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Module 6: Repro/Endocrine > Teratology > Flashcards

Teratology Flashcards

1
Q

What is considered a minor anomaly in teratology?

A

Are not themselves detrimental to health

(i. e. small ears, pigment spots)
- occur in ~15% of newborns

Minor anomalies serve as clues for diagnosing more serious defects

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2
Q

What are causes of birth defects?

A
  • Genetics
  • Environmental Teratogens
  • -> Infectious agents
  • -> physical agents
  • -> chemicals agents
  • -> hormones
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3
Q

What are the two groups of anomalies?

A
  1. Syndrome
    - Group of anomalies that occur together from a specific common cause
    - cause has been determined
    - risk of recurrence is known
  2. Association
    - non-random appearance of anomalies
    - cause has not been determined
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4
Q

What are the principles of teratology?

A
  1. Genotype of conceptus determines susceptibility of teratogenesis
  2. Susceptibility to teratogens varies depending on development age of exposure
  3. Dose and duration of exposure to teratogen determines manifestations of abnormal development
  4. Teratogens act in specific ways on developing cells/tissues to initiate abnormal development
  5. Manifestations of abnormal development are:
    Death
    Malformation
    Growth Retardation
    Functional Disorders
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5
Q

When is the conceptus most susceptible to teratogens?

A

During the period of embryogenesis
–> may be one or more stages of susceptibility

  • no stage is completely safe
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6
Q

What infectious agents are considered teratogens?

A

TORCH

Toxoplasma

Rubella

Cytomegalovirus

HSV

Elevated body temperature - infections with fever can cause birth defects

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7
Q

What teratogen is concurrent with the following congenital malformations:

Cataracts
glaucoma
heart defects
deafness
tooth abnormalities

A

Rubella virus

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8
Q

What teratogen is concurrent with the following congenital malformations:

Often fatal
If not, includes:
microcephaly
blindness
mental retardation

A

Cytomegalovirus

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9
Q

What teratogen is concurrent with the following congenital malformations:

Micropthalmia
microcephaly
retinal dysplasia

A

HSV

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10
Q

What are the key features of Congenital Rubella Syndrome (CRS)?

A
  • Replication of virus in throat for weeks
  • high levels of virus present
  • viral infection of the placenta
  • All cells in fetus infected after maternal viral infection
  • Confirmed rubella during 1st trimesster
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11
Q

What teratogen is concurrent with the following congenital malformations:

Anencephaly
Spina bifida
mental retardation
facial defects
cardiac abnormalities
limb defects

A

Hyperthermia

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12
Q

What teratogen is concurrent with the following congenital malformations:

Microcephaly
Spina Bifida
Cleft palate
limb defects

A

X-rays

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13
Q

What teratogen is concurrent with the following congenital malformations:

Limb defects - loss of long bones
heart malformations

A

Thalidomide

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14
Q

What teratogen is concurrent with the following congenital malformations:

Cleft lip and palate
heart defects

A

Amphetamines

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15
Q

What teratogen is concurrent with the following congenital malformations:

Growth retardation
microcephaly
addiction

A

Cocaine

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16
Q

What teratogen is concurrent with the following congenital malformations:

Depressed nasal bridge
Short nose
Flat midface
Indistinct philtrum
Thin upper lip
heart defects
metal retardation

A

Alcohol

17
Q

What does FDA category A for use in pregnancy mean?
Example?

A

No risk shown in controlled human studies

Example: Prenatal vitamins

18
Q

What does FDA category B for use in pregnancy mean?
Example?

A

Animal studies show no risk and with no risk in controlled human studies

OR

Animal studies show increased risk but controlled human studies show no risk

Example: Penicillin or Acetominophen

19
Q

What does FDA category C for use in pregnancy mean?
Example?

A

Animal studies show incrased risk and no controlled human studies

OR

No animal or human studies

Example: nifedipine/sumatriptan

20
Q

What does FDA category D for use in pregnancy mean?
Example?

A

Proven risk in humans
Benefits might outweigh risks

Example: Valproic Acid, Gentamicin

21
Q

What does FDA category X for use in pregnancy mean?
Example?

A

Proven risk in humans, animals, or both
Risk outweight benifits

Example: Isotretinoin/Misoprostol/Warfarin (use heparin instead)

22
Q

What disease causes caudal regression?

A

Diabetes

23
Q

What drug inhibits abortion of an already malformed fetus?

A

Progestins

24
Q

What drug inhibits the formation of long bones?

A

Thalidomide

20-30% of fetuses between the 27th and 40th day after conception

25
Q

What did Diethylstilbesterol (DES) cause?

A

Mullerian Anomalies

Vaginal Clear Cell Carcinoma in young girls

26
Q

What drugs cause fetal hydantoin syndrome and how?

A

Anti-convulsants

Valproate<trimethadione></trimethadione>

<p>
2-3x increaed risk for NTD due to impared folate metabolism</p>

</trimethadione>

27
Q

What can warfarin cause during pregnancy?

A

Microcephaly
Nasal hypoplasia
Stippled vertebrae and femoral epiphyses

6-9 weeks

Likely results from tissue microhemmohages

15-25% affected during first trimester exposure

28
Q

What does perinatal ACEI use cause?

A

Cardiovascular Anomalies

Fetal/Neonatal renal Failure

Oligohydramnios

Pulmonaryhypoplasia

IUGR

Still birth

Potter’s sequence

29
Q

What drugs are contraindicated for breast feeding?

A

methotrexate

lithium

30
Q

What is beta-methasone prescribed for?

A

Pulmonary immaturity

Neonatal necrotizing enterocolitis

Intracranial Hemorrhage

31
Q

When might you give penicillin to a mother?

A

prevention of neonatal group B strep infection

Module 6: Repro/Endocrine (28 decks)

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