Embryonic Teratnogens

Question 1

ACE inhibitors

Answer 1

Renal failure –> Oligohydramnios –> Potter Sequence

Question 2

Gentamicin

Answer 2

(Aminoglycosides)

Ototoxicity

Question 3

Levofloxacin

Answer 3

(Fluroquinolones)

Cartilage damage

Question 4

Tetracyclines

Answer 4

Discolored Teeth

Question 5

Cyclophosphamide

Answer 5

ear/facial abnormalities, limb hypoplasia, absence of digits

Question 6

Methotrexate

Answer 6

Neural tube defects, abortion (deals with folate metabolism) –> used to terminate ectopic pregnancy

Question 7

Carbamazepine

Answer 7

Neural tube defects

Question 8

Valproic Acid

Answer 8

Neural tube defect

Question 9

Phenytoin

Answer 9

Fetal Hydantoin syndrome (IUGR: small head, limb defects, intellectual disability)

Question 10

Lithium

Answer 10

Ebstein anamoly

Question 11

Statins

Answer 11

CNS and limb abnormalities

Question 12

Warfarin

Answer 12

facial/limb/CNS anomalies, spontaneous abortion, nasal hypoplasia

Heparin is safe during pregnancy
“Do not wage warfare on the baby, keep it happy with heparin”

Question 13

Isotretinoin

Answer 13

(Vit A agonist)
Spontaneous abortions, heart problems, neural problems, paraythroid problems

Avoid excess Vit A inpregnancy

Question 14

Diethylstilbestrol

Answer 14

(DES) Clear cell vaginal adenocarcinoma

Question 15

Thalidomide

Answer 15

(treat leprosy)

Phocomelia (severe limb hypoplasia)

Question 16

Ethanol

Answer 16

FAS:
Holoprosencephaly
intellectual disability
narrow eye openings, wide set eyes, smooth philtrum, thin upper lip, cleft palate
**MOA: failure of cell migration!!!**

Question 17

X rays

Answer 17

CNS malformations (early), cancer (late)

Question 18

Maternal diabetes

Answer 18

Cardiac defects, neural tube defects, CAUDAL REGRESSION SYNDROME

Question 19

Maternal Iodine Def

Answer 19

Hypothyroidism

Question 20

Nicotine and Cocaine

Answer 20

Placental abruption, low birth wait, IUGR

Question 21

Blueprint for skeletal morphology, code for transcription Regulators (gene & what occurs with mutation)

Answer 21

Homeobox (HOX) genes

• mut: synpolydactyly (too many fingers, fused)
• Retinoic acid alters expression

Question 22

Expressed at buds of limbs, organize anterior to posterior (gene & mut)

Answer 22

Sonic Hedgehog Gene

-mut: holoproscencephaly

Question 23

Dorsal-vetral axis

Answer 23

Wnt-7 gene

Noses and toes same dir (Nt, noses and toses)

Question 24

Limb lengthening

cause and mut

Answer 24

Fibroblast GF

-FGF rec 3 mutation: achondroplasia

Question 25

Cocaine

Answer 25

Low birth weight, preterm birth, IUGR, placental abruption

Question 26

Smoking

Answer 26

Low birth weight, preterm labor, placental problems, IUGR, SIDS

nicotine causes vasoconstriction making it bad for the placenta and umbilical a/v

Question 27

Methylmercury

Answer 27

Neurotoxicity

High in swordfish, shark, tilefish, king mackerel