Teratogens Flashcards

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1
Q

fetal hydantoin syndrome: is related to a ___ defect in the fetus

A

metabolic

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2
Q

when does the embryonic period end and the fetus period begins

A

at the end of the 10th completed week after menstration

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3
Q

period of greatest sensitivty of embryo to teratogens

A

3-8 weeks

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4
Q

FDA classification of risk

  • studies in humans and animals
  • demonstrate fetal abnormalities
  • evidence of fetal risk
  • risk of drug clearly outweighs any benifit
  • dugs contraindicated in pregnancy or those who may become pregnant
A

Category X

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5
Q

FDA classification of risk

  • positive evidence of human fetal risk
  • benifits for use during pregnancy may be acceptable despite the risk
  • drugs needed for life threatening situation
  • other safer drug not available or ineffective
A

Category D

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6
Q

FDA classification of risk

  • animal reproductive studies
  • have demonstrated risk to fetus
  • and there are no controlled studies in women
  • or studies in women and animals are not available
A

Category C

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7
Q

FDA classification of risk

  • animal reproductive studies
  • have not demonstrated fetal risk
  • no controlled studies in pregnanct woman
  • or animal studies show adverse effect
  • that was not confirmed in RCT of pregnant women
A

Category B

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8
Q

FDA classification of risk

  • controlled studies in women
  • fail to demonstrate risk to fetus in first trimester
  • possibility of fetal harm seems remote
  • category with fewest drugs
A

Category A

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9
Q

possible effects of ionizing radiation on fetus (4)

A
  1. growth retardation
  2. microcephaly
  3. eye defects
  4. possible risk of childhood leukemia with exposure of > 2rad during 3rd trimester
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10
Q

Embryonic abnormality associated with maternal hyperthermia at what stage of development?

A

neural tube defects

2-3 week embryo

maternal fever > 40 degree > 48 hours

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11
Q

maternal metabolic condition associated with caudal regression sirenomelia

A

Maternal diabetes

poorly controlled

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12
Q

low birth weight,

cutaneous scars,

papular lesions,

localized absence of skin on a limb,

hypoplasia of one or more limbs, malformed digits along with various ocular and central nervous system (CNS) abnormalities

A

Fetal varicella syndrome (FVS) is a rare complication of maternal varicella infection occurring in <2% of the babies born to women infected with varicella between 7 and 28 weeks of pregnancy

https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/pd.3843

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13
Q

growth delay

intellectual disability

hypoplastic distal phalanges and nails

cleft lip and palate

wide anterior fontanelle, metopic ridging, hypertelorism, broud flat nasal bridge

hirsutism

A

Fetal hydantoin syndrome

(Dilantin)

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14
Q

fetuses with deficiency of this enzyme develope fetal anticonvulasant syndrome

A

homozygous deficiency in dilantin epoxide hydrolase

can be diagnosed through parental carrier status

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15
Q

what is the specific congenital abnormality concern with valproic acid

A

neural tube defects

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16
Q

nasal hypoplasia and depressed nasal bridge

stipling of uncalcified epiphyses

nail/fingertip hypoplasia

low birth weight

mental retardation

A

Fetal warfarin exposure

17
Q

abnormalities of the 1st and 2nd phalageal arch surrounding the 1st pharygeal cleft

35% risk for embropathy if used >2 weeks post conception

A

Retinoic acid Embryopathy

Isotretinoin (Accutane ) exposure

also associated with microtia, micrognathia, hypertelorism

conotruncal cardiac defects

hydrocephalus and developmental delay

18
Q

fetal renal compromise: renal tubular dysgenesis

oligohydraminios

anuria

renal failure

fetal hypocalvaria

A

ACE inhibitors

19
Q

likley karyotype of an ovarian teratoma?

A

46, XX, digynous

20
Q

likley karyotype for a complete hydatidiform mole

A

46, XX or 47 XY diandrous

21
Q

likley karyotype of the picture seen

A

complete hydatidiform mole

46, XX of 46 XY diandrous

22
Q

first trimester screening

low hCG

low PAPP-A

small placenta

abnormal fetus

A

triplody

partial mole

formed by single sperm followed by duplication

69, XXX

69, XXY

23
Q

first trimester screening

very high hCG

high PAPP-A

hydropic placenta and IUGR fetus

or gestational sac

A

triploidy

partial mole

formed by two sperms and 1 egg

69, XXX

69, XXY

24
Q

congenital anomalies affect _____% of newborns

A

3-5%

25
Q
A