Teratogens

Question 1

ACE inhibitors

Answer 1

Renal damage

Question 2

Alkylating agents

Answer 2

Absence of digits

multiple anomalies

Question 3

Aminoglycosides

Answer 3

Ototoxicity

“A mean guy hit the baby in the ear”

Question 4

Antiepileptic drugs

Answer 4

Neural tube defects

cardiac defects

cleft palate

skeletal abnormalities (phalanx/nail hypoplasia, facial dysmorphism)

High-dose folate supplementation
recommended

Most commonly *valproate,
*carbamazepine, *phenytoin, *phenobarbital

Question 5

Diethylstilbestrol (DES)

Answer 5

Vaginal clear cell adenocarcinoma

congenital Müllerian anomalies

Question 6

Folate antagonists

Answer 6

Neural tube defects

Includes *trimethoprim, *methotrexate, antiepileptic drugs.

Question 7

Isotretinoin

Answer 7

Multiple severe birth defects

**Contraception mandatory.

IsoTERATinoin

Question 8

Lithium

Answer 8

Ebstein anomaly (apical displacement of *tricuspid valve)

Question 9

Methimazole

Answer 9

Aplasia cutis congenita

Question 10

Tetracyclines

Answer 10

Discolored teeth

inhibited bone growth

“Teethracyclines”

Question 11

Thalidomide

Answer 11

Limb defects (*phocomelia, micromelia—“flipper” limbs)

“Limb defects with “tha-limb-domide”

Question 12

Warfarin

Answer 12

Bone deformities

fetal hemorrhage

abortion

ophthalmologic abnormalities

“Do not wage warfare on the baby; keep it heppy with heparin (does not cross placenta)”

Question 13

Alcohol

Answer 13

Common cause of birth defects and intellectual
disability

*fetal alcohol syndrome

Question 14

Cocaine

Answer 14

Low birth weight

preterm birth

IUGR- Intrauterine growth restriction

placental abruption

Cocaine–>vasoconstriction

Question 15

Smoking (nicotine, CO)

Answer 15

Low birth weight (leading cause in developed
countries)

preterm labor

placental problems

IUGR

SIDS

Nicotine–>vasoconstriction
CO–>impaired O2 delivery.

Question 16

Iodine (lack or excess)

Answer 16

Congenital goiter or hypothyroidism (cretinism)

Question 17

Maternal diabetes

Answer 17

Caudal regression syndrome (anal atresia to sirenomelia)

congenital heart defects

neural tube defects

macrosomia

Question 18

Methylmercury

Answer 18

Neurotoxicity

Highest in swordfish, shark, tilefish, king mackerel

Question 19

Vitamin A excess

Answer 19

Extremely high risk for spontaneous abortions
and birth defects (cleft palate, cardiac)

• isotretinoine- for acne
• EmergenC

Question 20

X-rays

Answer 20

Microcephaly

intellectual disability

Minimized by *lead shielding.