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USMLE Reproductive > Teratogens > Flashcards

Teratogens Flashcards

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USMLE® Step 1 flashcards
1
Q

What are some of the effects of ACEi in pregnancy?

A

1st trimester numerous congenital malformations
- Hypocalvaria (absent skull bones)

2/3rd trimester: Oligohydramnios

  • Decreased fetal kidney function
  • Fetal renal failure
  • Potter’s syndrome
  • Pulmonary hypoplasia, limb/skeletal deformities
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2
Q

What time period is the fetus most susceptible to teratogens?

A

Weeks 2 - 8

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3
Q

What are some of the teratogenic effects of antiepileptic drugs (Valproate, carbamazepine, phenytoin, phenobarbital) cause?

A
  • Neural tube defects
  • Cardiac defects
  • Cleft palate
  • Skeletal abnormalities (phalynx/nail hypoplasia, facial dysmorphism)
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4
Q

What are the teratogenic effects of alkylating agents?

A
  • Multiple anomalies

- Absence of digits

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5
Q

What are the teratogenic effects of aminoglycosides?

A

Ototoxicity

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6
Q

What are the teratogenic effects of diethylstillbesterol?

A
  • Hypoplastic uterus, cervical hypoplasia, vaginal adenosis + metaplasia
  • Vaginal clear cell adenocarcinoma
  • Congenital Mullerian anomalies
  • Infertility
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7
Q

What are the teratogenic effects of fluoroquinolones?

A

Cartilage damage

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8
Q

What are examples of folate antagonists which may cause NT defects?

A
  • Antiepileptics
  • Trimethoprim
  • Methotrexate (can induce abortion in ectopic)
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9
Q

What is a drug which is a folate antagonist that may also induce abortion in ectopic pregnancy?

A

Methotrexate

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10
Q

What might sulfonamides cause in the newborn?

A

Kernicterus

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11
Q

What acne medication may have teratogenic effects?

A

Isotretinoin

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12
Q

What are the teratogenic effects of Isotretinoin (or large amounts of Vit A)?

A

Craniofacial

  • Microtia (missing ear)
  • Dysmorphism

CNS, cardiac, thymic defects

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13
Q

What defect may be present in the baby of a mother taking lithium?

A

Ebstein anomaly

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14
Q

What are the teratogenic effects of Methimazole (used to treat hyperthyroidism)?

A
  • Aplasia cutis congenita (congenital absence of skin, particularly on the scalp)
  • Propylthiouracil (PTU) used instead
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15
Q

What are the teratogenic effects of tetracyclines?

A
  • Discoloured teeth

- Inhibited bone growth

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16
Q

What are the teratogenic effects of thalidomide?

A

Limb defects (phocomelia, micromelia - ‘flipper’ limbs)

17
Q

What are the teratogenic effects of Warfarin?

A
  • Bone and cartilage abnormalities
  • Stippled epiphyses (small white dots on X-ray)
  • Nasal and limb hypoplasia
  • Optic nerve atrophy
  • Fetal cerebral hemorrhage
18
Q

What is used instead of warfarin in pregnant mothers?

A

Heparin

19
Q

What are the characteristic facial features in fetal alcohol syndrome?

A
  • Smooth philtrum
  • Thin vermillion border (upper lip)
  • Short palpebral fissures (small opening of eyes)
20
Q

What is one of the hypotheses for fetal alcohol syndrome’s features?

A

Impaired migration of neuronal and glial cells

21
Q

What are possible features of fetal alcohol syndrome?

A
  • Developmental delay
  • Microcephaly, holoprosencephaly (severe)
  • Heart defects (ASD, VSD, tetralogy of fallot)
  • Heart-lung fistulas (severe)
  • Limb defects (fingers, hip)
  • Facial abnormalities
22
Q

What are the teratogenic effects of cocaine?

A
  • Preterm birth, low birth weight (vasoconstriction), IUGR

- Placental abruption

23
Q

What are the teratogenic effects of smoking?

A
  • Low birth weight, preterm labor (vasoconstriction)
  • Placental problems
  • IUGR
  • ADHD
  • SIDS (sudden infant death syndrome)
24
Q

What are the teratogenic effects of iodine?

A
  • Congenital hypothyroidism (cretinism)

- Congenital goiter

25
Q

What are the effects on the fetus/neonate of maternal diabetes?

A
  • Large baby (macrosomia) -> shoulder dystocia
  • Neonatal hypoglycemia (islet cell hyperplasia)
  • Heart defects (VSD, transposition)
  • Polycythemia
  • Neural tube defects
  • Neonatal respiratory distress syndrome
  • Caudal regression syndrome (sacral agenesis, sirenomelia/mermaid legs)
26
Q

What are teratogenic effects of methylmercury (fish)?

A
  • Neurotoxicity -> delayed milestones
27
Q

What are teratogenic effects of X-rays?

A
  • Microcephaly
  • Intellectual disability
    Minimised by lead shielding
28
Q

Describe neonatal abstinence syndrome?

A

Secondary to usually opioids

  • Uncoordinated sucking reflexes
  • Irritability, high-pitched crying
  • Tremors
  • Tachypnea
  • Sneezing
  • Diarrhea
  • Seizures
29
Q

What is neonatal abstinence syndrome treated with?

A
  • Methadone
  • Morphine
  • Buprenorphine
30
Q

What are the effects of phenylalanine (mother w. PKU) on the baby?

A
  • IUGR
  • Retardation
  • Microcephaly
  • Cocarc of aorta, hypoplastic L heart

USMLE Reproductive (14 decks)

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