Development and Teratogenesis Flashcards

1
Q

Teratogens

A

Come from the outside

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2
Q

4 classes of teratogens and examples

A
Maternal illness (PKU, diabetes)
INfectious agents (TORCH) 
Physical agents (radiation or heat exposure)
Drugs (thalidomide, antiepileptic drugs)
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3
Q

Response ot teratogens

A

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

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4
Q

All or nothing theory

A

In enough cells die, spontaneous abortion

If only a few cells die, others can compensate

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5
Q

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

A

10-14

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6
Q

Day 27

A

Closure of neural tube

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7
Q

Day 30

A

Appearance of limb buds

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8
Q

Weeks 4 and 5

A

Branchial arches, clefts, piuches, and optic vesicle

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9
Q

Week 5 to 7

A

HEart and kidneys

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10
Q

Week 8

A

Mature limb architecture

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11
Q

Weeks 7 to 10

A

Internal and external genitalia

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12
Q

Week 10

A

Rotation into abdominal cavity

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13
Q

Teratogenesis occurs _______

A

After fertilization

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14
Q

Toxic mutagenesis

A

Exposure prior to conception causing mutations

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15
Q

Toxic mutagenesis females vs. males

A

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

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16
Q

Infectious agents mechanisms

A

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

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17
Q

Infectious teratogenic agents

A

TORCH, varicella, and parvovirus B19

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18
Q

TORCH infection

A

Toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis

19
Q

Maternal illnesses mech

A

Diffusion of teratogenic metabolite or antibody across the placenta

20
Q

Insulin-dependent diabetes mellitus birth defect

A

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

21
Q

PKU (in short)

A

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

Causes phenylalanine embryopathy

Treat using low Phe diet

22
Q

Androgen-producing tumors effect

A

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

23
Q

MG can lead to

A

Transient neonatal myasthenia

24
Q

Maternal illness antibody diseases

A

Transient neonatal myasthenia and systemic lupus erythematosus

25
Q

Maternal antibodies can

A

Cross placenta into the fetus

26
Q

Systemic lupus erythematosus can lead to

A

Fetal heart block

27
Q

Elevation in maternal core temperature can lead to

A

Neural tube defects

28
Q

ACE inhibitors can cause

A

Miscarriage
Oligohydramnios
Renal failure
Hypotension

29
Q

Antiepileptics can cause

A

Cardiovascular
Orofacial clefts
Neural tube malformations
GU defects

30
Q

Teratogenic meds

A
Thalidomide 
Retinoic Acid
Statins 
ACE inhibitors 
Antiepileptics
31
Q

FASD includes

A

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

32
Q

Alcohol can affect

A

CNS abnormalities, growth retardation, facial dysmorphism and abnormalities

33
Q

First trimester alcohol

A

Facial anomalies/structural anomalies/including brain size

34
Q

Second trimester alcohol

A

Increased spontaneous abortion

35
Q

Third trimester - alcohol

A

Predominantly effects weight, length, and brain growth

36
Q

How are FAS and pFAS different than ND-PAE

A

No facial dysmorphology or growth retardation

37
Q

Clinical features at birth - alcohol

A

Facial dysmorphism

38
Q

Facial dysmorphism of FAS

A

Short palpebral fissure
Thin vermillion border
Smooth philtrum

39
Q

Structural CNS impairment - alcohol

A

Decreased head size

40
Q

Neurologic CNS impairment - alcohol

A

Hard - reflexes, tone, cranial nerve defects

Soft - poor coordination or balance

41
Q

FAS diagnosis

A

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

42
Q

pFAS diagnosis

A

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

43
Q

NDPAE diagnosis

A

Requires confirmation

Imapaired cog function, self-regulation, and adaptive function