Mehl. Notable teratogens + substance abuse 03-25 (1)

Question 1

M.
- Agent that causes malformations in the fetus.
- Not an exhaustive list. Point is to be HY, not superfluous.
- Fetus is most susceptible at 3-8 weeks’ gestation.

Answer 1

.

Question 2

M. Renal issues. ?

Answer 2

ACE inhibitors

Question 3

M. ACE inhibitors? 1

Answer 3

Renal issues.

Question 4

M. Hearing issues.?

Answer 4

Aminoglycosides

Question 5

M. Aminoglycosides?

Answer 5

Hearing issues.

Question 6

M.
Neural tube defects (disrupt folate metabolism).
Fetal hydrantoin syndrome (fingernail/digital hypoplasia, facial anomalies)

Answer 6

Anti-epileptics

Question 7

M. Anti-epileptics

Answer 7

Neural tube defects (disrupt folate metabolism).
Fetal hydrantoin syndrome (fingernail/digital hypoplasia, facial anomalies)

Question 8

M. Aplasia cutis congenita, choanal atresia, esophageal atresia.?

Answer 8

Carbimazole/methimazole

Question 9

M. Carbimazole/methimazole

Answer 9

Aplasia cutis congenita, choanal atresia, esophageal atresia.

Question 10

M. Vaginal clear cell carcinoma 30-40 years later.?

Answer 10

Diethylstilbestrol (DES)

Question 11

M. Diethylstilbestrol (DES)? 1

Answer 11

Vaginal clear cell carcinoma 30-40 years later.

Question 12

M. Craniofacial and cardiac abnormalities; cleft lip/palate.?

Answer 12

Isotretinoin

Question 13

M. Isotretinoin? 2

Answer 13

Craniofacial and cardiac abnormalities; cleft lip/palate.

Question 14

M. Ebstein anomaly (atrialization of right ventricle).?

Answer 14

Lithium

Question 15

M. Lithium? 1

Answer 15

Ebstein anomaly (atrialization of right ventricle).

Question 16

M. Neural tube defects.?

Answer 16

Methotrexate

Question 17

M. Methotrexate? 1

Answer 17

Neural tube defects.

Question 18

M. Premature closure of ductus arteriosus; oligohydramnios; inhibited labor.?

Answer 18

NSAIDs

Question 19

M. NSAIDs? 3

Answer 19

Premature closure of ductus arteriosus; oligohydramnios; inhibited labor.

Question 20

M. Craniofacial anomalies; growth deficits.?

Answer 20

Ribavirin

Question 21

M. Ribavirin? 2

Answer 21

Craniofacial anomalies; growth deficits.

Question 22

M. Fetal teeth discoloration; inhibition of bone growth?

Answer 22

Tetracyclines

Question 23

M. Tetracyclines? 2

Answer 23

Fetal teeth discoloration; inhibition of bone growth

Question 24

M. Phocomelia (severe flipper-like malformation of limbs). Was used frequently in the 1950s-60s to treat nausea in pregnancy.

Answer 24

Thalidomide

Question 25

M. Thalidomide?

Answer 25

Phocomelia (severe flipper-like malformation of limbs). Was used frequently in the 1950s-60s to treat nausea in pregnancy.

Question 26

M. Bone and facial anomalies. CNS defects like Dandy-Walker malformation (HY Neuroanatomy PDF). Bleeding diathesis in fetus.

Answer 26

Warfarin

Question 27

M. Warfarin?

Answer 27

- Bone and facial anomalies. - CNS defects like Dandy-Walker malformation (HY Neuroanatomy PDF). - Bleeding diathesis in fetus.

Question 28

M. Substance abuse in pregnancy. Most common cause of mental retardation?

Answer 28

Alcohol - cause fetal alcohol syndrome; most common cause of mental retardation

Question 29

M. Substance abuse in pregnancy. Alcohol. What lips?

Answer 29

Thin vermillion border (thin upper lip).

Question 30

M. Substance abuse in pregnancy. Alcohol. What cardio/pulmo?

Answer 30

Heart/lung defects (defective neural crest migration).

Question 31

M. Substance abuse in pregnancy. Alcohol. what specific finding?

Answer 31

Smooth, flat, and/or elongated philtrum.

Question 32

M. Substance abuse in pregnancy. Alcohol. eyes?

Answer 32

Widely spaced eyes (hypertelorism), midface hypoplasia, short nose.

Question 33

M. Substance abuse in pregnancy. Amphetamines + cocaine. in uterus? neuro?

Answer 33

IUGR; cognitive deficits.

Question 34

M. Substance abuse in pregnancy. Amphetamines + cocaine. NBME can give long vignette of drug use, followed by ask what is most likely to occur in the pregnancy -> answer = “preterm delivery and birth.” Sounds non- specific and vague, but it’s still most likely in comparison to most other things.

Answer 34

.

Question 35

M. Substance abuse in pregnancy. Amphetamines + cocaine. incr risk for what?

Answer 35

Cocaine in particular also increases risk of abruptio placentae.

Question 36

M. Substance abuse in pregnancy. Anti-epileptics. disruption of what?

Answer 36

Neural tube defects (disrupt folate metabolism).

Question 37

M. Substance abuse in pregnancy. Anti-epileptics. syndrome?

Answer 37

Fetal hydrantoin syndrome (fingernail/digital hypoplasia, facial anomalies).

Question 38

M. Substance abuse in pregnancy. Heroin/opioids. CP?

Answer 38

Neonatal heroin/opioid withdrawal. Piloerection (goosebumps), yawning, rhinorrhea.

Question 39

M. Substance abuse in pregnancy. MDMA (ecstasy) uterus, neuro?

Answer 39

IUGR; cognitive deficits.

Question 40

M. Substance abuse in pregnancy. Smoking. dysfunction?

Answer 40

IUGR and reduced IQ.