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teratogens Flashcards

1
Q

early fetal development - when is extremely susceptible to teratogens

A

embryonic period (3-8 weeks)

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2
Q

teratogens effects according to period

A

before week 3 –> all-or-none
3-8 weeks (embryonic period - most suscpetible)
after 8 weeks –> growth and function affected

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3
Q

Antibiotics to avoid in pregnancy (and why)

A
  1. Sulfonamides –> Kernicterus
  2. Amniglycosides –> Ototoxicity
  3. Fluoroquinolones –> Cartilage damage
  4. macrolides –> embryotoxic
  5. tetracyclines –> DIscolored teeth, inhibiton of growth
  6. Chloramphenicol –> Gray babe syndrome
  7. Griseofluvin –> teratogenic
  8. Ribavirin (antiviral)
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4
Q

drugs and substance that affect pregnancy (beside antibiotics) (14)

A
  1. ACE inhibitors 2. Alkylating agents 3. Antiepileptics
  2. Diethylstibestrol 5. Folate antagonists
  3. Isotretinoin 7. Lithium 8. Methimazol
  4. Thalidomide 10. Warfarin 11. Alcohol 12. Cocaine
  5. Smoking (nicotine, CO) 14. others factors
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5
Q

Alkylating agents - effects on fetus

A
  1. absence of digits

2. multiple anomalies

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6
Q

aminoglycosides - effects on fetus

A

ototoxicity

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7
Q

Warfarin - effects on fetus

A
  1. bone deformities
  2. fetal hemorrhage
  3. abortion
  4. opthalmologic abnormalities
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8
Q

lithium - effects on fetus

A

Ebstein anomay: apical displacement of tricuspid valve

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9
Q

Methimazole - effects on fetus

A

aplasia cutis congenita

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10
Q

tetracyclines - effects on fetus

A
  1. discolored teeth

2. inhibited bone growth

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11
Q

thalidomide - effects on fetus

A

limb defects (phocomelia, micromelia - flipper limbs)

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12
Q

phocomelia

A

a rare congenital deformity in which the hands or feet are attached close to the trunk, the limbs being grossly underdeveloped or absent.

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13
Q

micromelia

A

limb is abnormally shortened

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14
Q

isotretinoin (13-cis retinoic acid) - effects on fetus

A

multiple severe birth defects (contraception mandatory)

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15
Q

Folate antagonists - effects on fetus

A

neural tube defects

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16
Q

Folate antagonists include ….(drugs)

A
  1. TMP
  2. Methotrexate
  3. antiepileptic drugs
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17
Q

Diethylstilbestrol - effects on fetus

A
  1. vaginal clear cell adenocarcinoma

2. congenital Mullerian anomalies

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18
Q

antiepileptic drugs - effects on fetus

A
  1. neural tube defects
  2. cardiac defects
  3. cleft palate
  4. skeletal abnormalities (phalanx/nail) hypoplasia, facial dysmorphism)
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19
Q

antiepileptic drugs that affect fetus - which drugs Most commonly

A
  1. carbamazepine
  2. phenobarbital
  3. phenytoin
  4. valproate
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20
Q

antiepileptic drugs - co-administration with

A

high-dose folate supplementation

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21
Q

Ace inhibitors - effects on fetus

A

renal damage

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22
Q

substance abuse that affects fetus

A
  1. Alcohol
  2. cocaine
  3. Smoking (nicotine, CO)
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23
Q

alchohol abuse - effects on fetus

A
  1. common cause of birth defects and intellectual disability
  2. fetal alcohol syndrome
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24
Q

cocaine abuse - effects on fetus

A
  1. low birth weight
  2. preterm birth
  3. Intrauterine growth restriction (IUGR)
  4. placental abruption
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25
Q

cocaine - mechanism of effect on fetus

A

vasoconstriction

26
Q

smoking - mechanism of effect on fetus

A

nicotine –> vasoconstriction

CO –> impaired 02 delivery

27
Q

smoking - effects on fetus

A
  1. Low birth weight (leading cause in developed countries)
  2. preterm labor
  3. placental problems
  4. Intrauterine growth restriction (IUGR)
  5. SIDS
28
Q

Other factors that affect fetus

A
  1. iodine (lack or excess)
  2. Maternal diabetes
  3. Methylmercury
  4. Vitamin A excess
  5. X-rays
29
Q

iodine (lack or excess) - effect on fetus

A

congenital goiter or hypothiroidism (cretinism)

30
Q

Maternal diabetes - effect on fetus

A
  1. Caudal regression syndrome or sacral agenesis (anal atresia to sirenomelia-fused leg together)
  2. congenital heart defects
  3. neural tube defects
  4. macrosomia
31
Q

Caudal regression syndrome

A

Sacra agenesis : anal atresia to sirenomelia-fused leg togethe

32
Q

Methylmercury - effect on fetus

A

neurotoxicity

33
Q

Methylmercury - found?

A
  1. swordfish
  2. shark
  3. tilefish
  4. king mackerel
34
Q

Vitamin A excess - effect on fetus

A

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

35
Q

X-rays - effect on fetus

A
  1. Microcephaly

2. intellectual disability

36
Q

How to minimize X-rays effect on fetus

A

lead shielding

37
Q

Leading cause of low body weight in in developed countries

38
Q

Leading cause of intellectual disability in USA

A

Fetal alcohol syndrome

39
Q

Fetal alcohol syndrome - mechanism

A

failure of cell migration

40
Q

newborns of alcohol consumption mothers have increased incidence of congenital abnormalities, including

A
  1. pre and postnatal developmental retardation 2
  2. microcephaly
  3. facial abnormalities
  4. limb disolocation
  5. heart defects
  6. heart-lung fistulas
  7. holoprosencephaly
41
Q

Fetal alcohol syndrome - Most severe form

A
  1. heart-lung fistulas

2. holoprosnecephaly

42
Q

Fetal alcohol syndrome - facial abnormalities

A
  1. smooth philtrum
  2. thin vermilion border (upper lip)
  3. small palpebras fissures
43
Q

aplasia cutis congenita - drug

A

methimazole

44
Q

limb defects (phocomelia, micromelia - flipper limbs) - drug

A

Thalidomide

45
Q

congenital Mullerian anomalies - drug

A

Diethylstilbestrol

46
Q

drugs that affect bone/limbs of fetus (and how)

A
  1. Warfarin (bone deformities)
  2. tetracyclines (inhibited bone growth)
  3. thalidomide (limb defects (phocomelia, micromelia - flipper limbs))
  4. alcohol (limb disolocation)
  5. antiepileptics (skeletal abnormalities (phalanx/nail) hypoplasia, facial dysmorphism))
47
Q

opthalmologic abnormalities of fetus - drug

48
Q

vaginal clear cell adenocarcinoma - drug

A

Diethylstilbestrol

49
Q

neurotoxicity of fetus - drug

A

Methylmercury

50
Q

Intrauterine growth restriction (IUGR) - drugs

A
  1. Smoking

2. cocaine

51
Q

congenital cardiac defect associations - fetal alcohol syndrome

A
  1. VSD 2. ASD 3. PDA

4. tetrallogy of fallot

52
Q

congenital cardiac defect associations - congenital rubella

A
  1. septal defects
  2. PDA
  3. Pulmonary stenosis
53
Q

congenital cardiac defect associations - down syndrome

A
  1. AV septal defect (endocardial cushion defect)

2. VSD 3. ASD

54
Q

congenital cardiac defect associations - diabetic mother

A

transposition of great vessels

55
Q

congenital cardiac defect associations - Marfan

A
  1. MVP
  2. Thoracic aortic aneurysm
  3. Thoracic aortic dissection
  4. Aortic regurgitation
56
Q

congenital cardiac defect associations - Prenatal lithium exposure

A

Ebstein anomaly

57
Q

congenital cardiac defect associations - Turner syndrome

A
  1. bicuspid aortic valve

2. coarctation of aorta

58
Q

congenital cardiac defect associations - Williams syndrome

A

supravalvular aortic stenosis

59
Q

congenital cardiac defect associations - 22q11 syndrome

A
  1. Truncus arteriosus

2. Tetralogy of Fallot

60
Q

bicuspid aortic valve complications

A
  1. AR
  2. AS
  3. AORTIC DISSECTION
  4. THORACIC AORTIC ANEURYSM
  5. coarctation of the aota

Reproductive (20 decks)

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