teratogens

Question 1

risk of major malformation in the general pop is

Answer 1

1-3 %

Question 2

what are the causes of congenital malformations?

Answer 2

65% uknown
25% genetic
< 1 % drugs/chemical

Question 3

when is the all or non period in embryology

Answer 3

time after ovulation before implantation 12 days

Question 4

when are most morphological features formed?

Answer 4

by the first trimester

Question 5

when does the placenta play a role as a barrier

Answer 5

after 5 weeks gestation -

Question 6

hyperglycemia in first 8 weeks of pregnancy increases risk of

Answer 6

cardiac defects
neural tube
hyperglycemia inducing apoptosis

Question 7

risks of uncontrolled DM on neonate

Answer 7

hypoglycemia after birth

Question 8

severe maternal hypothyroidism can cause

Answer 8

decreased IQ

Question 9

3 conditions where antibodies cross the placenta

Answer 9

1- lupus: can get congenital heart block
2- graves disease: fetal hyperthyroidism
3- IPT: fetal thrombocytopenia

Question 10

Isotretinoin accutane can cause

Answer 10

miscarriage in 40%
malformations in 25%
- small ears
- cardiac and neurological problems

Question 11

thalidomide malformations

Answer 11

• phocomelia - flipper like appendages

Question 12

period of risk for fetal warfarin syndrome

Answer 12

6-9 weeks
nasal hypoplasia
IUGR?
Stippled epiphyses

Question 13

when does the Neural tube close?

Answer 13

3-4 weeks - EARLY

-

Question 14

Carbamazepine has an early side effect

Answer 14

just NTDs 1% risk - at 3-4 weeks

Question 15

Lamotrigine

Answer 15

has no effects on malformations

Question 16

Valproic acid

Answer 16

AVOID

-2% risk - possible cardiac anomalies, emerging concern about neurocognitic development

Question 17

Phenytoin can case

Answer 17

craniofacial abnormalities
impaireed growth
fetal hydantoin syndrome
Risk is <10%

Question 18

When are ACE inhibitors teratogenic?

Answer 18

second and third trimester

- cause oliguria, renal failure, contractures, thin scalp

Question 19

lithium causes

Answer 19

Ebstein’s anomaly - insertion of the tricuspid valve is misplaced
risk < 1%

Question 20

what can you give an 18 week pregnant woman who has a DVT

Answer 20

Heparic and LMWH

- cant cross the placenta

Question 21

To treat asthma

Answer 21

bronchodilators are safe

inhaled steroids are safe

Question 22

Systemic steroids can

Answer 22

increase risk of cleft-lip and palate by 2-fold

Question 23

what is the amount of radiation that can cause miscarriage or malformations?

Answer 23

> 5-15 rads

Question 24

fetal alcohol syndrome can cause a triad

Answer 24

growth retardation
dysmorphic facies
decreased IQ and behavioral abnormalities

Question 25

how much alcohol to cause FAS

Answer 25

• 8 beers a day

2g/kg/day

Question 26

how much folic acid

Answer 26

1-5 mg daily for 3 months prior to conception

Question 27

when are drugs generally considered safe in infants

Answer 27

relative dose < 10%