Teratogens

Question 1

ACE inhibitors

Answer 1

renal failure, oligohydramnios, hypocalvaria

Question 2

alkylating agents

Answer 2

multiple anomalies (e.g., ear/facial abnormalities, absence of digits)

Question 3

aminoglycosides

Answer 3

ototoxicity

Question 4

antiepileptic drugs

Answer 4

neural tube defects, cardiac defects, cleft palate, skeletal abnormalities (phalanx/nail hypoplasia, facial dysmorphism)

most commonly due to valproate, carbamazepine, phenytoin, phenobarbital

Question 5

diethylstilbestrol

Answer 5

vaginal clear cell adenocarcinoma, congenital Mullerian anomalies

Question 6

fluoroquinolones

Answer 6

cartilage damage

Question 7

folate antagonists

Answer 7

neural tube defects

most commonly due to trimethoprim, methotrexate

Question 8

isotretinoin

Answer 8

craniofacial (microtia, dysmorphism), CNS, cardiac, thymic defects

contraception mandatory

Question 9

lithium

Answer 9

Ebstein anomaly

Question 10

methimazole

Answer 10

aplasia cutis congenita (congenital absence of skin, typically on scalp)

Question 11

tetracyclines

Answer 11

discolored teeth, inhibited bone growth

Question 12

thalidomide

Answer 12

limb defects (phocomelia: flipper-like limbs)

Question 13

warfarin

Answer 13

bone and cartilage deformities (stippled epiphyses, nasal and limb hypoplasia), optic nerve atrophy, cerebral hemorrhage

Question 14

alcohol

Answer 14

fetal alcohol syndrome

Question 15

cocaine

Answer 15

preterm birth, low birth weight, fetal growth restriction (FGR)

cocaine => vasoconstriction

Question 16

tobacco smoking

Answer 16

preterm birth, low birth weight, FGR, sudden infant death syndrome, ADHD

nicotine => vasoconstriction; CO => impaired O2 delivery

Question 17

iodine lack or excess

Answer 17

congenital hypothyroidism

Question 18

maternal diabetes

Answer 18

caudal regression syndrome, cardiac defects (transposition of the great arteries, VSD), neural tube defects, macrosomia, neonatal hypoglycemia (islet cell hyperplasia), polycythemia, respiratory distress syndrome

Question 19

maternal PKU

Answer 19

fetal growth restriction, microcephaly, intellectual disability, congenital heart defects

Question 20

methylmercury

Answer 20

neurotoxicity

increased concentration in top-predator fish (shark, swordfish, king mackerel, tilefish)

Question 21

x-rays

Answer 21

microcephaly, intellectual disability