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obstetric - gynecol STEP 2 > teratogens > Flashcards

teratogens Flashcards

1
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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2
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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3
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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4
Q

Alkylating agents - effects on fetus

A
  1. absence of digits

2. multiple anomalies

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5
Q

Warfarin - effects on fetus

A
  1. bone deformities
  2. fetal hemorrhage
  3. abortion
  4. opthalmologic abnormalities
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6
Q

Methimazole - effects on fetus

A

aplasia cutis congenita

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7
Q

thalidomide - effects on fetus

A

limb defects (phocomelia, micromelia - flipper limbs)

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8
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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9
Q

micromelia

A

limb is abnormally shortened

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10
Q

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

A

multiple severe birth defects (contraception mandatory)

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11
Q

Folate antagonists - effects on fetus / drugs?

A

neural tube defects

  1. TMP
  2. Methotrexate
  3. antiepileptic drugs
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12
Q

Complications of DES daughters

A
  1. clear cell adeno of vagina + cervic
  2. stractureal anomalies of the reproductive syystem
  3. pregnancy problems
  4. infertility
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13
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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14
Q

antiepileptic drugs that affect fetus - which drugs Most commonly

A
  1. carbamazepine
  2. phenobarbital
  3. phenytoin
  4. valproate
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15
Q

antiepileptic drugs - co-administration with

A

high dose of follate acid

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16
Q

substance abuse that affects fetus

A
  1. Alcohol
  2. cocaine
  3. Smoking (nicotine, CO)
17
Q

alchohol abuse - effects on fetus

A
  1. common cause of birth defects and intellectual disability
  2. fetal alcohol syndrome
18
Q

cocaine abuse - effects on fetus

A
  1. low birth weight
  2. preterm birth
  3. Intrauterine growth restriction (IUGR)
  4. placental abruption
19
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
20
Q

iodine (lack or excess) - effect on fetus

A

congenital goiter or hypothiroidism (cretinism)

21
Q

Methylmercury - effect on fetus / found

A

NEUROTOXICITY

  1. swordfish
  2. shark
  3. tilefish
  4. king mackerel
22
Q

Vitamin A excess - effect on fetus

A

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

23
Q

X-rays - effect on fetus

A
  1. Microcephaly

2. intellectual disability

24
Q

Leading cause of low body weight in in developed countries

A

smoking

25
Q

Leading cause of intellectual disability in USA / mechanism

A

Fetal alcohol syndrome –> failure of cell migration

26
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
27
Q

Fetal alcohol syndrome - Most severe form

A
  1. heart-lung fistulas

2. holoprosnecephaly

28
Q

Fetal alcohol syndrome - facial abnormalities

A
  1. smooth philtrum
  2. thin vermilion border (upper lip)
  3. small palpebras fissures
29
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)
30
Q

Males exposed to DES in the utero - complciations

A

cryptorchidism
microphallus
hyposadias
testicular hypoplasia

31
Q

azathiprine in pregnancy

A

safe

32
Q

lithium exposure during pregnancy

A

1st trimester: Ebstein anomaly

2nd and 3rd trimester: goiter and neonatal neuromuscular dysfunction

33
Q

woman under lithium becomes pregnant –> ….

A

slow tapering lithium

no abrupt stopping

34
Q

inhale steroids during pregnancy

A

ok

35
Q

fetal hydantion syndrome

A

small body size, microcephali, digital hypoplasia, nail hypoplasia, hirsutism, cleft palate, rib abnormalities
- phenytoin, carbamazepine

obstetric - gynecol STEP 2 (22 decks)

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