Fetal Alc Exposure Flashcards

1
Q

What is the most prevalent drinking pattern during pregnancy?

A

only during first month

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2
Q

What is the second most prevalent drinking pattern during pregnancy?

A

drinking throughout pregnancy (typically due to SUD)

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3
Q

What is the third most prevalent drinking patterns prevalence?

A

starting to drink during 3rd trimester (often due to psychological stress or Dr. unknowingly saying its okay)

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4
Q

What is the iceberg idea with FASD?

A

As amount x frequency decreases, you move from directly observable issues (FAS/pFAS), to unseen functional damage (ARND)

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5
Q

How many people out of 1000 have FAS/pFAS?

A

1-7:1000

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6
Q

How many people out of 100 have ARND?

A

1-5:100

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7
Q

What are the 4 different fetal alcohol spectrum disorders?

A
  • FAS- fetal alcohol syndrome
  • pFAS- partial fetal alcohol syndrome
  • ARBD- alcohol related birth defects
  • ARND- alcohol related neurodevelopmental disorder

umbrella disorders!

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8
Q

When was FAS termed and by who?

A

1973 by Kenneth Jones and Ann Streissguth

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9
Q

When was FASD termed?

A

2004

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10
Q

What is the US monetary burden of FASD?

A

$4B/year

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11
Q

What is the prevalence of FASD as a whole?

A

1-5% although likely underestimate

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12
Q

DSM and FASD

A
  • Called Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure
  • In DSM-V (2013)
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13
Q

What are the three signs of FAS?

A
  1. Facial abnormalities
  2. Growth Retardation
  3. Brain Alterations
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14
Q

What are the facial characteristics of FAS?

A
  • thin upper lip
  • smooth philtrum
  • small head
  • underdeveloped jaw
  • flat midface
  • short eyelid opening
  • short nose
  • epicanthal folds
  • low nasal bridge
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15
Q

What are neural crest cells?

A

Cells in communication with the developing brain that give rise to a lot of tissue in the body

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16
Q

Cranial Neural Crest Cells and FAS

A
  • stem cells, many give rise to the face
  • can see and track these individuals
17
Q

When are cranial neural crest cells formed?

A

formation of these cells is first trimester

18
Q

What are the neurobehavioral consequences of prenatal alcohol?

A
  • learning, memory, and motor deficits
  • ADHD/anxiety/depression
  • social behavior problems
  • increased risk for SUD

often individuals have several of these- why its considered a spectrum

19
Q

What NTs are altered due to prenatal alc exposure?

A
  • 5-HT, dopamine
  • Glutamate, GABA
  • Opioid
  • Acetylcholine
  • etc.
20
Q

What parts of the brain are affected due to fetal alcohol exposure?

A
  • cerebral cortex
  • striatum
  • hippocampus
  • cerebellum
  • brain stem
  • dopaminergic system
  • hypothalamus

reflects the idea that alc is a dirty drug

21
Q

What happens to the corpus callosum in FAS brain?

A

very different shape/size

22
Q

How does the cerebellum appear in someone with FAS?

A
  • more gaps
  • smaller

cerebellum involved in cognitive function

23
Q

How are ventricles different in someone with FAS?

A

much larger due to brain matter loss

24
Q

What are the other known effects of prenatal alcohol?

A
  • Impaired LTP and neurogenesis (inc stem cells)
  • epigenetic changes (alterations in gene expression that can be passed down)
  • Affected neuronal migration leading to disorganized brain structure
  • white matter deficits (less myelin=info transferred at wrong speed)
25
Q

What is the typical FASD treatment and what’s wrong with it?

A
  • Anxiolytics, antidepressents, and stimulants
  • Not great bc many drug interactions and can increase risk of drug misuse
26
Q

What foods contain choline?

A

salmon, eggs, nuts, chicken, beef, broccoli

27
Q

What is choline?

A

precursor to acetylcholine

28
Q

Why is choline supplementation an idea for helping FASD?

A
  • hypothesized that choline deficiency may contribute to effects of prenatal alc exposure
  • lots of promise in animal models+ in human preliminary studies if given during pregnancy
29
Q

Behavioral therapies for FASD

A
  • works best when started early; however, difficult to diagnose unless confirmed exposure
  • in animal models, exercise and environmental enrichment helps
  • in humans, CBT and social skills intervention are used