Harvluck B11 W3 Flashcards
Yellow card marking system
Post-marketing surveillance of drugs to find information about side effects.
Fetotoxic effects of oestrogen
Feminisation of male foetus
Threshold dose where teratogen has no observable effect
No observable effect level
Type of Intrauterine growth restriction in later pregnancy
Assymetrical
Percentage of birth defects that are genetic
20%
Fetotoxic drugs after first trimester
Quinolones and tetracyclines
Effect of vitamin A on foetus
Spina bifida malformation, cleft palate and limb deformity.
Point in gestation where newborn weight doubles
5 Months
What is cephalo-caudal progression?
Development begins from head to toe
APGAR score
Used to assess newborn baby:
Appearance
Pulse
Grimace
Activity
Respiration
Difference between foramen ovale and fossa ovalis?
Foramen ovale is the hole between the L and R atria prior to birth. Fossa ovalis is the adult depression in the upper R atria.
Monotopic defect
Localised defect to one system
Polytopic defect
Multi-system defect due to one event.
When is the fundus palpable?
Week 22
Uterine arteries to placenta
Provide high flow and low resistance blood to the placenta.
When is renal function fully achieved?
36 weeks
Antibiotics prescribed in pregnancy
Penicillin, cephalosporin and erythromycin and candamycin
Effect of ACE inhibitors on foetus
Reduces kidney function, leading to ologihydroamniosis, lung and kidney hypoplasia and hypotension.
Teratogenic metabolic disease
Diabetes mellitus
Closure of ductus venosus
Spasm of smooth muscle due to increase in O2 and decrease in prostaglandins
Background risk of congenital malformation
2-3%
Effect of benzodiazepines
Sedative medication which causes neonatal respiratory depression
Warfarin foetotoxic effects
Nasal hypoplasia and skeletal defects
Dysparenia
Painful sex
Antibiotic which reduces teeth formation
Tetracycline
Effect of anti-depressants
Impacts foetus after first trimester and causes neonatal withdrawal syndrome
Insulin-like growth factor in 1st trimester
IGF-2
Role of IGF-1 in foetus
Regulates foetal growth and development in the 2nd and 3rd trimester, for organ size increase
What is the role of colostrum?
Contains many anti-viral and anti-infective properties for priming of foetal gut
Raised umbilical artery index and absent end diastolic flow- indication
Foetal hypoxia
How does drug excretion change in pregnancy?
Increased excretion due to 30-50% in GFR kidney function and decrease in albumin due to greater plasma volume as a result of oedema
Turner syndrome
Abnormal urethra opening on penis underside
Cause of great vessel transposition
Exposure to teratogens 34 days post-conception
Consequence of rubella virus infection in foetus
Affects development of sensory organs of eyes and ears + heart. It results in microencephaly and cataracts
Talipes- defect type
Deformation
Drugs which cannot cross placenta
Insulin, heparin, iron dextran
Marriage of two related people
consanguineous
Newborn examination looks at:
Eyes, heart, hips, testicles and hips.
Period where functional specialisation of lungs occurs
Foetal period
Effect of smoking on foetus
Hypoxia and vasoconstriction
When does CRL have highest increase?
Pre-embryonic and embryonic period and foetal period.
Hormones for foetal growth
Insulin, Leptin, IGF-1 and IGF-2 and TNF-lapha
Treatment of severe nausea in pregnancy
Corticosteroids
Formation of bronchioles in foetus
Week 8-16
pH of breast milk compared to plasma
breast milk pH is 7.4
Stage of foetal lung development where premature baby is viable
Terminal sac stage
Effect of cocaine on pregnancy
Maternal vasodilation and hypoxia
Which shunt closes first when placental support ends?
Ductus arteriosus
Genetic tests for identifying congenital abnormalities
DNA analysis
Cytogenetic testing
Fluorescence in situ hybridisation
Microdeletion analysis
Fluorescence in situ hybridisation
Uses DNA probes to analyse individual cell genomes
Trisomy 18 defect
Edward’s syndrome that leads to foetal growth restriction
Biochemical tests in pregnancy
Hcg
Oestriol
A-fetoprotein
Late sign of foetal hypoxia
Reverse end diastolic flow
Birth defects from radiation poisoning
Microencephaly, spina bifida, blindness
Routes of teratogenic exposure from most to least harmful
Parenteral transmission: Bypasses GI system
Oral
Topical
Example of transplacental carcinogenicity
Diethylstilboestrol
Mendelian disorders
Monogenic inheritance, with expression in the phenotype
Multifactorial inheritance
Polygenic
Cause of cleft lip
Exposure to teratogen 36 days post-exposure
Antenatal test for congenital abnormalities
Triple test, nuchal fold and anomaly scan
Nuchal fold
Fold of skin at the back of foetal neck present during 2nd pregnancy trimester
-> Increased thickness is associated with abnormalities
Most common form of spina bifida
Spina bifida occulta
Most severe form of spina bifida
Meningococele spina bifida where the meninges protrude through the spine
Growth phase where height increase is slowest?
Pre-pubertal
Percentage of children walking by 13 mths
70%
Percentage of children walking by 1 year
50%
Percentage of children walking by 15 mths
90%
Cause of IUGR
Infection: TORCH
Maternal malnutrition, hypertension, cardiovascular disease + smoking
Placental factors: infarction, abruption, insufficiency
Cause of assymmetrical intrauterine growth?
Occurs in later hypertrophic stage of development where glycogen deposition in liver and adipose deposition of brown fat happens.
Cause of symmetrical intrauterine growth?
Occurs in early stage of foetal growth which is driven by hyperplasia.
