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Y4R1 - Pediatrics I 👶 > L7: Teratogenicity > Flashcards

L7: Teratogenicity Flashcards

1
Q

Def of Teratogen

A
  • Any agent that can produce malformation (birth defect), by interfering with normal embryonic & fetal development.
  • Teratogen acts on somatic cells of the developing organism → produce birth defect.
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2
Q

Teratogen acts on somatic cells of the developing organism → produce birth defect.

A

..

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3
Q

Def of Teratogenicity

A

Capability of producing fetal malformation.

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4
Q

Def of Teratology

A

Science studies cause, mechanism & pattern of abnormal development

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5
Q

Difference Between Teratogen & Mutagen

A
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6
Q

Incidence of Teratogenicity

A
  • An estimated 303.000 newborns die within 28 days of birth every year worldwide due to congenital anomalies.
  • Approximately 10% of all birth defects are attributed to teratogens.
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7
Q

Principles of Clinical Teratology

A
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8
Q

Exposure to teratogen in

  • Pre-implantation
A
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9
Q

Exposure to teratogen in

  • Implantation to time of organogenesis
A
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10
Q

Exposure to teratogen in

  • Fetal –> neonatal Stage
A
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11
Q

Factors affecting Teratogenicity

A
  • Time of exposure
  • Dosage
  • Hereditary predisposition
  • Specificity of teratogens
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12
Q

Factors affecting Teratogenicity

  • Time of Exposure
A
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13
Q

Factors affecting Teratogenicity

  • Dosage
A

Depend on:

  • Maternal response
  • The ability to metabolize the chemical (such as delayed clearance).
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14
Q

MOA of Teratogens

A
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15
Q

Importance of preventive medicine

A
  • Knowledge of which agents are potential teratogens and their effect on the developing fetus is important because limiting exposure to teratogens is an effective way to prevent birth defects.
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16
Q

Types of Teratogenic Agents

A
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17
Q

Drugs & Chemical Teratogens

  • Alcohol
A
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18
Q

Drugs & Chemical Teratogens

  • Lithium
A

Ebstein anomaly

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19
Q

Drugs & Chemical Teratogens

  • Toluene
A
  • Microcephaly, Psychomotor retardation.
  • Caudal regression sequence.
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20
Q

Drugs & Chemical Teratogens

  • Tobacco
A
  • Dose related IUGR
  • Fetal loss.
  • Prematurity
  • Neonatal death
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21
Q

Drugs & Chemical Teratogens

  • Lead
A
  • Anemia
  • Abortion
  • Neurological disorders
  • Mental retardation
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22
Q

Drugs & Chemical Teratogens

  • CO
A
  • Still birth
  • Spontaneous Abortion
  • Prematurity
  • Growth retardation
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23
Q

Drugs & Chemical Teratogens

  • Mercury
A
  • Minamata syndrome (Multiple neurological symptoms)
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24
Q

Drugs & Chemical Teratogens

  • Pesticides
A

Incraesed risk of fetal death

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25
Q

Drugs & Chemical Teratogens

  • Chloroquine
A

Deafness, Chorioretinitis

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26
Q

Drugs & Chemical Teratogens

  • Pencillamine
A

Cutis laxa syndrome

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27
Q

Drugs & Chemical Teratogens

  • Warfarin
A
  • Nasal hypoplasia
  • Stippled epiphysis
  • Hypoplasia of terminal and proximal phalanx of index finger
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28
Q

Drugs & Chemical Teratogens

  • Streptomycin
A

Deafness (10 - 15% sensori-neural hearing loss)

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29
Q

Drugs & Chemical Teratogens

  • Tetracycline
A
  • Enamel hypoplasia (Increased caries)
  • Permanent teeth discoloration
  • Diminished growth of long bones (weakened fetal bones)
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30
Q

Drugs & Chemical Teratogens

  • Trimethoprim
A
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31
Q

Drugs & Chemical Teratogens

  • Anticonvulsants
A
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32
Q

The least teratogenic anticonvulsant is …….

A

phenobarbitone

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33
Q

Drugs & Chemical Teratogens

  • Phenytoin
A
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34
Q

Drugs & Chemical Teratogens

  • Valproic Acid
A
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35
Q

Drugs & Chemical Teratogens

  • Fetal valproic Syndrome
A
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36
Q

Drugs & Chemical Teratogens

  • Diazepam
A
  • 1st trimester exposure: increased risk for cleft lip and palate.
37
Q

Drugs & Chemical Teratogens

  • Carbamazpine (Tegretol)
A

Phenotype similar to FHS

38
Q

Drugs & Chemical Teratogens

  • Cocaine
A
39
Q

Drugs & Chemical Teratogens

  • Thalidomide
A
40
Q

Drugs & Chemical Teratogens

  • ACEI
A
41
Q

Drugs & Chemical Teratogens

  • Vit A
A
42
Q

Drugs & Chemical Teratogens

  • hormones
A
43
Q

Drugs & Chemical Teratogens

  • OCP
A
44
Q

Drugs & Chemical Teratogens

  • Androgenic Agents
A
45
Q

Drugs & Chemical Teratogens

  • Aspirin
A

In the 1st trimester —-> cleft palate.

46
Q

Drugs & Chemical Teratogens

  • Chemotherapy
A

All Chemotherapy —> Multiple congenital anomalies

47
Q

Drugs & Chemical Teratogens

  • Metronidazole
A
  • If it used in first trimester, it may cause fetal malformations. –> but using it in second and third trimester is acceptable
48
Q

Drugs & Chemical Teratogens

  • Corticosteroids
A

1% risk for cleft palate or adrenal atrophy.

49
Q

Drugs & Chemical Teratogens

  • Retinoids
A
  • Eye and ear defects —> Hydrocephalus
50
Q

Classification Based on Teratogenie Potential

A
51
Q

Classification Based on Teratogenie Potential

  • Category A
A
52
Q

Classification Based on Teratogenie Potential

  • Category B
A
53
Q

Classification Based on Teratogenie Potential

  • Category C
A
54
Q

Classification Based on Teratogenie Potential

  • Category D
A
55
Q

Classification Based on Teratogenie Potential

  • Category X
A
56
Q

Teratogenic Maternal Infections

A
  • CMV
  • HSV
  • VZV
  • Rubella
  • HIV
  • Syphilis
  • Toxoplasma
  • TB
57
Q

Teratogenic Maternal Infections

  • CMV
A
58
Q

Teratogenic Maternal Infections

  • HSV
A
59
Q

Teratogenic Maternal Infections

  • VZV
A
60
Q

Teratogenic Maternal Infections

  • Rubella
A
61
Q

Teratogenic Maternal Infections

  • HIV/AIDS
A
62
Q

Teratogenic Maternal Infections

  • Syphilis
A
63
Q

Teratogenic Maternal Infections

  • Toxoplasma
A
64
Q

Teratogenic Maternal Infections

  • TB
A

Weight loss - lymphadenopathy - refusal to suckle - hepatosplenomegaly

65
Q

Teratogenic Physical Agents

A
  • Ionizing Radiation
  • Maternal Hyperthermia
66
Q

Teratogenic Physical Agents

  • Ionizing Radiations
A
67
Q

Teratogenic Effects of Ionizing Radiation

A
68
Q

Teratogenic Effects of Ionizing Radiation

  • Most Sensitive Time
A

from 2nd to 5th week.

69
Q

Teratogenic Effects of Ionizing Radiation

  • Safe Time
A
  • Beyond 20w: the fetus id completely developed and become more resistant to the effect of radiation
70
Q

Teratogenic Effects of Maternal Hyperthermia

A
71
Q

Teratogenic Maternal Diseases

A
  • DM
  • Hyperthyroidism
  • Hypothyroidism
  • SLE
  • PKU
  • Malnutrition
72
Q

Teratogenic Maternal Diseases

  • DM
A
73
Q

Teratogenic DM effects

  • Which Type?
A

DM Type I is More

74
Q

Teratogenic DM effects

  • Neural
A
  • Neural tube defect: anencephaly, spina bifida
  • Hydrocephalus, holoprosencephaly
75
Q

Teratogenic DM effects

  • Heart
A

CHD: TGA (8%), hypertrophic cardiomyopathy

76
Q

Teratogenic DM effects

  • Renal
A

Renal disorders: Agenesis, double ureter, renal vein thrombosis

77
Q

Teratogenic DM effects

  • Others
A
78
Q

Teratogenic Hyperthyroid effects

A
79
Q

Teratogenic Hypothyroid effects

A

Increased risk for loss of pregnancy

80
Q

Teratogenic SLE effects

A
  • Early Loss of pregnancy
  • Complete Heart Block
  • Lupus Rash
81
Q

Teratogenic PKU effects

A
82
Q

Teratogenic effects

  • Vit A Deficiency
A

Anophthalmia

83
Q

Teratogenic effects

  • FA Deficiency
A
84
Q

Teratogenic effects

  • Vit D Deficiency
A

Bone & teeth malformation

85
Q

Teratogenic effects

  • Ca Deficiency
A

Bone Malformtions

86
Q

Teratogenic effects

  • K deficiency
A

Preterm Labor

87
Q

Teratogenic effects

  • Fe Deficiency
A

Anemia

88
Q

Notes on thyroid Disorders & teratogenicity

A
89
Q

Father Role in Teratogenicity

A

Y4R1 - Pediatrics I 👶 (28 decks)

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