Genetics/Prenatal Screening Flashcards

1
Q

define malformation

A

congenital morphologic anomaly of single organ or body part from alteration of primary development of the organ

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2
Q

teratogen exposure at 15-25 days has wha two effects?

A

CNS or cardiac

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3
Q

teratogen exposure at 20-30 days has what effects?

A

axial skeleton, limbs and muscles

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4
Q

teratogen exposure at 25-40 days has what issues?

A

eyes heart and lower limbs

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5
Q

teratogen expposure after 60 days has what implication?

A

inhibited fetal growth

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6
Q

ACE and ARBs cause what in fetus?

A

2/3rd trimester cause oligohydramnios, renal failure and pulmonary hypoplasia

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7
Q

warfarin causes what in fetus?

A

fetal bleeding, malformed bones, ID and microcephaly

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8
Q

lithium in fetus leads to what?

A

ebstein anomaly

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9
Q

what is ebstein anomaly?

A

abnormally large and poorly functional tricuspid valves

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10
Q

what does nicotine cause in fetus?

A

growth restriction

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11
Q

what is classic triad of congenital toxoplasmosis?

A

chorioretinities
hydrocephalus
intracranial calcifications

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12
Q

what is classic triad of congenital rubella?

A

sensorineural deafness
ocular defects (catracts)
cardiac anomalies (PDA)
blueberry muffin

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13
Q

what are common congenital CMV issues?

A
hearing loss
microcephaly
periventricular calcifications
chorioretinitis
petichiae
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14
Q

what can happen wiht maternal PKU?

A

if phenylalanine builds up it is toxic to developing brain

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15
Q

trisomy 18 is called what?

A

edward syndrome

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16
Q

what happens to babies with edward syndrome?

A

die in a year

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17
Q

what are the classic physical finding of edward syndrome?

A

small head and jaw
low set ears
clenching of hands
rocker bottom feet

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18
Q

what is name of trisomy 13?

A

patau syndrome

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19
Q

what are classic physical findings of patau syndrom?

A

polydactyly
holoprosencephaly
cleft lip/palate

20
Q

what does CVS stand for?

A

chorionic villus smapling

21
Q

what is sampled in CvS?

A

placental biopsy

22
Q

when do you perform a CVS?

A

10-14 weeks

23
Q

what can CVS not test for?

24
Q

when is amniocentesis performed?

A

15 weeks and beyond

25
what can you test for in amniocentesis?
NTDs
26
what is amniocentesis a measurement of?
fetal cells in the amniotic fluid
27
what is quad screening?
measurement of AFP, hCG, DIA and uE3 at 15-22 weeks gestation
28
what are typical values of AFP, uE3, hCG, and inhibin A in positive down syndrome quad screen?
low AFP and uE3 | high hCg and inhibin A
29
name some causes of elevated AFP in screening
``` NTDs, anencephaly abdominal wlal defects GI defects multiple gestations ```
30
what makes hCG?
syncytiotrophoblasts
31
when does hcg peak?
at 8 weeks gestation then decreases and plateaus
32
what is most sensitive marker for down syndrome?
hCG
33
where is uE3 made?
placenta
34
what happens to uE3 levels throughout pregnancy?
steadily increase
35
what are levels of AFP, uE3 and hCG in T18
all low
36
what are levels of AFP, uE3 and hCg in T13?
all low
37
what is AFP level in NTDs?
HIGH
38
what is cfDNA screening?
cell free screening
39
explain how we think cfDNA screening works
cell free fetal DNA circulates in maternal plasma as cells turnover during development so we can use this to sequence the genome and map it
40
when is cfDNA screening able to determine the most?
third trimester
41
what can effect the levels of cfDNA in maternal circulation?
obesity
42
what do you do to confirm results of cfDNA screening?
CVS or amniocentesis
43
what are some ultrasound signs of DS in 2nd trimester?
nuchal fold duodenal atresia AV canal absent nasal bone
44
which of T21, 18 and 13 can be well detected by fetal ultrasound?
18 and 13 are best
45
what are findings of T18 on ultrasound?
growth restirciton clenched fists cardiac defects