Teratogens

Question 1

ACE inhibitors

Answer 1

Renal damage

Question 2

Alkylating agents

Answer 2

Absence of digits, multiple anomlies

Question 3

Aminoglycoside

Answer 3

Ototoxicity

Question 4

Antiepileptic drugs (valproate, carbamazepine, phenytoin, phenobarbital)

Answer 4

• neural tube defects (valproate, carbamazepine)
• cleft palate (phenytoin)
• skeletal abnormalities

Question 5

Diethylstilbestrol

Answer 5

• Vaginal clear cell adenocarcinoma

- Mullerian anomalies

Question 6

Folate antagonists (trimethoprim, methotrexate, antiepileptic drugs)

Answer 6

NT defects

Question 7

Isotretinoin

Answer 7

• multiple severe defects

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

Question 11

Talidomide

Answer 11

Limb defects (phocomelia, micromelia- “flipper limbs”)

Question 12

Warfarin

Answer 12

Bone deformities, fetal hemorrhage, abortion, opthal abnormalities

Question 13

Alcohol

Answer 13

Fetal alcohol syndrome: leading cause of intel disability in the US

• microcephaly
• facial abnml (smooth philtrum, thin upper lip, small palpebral fissures)
• and heart-lung fistulas, heart defects, limb dislocation

Note: failure of cell migration

Question 14

Cocaine

Answer 14

• low birth wt (IUGR)
• preterm
• placental abruption

Question 15

Smoking (nicotine, CO)

Answer 15

• low birth wt (leading case in developed countries)
• preterm labor
• placental problems
• IUGR
• SIDS

Note: nicotine and cocaine cause vasoconstriction and CO causes less O2 delivery

Question 16

Iodine (lack or excess)

Answer 16

• congenital goiter or hypothyroidism

Question 17

Maternal DM

Answer 17

• caudal regression syndrome (anal atresia to sirenomelia)
• congenital heart defects
• NT defects
• macrosomia

Question 18

Methylmercury (from fish, sharks, etc)

Answer 18

Neurotoxicity

Question 19

Vit A excess

Answer 19

• extremely high risk for spontaneous abortion and birth defects (cleft palate, cardiac)

Note: think isotretinoin

Question 20

X-rays

Answer 20

• microcephaly

- intel disability

Question 21

Heart- EtOH

Answer 21

• VSD/ASD/PDA

- tet

Question 22

Heart- rubella

Answer 22

• PDA
• septal defect
• pulm art stenosis

Question 23

Heart- Down

Answer 23

• AV septal defect (endocardial cushion) - VSD/ASD

Question 24

Heart- DM mom

Answer 24

Transposition

Question 25

Heart- Marfan

Answer 25

• MVP (mitral valve prolapse)
• ao regurg
• thoracic ao aneurysm and dissection

Question 26

Heart- Li

Answer 26

Ebstein anomaly

Question 27

Heart- Turner

Answer 27

• bicuspid ao valve

- coarc of ao

Question 28

Heart- Williams

Answer 28

supravalvular aortic stenosis

Question 29

Heart- 22q11

Answer 29

• truncus arteriosus

- tet