Fetal conditions - Teratology Flashcards

1
Q

What is the major cause of birth defects?

A

Unknown; 65%

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2
Q

Chemically induced birth defects, which include those caused by medications, are believed to account for ____ percent of all birth defects

A

Less than 1

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3
Q

Teratogen vs hadegen vs trophogen

  • An agent that interferes with normal maturation and function of an organ
  • Any agent that acts during embryonic or fetal development to produce a permanent alteration of form or function
  • An agent that alters growth
A
  • An agent that interferes with normal maturation and function of an organ
    • ​Hadegen
  • Any agent that acts during embryonic or fetal development to produce a permanent alteration of form or function
    • _​_Teratogen
  • An agent that alters growth
    • Trophogen

Summary:

  • Hadegen – maturation and function
  • Trophogen – growth

Memory aid:

  • Growthrophogen
  • AlTERation – TERatogen
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4
Q

Criteria for a teratogen

A
  • The defect must be completely characterized
  • The agent must cross the placenta
  • Exposure must occur during a critical developmental period
  • There must be a biologically plausible association
  • Epidemiological findings must be consistent
  • The suspected teratogen causes a defect in an animal
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5
Q

Teratogenesis is studied by ____

A

Treating pregnant female animals of at least 2 species at selected times during early pregnancy when organogenesis takes place

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6
Q

Ethanol is a potent teratogen and can cause fetal alcohol syndrome characterized by ____, ____ and ____

A
  • Central nervous system dysfunction
  • Growth restriction (pre- or post-natal)
  • Facial abnormalities
    • Small palpebral fissures
    • Thin vermilion border
    • Smooth, hypoplastic philtrum

Memory aid:

  • Alcoholic C-G-F
    • CNS dysfunction
    • Growth restriction
    • Facial abnormalities
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7
Q

Binge drinking has been linked to an increased risk of ____

A

Stillbirth

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8
Q

Fetal alcohol syndrome

  • Most severe form
  • Mechanism
A
  • Most severe form
    • Heart-lung fistulas and holoprosencephaly
  • Mechanism
    • Failure of cell migration
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9
Q

Both ____ and ____ have been reported in preterm newborns and adults treated with gentamicin or streptomycin

A

Nephrotoxicity and ototoxicity

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10
Q

What may develop when chloramphenicol is given to preterm neonate?

A

Gray baby syndrome

  • Cyanosis
  • Vascular collapse
  • Death
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11
Q

Teratogenic effects of nitrofurantoin

A

Seen in first trimester

  • Cleft
  • Hypoplastic left heart syndrome
  • ASD
  • Micropthalmia

Memory aid:

  • Nitro causes micro
    • Small left heart
    • Small eyes
    • Septal defect
    • Cleft
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12
Q

Effects of sulfonamides

A
  • Kernicterus
  • Anencephaly
  • Left ventricular outflow tract obstruction
  • Choanal atresia
  • Diaphragmatic hernia
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13
Q

Tetracycline may cause:

A
  • When used after 25 weeks
    • Yellow-brown discoloration of deciduous teeth
    • Deposition in fetal long bone
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14
Q

Effects of immunosuppressants

  • Corticosteroid
  • Mycophenolic acid
A
  • Corticosteroid
    • Cleft
  • Mycophenolic acid
    • Miscarriage or malformation (ear defects)

Memory aid:

  • _C_orticosteroid | _C_left
  • _M_ycophenolat_E__M_iscarriage or _M_alformation _E_ar defect
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15
Q

Effects of diethylstilbestrol (DES)

A
  • Female
    • Vaginal clear cell adenocarcinoma
    • T-shaped uterine cavity
    • Cervical collar
    • Breast cancer
  • Male
    • Epididymal cysts
    • Hypospadias
    • Cryptorchidism
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16
Q

Effect of warfarin

  • 6th to 9th week
  • 2nd and 3rd trimester
  • Generally
A
  • 6th to 9th week
    • Warfarin embryopathy (chondrodysplasia)
  • 2nd and 3rd trimester
    • CNS malformation and hemorrhage, respectively
  • Generally
    • Nasal hypoplasia
    • Bone deformities
    • Abortion
    • Fetal hemorrhage
    • Ophthalmologic abnormalities
17
Q

Effects of methotrexate

A
  • Clover-leaf skull
  • Wide nasal bridge
  • Low set ears
  • Micrognathia
  • Limb abnormalities
18
Q

Effects of radioiodine

A
  • Irreversible hypothyroidism
  • Risk for thyroid cancer
19
Q

Effect of lithium

A

Ebstein anomaly

  • Atrialization of the right ventricle
  • Memory aid:*
  • LIThium – _L_ow _I_mplantation _T_ricuspid
20
Q

Most potent teratogen

  • Teratogen
  • Effect
A
  • Teratogen
    • Retinoids (isotretinoin)
  • Effect
    • Cranial-neural crest defect
21
Q

Preformed vitamin A

  • Form
  • Level that may cause defect
A
  • Form
    • Retinol
  • Level that may cause defect
    • > 10,000 mIU/day
22
Q

Neonatal effects of SSRI

A
  • Neonatal abstinence syndrome
    • jitteriness or shivering
    • increased muscle tone
    • feeding or digestive disturbances
    • irritability or agitation
    • respiratory distress
  • Persistent pulmonary hypertension of the newborn

Summary:

  • Not considered a teratogen
  • Neonatal effects, so most probably, signs of withdrawal
23
Q

Paroxetine fetal effects

A

ASD and VSD

  • Memory aid:*
  • _S_SRI _P_aroxetin causes _S_hunt _P_roblems
24
Q

T/F. Antipsychotics are considered teratogenic

A

False; but they cause EPS and withdrawal symptoms

25
Q

Effect of ACE inhibitors

A

Fetal renal damage

26
Q

Effect of anti-epileptic drugs

A

Neural tube defects

  • Note:*
  • Anti-epileptic drugs are folate antagonists
27
Q

Effect of phenytoin

A

Fetal hydantoin syndrome

28
Q

Effect of OHAs

A

Neonatal hypoglycemia

29
Q

Effects of barbiturates

A

Neonatal dependence

30
Q

Effect of misoprostol

A

Mobius sequence, a rare neurological disorder characterized by weakness or paralysis (palsy) of multiple cranial nerves, most often the 6th (abducens) and 7th (facial) nerves

Memory aid:

  • Misoprostol
  • Mobius sequence
  • Multiple CN problems
31
Q

Effects of penicillamine

A

Cutis laxa, a group of rare connective tissue disorders in which the skin becomes inelastic and hangs loosely in folds

32
Q

Effects of methimazole

A

Aplasia cutis congenita

33
Q

Effect of fluoroquinolones

A

Cartilage damage

Memory aid:

  • _C_iprofloxacin
  • _C_artilage
34
Q

Effects of alkylating agents

A

Absence of digits, multiple anomalies

35
Q

Effects of cocaine

A
  • Low birth weight
  • Preterm birth
  • IUGR
  • Placental abruption

Memory aid:

  • COcaine is a
  • COnstrictor
36
Q

Effects of smoking

A
  • Low birth weight (leading cause in developed countries)
  • Preterm labor
  • Placental problems
  • IUGR
  • SIDS
37
Q

Methylmercury

  • Effect
  • Sources
A
  • Effect
    • Neurotoxicity
  • Sources
    • Swordfish
    • Shark
    • Tilefish
    • King mackerel
38
Q

X-rays

A

Microcephaly, intellectual disability