylalanine embryopathy

Treat using low Phe diet

Question 22

Androgen-producing tumors effect

Answer 22

In adrenals or ovaries…can lead to viriliation of female fetuses

Question 23

MG can lead to

Answer 23

Transient neonatal myasthenia

Question 24

Maternal illness antibody diseases

Answer 24

Transient neonatal myasthenia and systemic lupus erythematosus

Question 25

Maternal antibodies can

Answer 25

Cross placenta into the fetus

Question 26

Systemic lupus erythematosus can lead to

Answer 26

Fetal heart block

Question 27

Elevation in maternal core temperature can lead to

Answer 27

Neural tube defects

Question 28

ACE inhibitors can cause

Answer 28

Miscarriage Oligohydramnios Renal failure Hypotension

Question 29

Antiepileptics can cause

Answer 29

Cardiovascular Orofacial clefts Neural tube malformations GU defects

Question 30

Teratogenic meds

Answer 30

``` Thalidomide Retinoic Acid Statins ACE inhibitors Antiepileptics ```

Question 31

FASD includes

Answer 31

FAS, pFAS, Neurobehavrioal disorder with prenatal alcohol exposure (ND-PAE)

Question 32

Alcohol can affect

Answer 32

CNS abnormalities, growth retardation, facial dysmorphism and abnormalities

Question 33

First trimester alcohol

Answer 33

Facial anomalies/structural anomalies/including brain size

Question 34

Second trimester alcohol

Answer 34

Increased spontaneous abortion

Question 35

Third trimester - alcohol

Answer 35

Predominantly effects weight, length, and brain growth

Question 36

How are FAS and pFAS different than ND-PAE

Answer 36

No facial dysmorphology or growth retardation

Question 37

Clinical features at birth - alcohol

Answer 37

Facial dysmorphism

Question 38

Facial dysmorphism of FAS

Answer 38

Short palpebral fissure Thin vermillion border Smooth philtrum

Question 39

Structural CNS impairment - alcohol

Answer 39

Decreased head size

Question 40

Neurologic CNS impairment - alcohol

Answer 40

Hard - reflexes, tone, cranial nerve defects | Soft - poor coordination or balance

Question 41

FAS diagnosis

Answer 41

3 facial dysmorphology, growth retardation AND CNS involvement...does NOT require prenatal alc exposure confirmation

Question 42

pFAS diagnosis

Answer 42

Confirmation of alc exposure...2/3 facial dysmorphologies, growth retardation, OR CNS involvement

Question 43

NDPAE diagnosis

Answer 43

Requires confirmation | Imapaired cog function, self-regulation, and adaptive function