Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB GYN > Teratology , Drugs And Medication > Flashcards

Teratology , Drugs And Medication Flashcards

0
Q

This refers to agents that produces STRUCTURAL ABNORMALITIES

A

Teratogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Teratogen is derived from Greek word teratos which means?

A

Monsters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most of the major structural abnormalities are easily seen at ___ and an association with a specific ___ exposure is likely to be suspected

A

Birth

Prenatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Agent that interferes with normal MATURATION and FUNCTION of an organ

A

Hadegen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

This refers to an agent that alters growth

A

Trophogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Criteria for proof of human teratogenicity: (7)

A
  1. Careful delineation of clinical cases
  2. Rare environment exposure associated with rare defect with at least three reported cases
  3. Proof that agents acts on embryo or fetus, direct or indirectly
  4. Proven exposure to agent at critical times in prenatal development
  5. Association must be biologically plausible
  6. Consistent findings by two or more epidemiological studies of high quality
  7. Teratogenicity in experimental animals especially primates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

This is the period of 2 weeks from fertilization to implantation

A

Preimplantation period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

This is called the “all or none” period

A

Preimplantation period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Teratogens in the preimplantation period in animals can produce a ___ dependent diminution in ___ or ____

A

Dose dependent

Body length and size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

This is the critical period from the 2nd to the 8th week following conception

A

Embryonic period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

This is the most crucial with regard to structural malformations

A

Embryonic period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

This pertains to the 9th week to term, in which functional maturation may be involved

A

Fetal period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Alteration in the cardiac blood flow can result in ___ an example of which involves (2)

A

Deformations

Hypoplastic left heart or aortic coarctation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Category of drugs that shows studies in pregnant women have not shown an increased risk for fetal abnormalities

A

Category A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

This category of drugs if administered during the first, second, and third trimester of pregnancy the possibility of fetal harm appears remote

A

Category A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fewer than __ percentage of all medication are within the category A

A

1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Examples of category A drug

A

Levothyroxine
Potassium supplementation
Prenatal multivitamins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

This category shows that animal reproduction studies have shown adverse effect but adequate and well controlled studies in pregnant women have failed to demonstrate a risk to the fetus during the first trimester and in the later trimesters

A

Category B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Drugs under the category B

A

Antibiotics: Penicillins, Macrolides, Cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

This category shows that animal reproduction studies have shown that this medication is TERATOGENIC or EMBRYOCIDAL or Adverse effect and there are no adequate and well controlled studies in pregnant woman

A

Category C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Examples of drugs under category C

A 
Albuterol
Zidovudine
Lamivudine
Beta blocker
Calcium channel blocker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Category of this medication causes fetal harm when administered to pregnant woman

A

Category D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If this drug categories is used during pregnancy or if a woman becomes pregnant while taking this medication, she would be apprised to the potential hazard to the fetus

A

Category D and X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

This category of drugs usually contains medications used to treat potentially life threatening medical conditions

A

Category D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Examples of category D

A 
Systemic corticosteroids
Azathioprine
Phenytoin
Carbamazepine
Lithium 
Valproic acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

This category of medication is contraindicated in women who are or may become

A

Category X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

An example of a category X medications

A

Rubella vaccines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

List the possible disturbances of specific pathogenic processes

A

Cell death
Altered tissue growth
Abnormal cellular differentiation
Abnormal development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Folic acid metabolism can cause the following:

A

Neural tube defects
Cardiac defects
Cleft lip and palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Drugs that can interfere with folic acid metabolism

A

Hydration
Phenobarbital
Valproic acid
Carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Treatment for folic acid metabolism distrubances

A

Folic acid supplementation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

The mutations of this gene can cause neural tube defects

A

Tetrahydrofolate reductase 677C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Hydantoin can cause a homolozygous gene mutation of low ____

A

Epoxied hydroxylase activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Cigarette smoking and cleft palate cause the polymorphism in the gene of __

A

Transforming growth factor alpha-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

This are regulatory genes that encodes nuclear proteins to control the expression of other developmentally important genes

A

Homeobox genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Retinoic acid can prematurely activate the homeobox gene that can cause _____

A

Severe hindbrain and limb abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Valproic acids activates the homeobox genes that regulates the ___ skeletal patterning in turns causes ___ in the ___

A

Axial
Neural tube defects
Lumbosacral region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Paternal exposure may either involve:

A

Genetic mutation or chromosomal anomaly in the sperm

Drug in the seminal fluid can expose the fetus during intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Drugs that can cause changes in the gene expression and imprinting in the paternal exposure

A 
Ethyl alcohol
Cyclophosphamide 
Lead
Opiates
Mercury
Solvents
Pesticide 
Anesthetic gases
Hydrocarbons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Fetal alcohol syndrome diagnostic criteria

A

Dysmorphic facial feature
Prenatal and/or postnatal growth impairment
CNS abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Dysmorphic facial features in fetal alcohol syndrome involves:

A

Small palpebral fissure
Thin vermilion border
Smooth philtrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Women ingesting ___ or more drinks of alcohol per day throughout pregnancy have a ____ risk of fetal alcohol syndrome

A

8

30-50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Most frequent abnormalities brought about by anticonvulsant ingestion:

A

Orzo facial clefts

Congenital heart defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

This drug’s teratogenicity is strongly influenced by genetic make up of low activity of fetal epoxied hydroxylase

A

Phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

The used of phenytoin will show 7-10% have sufficient features of the ______ and one third show ____ and ____ anomalies

A

Fetal hydantoin syndrome
Minor craniofacial
Digital anomalies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Features of a fetal hydantoin syndrome

A 
Upturned nose
Mild midfacial hyplasia
Longer upper lip
Thin vermillion border
Lower distal digital hyplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Used to be considered as the epileptic drug of choice during pregnancy, teratogenic potential unclear

A

Carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

High potential for teratogenicity, abnormalities characteristic of anticonvulsant embryopathy

A

Trimethadone

Paramethadone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

This drug when given in the 1st trimester exposure has a 1-2% risk of spina bifida in the lumbosacral region, also acts directly in the homeobox gene governing caudal structure development

A

Valproic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

This drug when given in the first trimester there will be no structural abnormalities, usually occurs during the fetal period

A

ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Examples of ACE inhibitors

A

Enalapril
Captopril
Lisinopril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

ACE inhibitors causes anomalies as a result from prolonged fetal ___ and ____

A

Hypotension

Hypoperfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

This drug is associated with conjoined twins, and in animal studies shows CNS and Skeletal anomalies

A

Griseofulvin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

This anti fungal drug is used in immune compromised patients and several reports shows congenital malformation associated with this

A

Fluconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Fluconazole is associated with this syndrome:

A

Antley Bixler syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Antley Bixler syndrome is composed of the following:

A

Skull abnormalities
Cleft palate
Humoral radial fusion and other arm abnormalities

56
Q

Itraconzole is associated with this defect

A

Limb defects

57
Q

In the exposure of exogenous sex hormones prior to ____ completed weeks of gestation has no effect on external structures

A

7

58
Q

The exposure of exogenous sex hormone between ___ to ___ weeks can result to full masculinization of the female fetus and partial effects and genital ambiguity thereafter up to about ___

A

7-12

20

59
Q

Hormonal influence on behavior occurs much ___ than on the ____ genitalia and the degree if behavioral alteration is _____ to the ___ and _____ of exposure

A 
Later
External
Proportional
Dose
Length
60
Q

This disease has an enzymatic deficiency that causes the inability to hydroxylase cortisol precursors which eventually cause female masculinization

A

Congenital adrenal hyperplasia

61
Q

This drug cause the virilization of female fetus wherein there is labioscrotal fusion after first trimester exposure and phallic enlargement later

A

Testosterone

Anabolic steroids

62
Q

The presence of this drug and specifically this metabolite can cause the virilization of the female fetus and slight increased risk for cardiac defects

A

Androgenic progestin

Medroxyprogesterone Acetate

63
Q

Weak androgen that may cause female fetus virilization such as CLITOROMEGALY, FUSED LABIA, UROGENITAL SINUS MALFORMATIONS

A

Danazol

64
Q

Virilization of Danazol

A

Clitoromegaly
Fused labia
Urogenital sinus malformations

65
Q

Virilization of the female fetus by Testoterone and Anabolic steroids

A

Labioscrotal fusion

Phallic enlargement

66
Q

Both a carcinogen and teratogen used to vaginal and cervical clear cell adenocarcinoma in prenatally exposed women

A

Diethystilbestrol

67
Q

The anomalies associated with Diethylstilbestrol

A 
Muller own structural anomalies
Epididymal cysts
Microphallus
Cryptochordism
Testicular hypoplasia
68
Q

Category of corticosteroids and in animal studies causes ____

A

Category
Cleft palate
Facial clefts

69
Q

Mycophenolate mofetil has this enzyme inhibitor

A

Inosine monophosphate dehydrogenase inhibitors

70
Q

This drug is used to prevent rejection in kidneys recipients and treatment of autoimmune disease

A

Mycophenolate mofetil

71
Q

The use of Mycophenolate mofetil will increased the risk of the following:

A

Spontaneous abortions
Ear bilateral microtia
Antonia
Atresia of external auditory canals

72
Q

Category of Mycophenolate mofetil

A

Category D

73
Q

To drug is used to treat thyroid malignancies that can ablate the fetal thyroid which increase risk of childhood thyroid carcinoma

A

Radioactive iodine 131

74
Q

This is a known teratogen which the it’s effect can hinders the development of the nervous system

A

Methyl mercury

75
Q

Prenatal exposure to methyl mercury can appear yo cause a disturbance in the neuronal cell division and migration which results to range of defects from:

A

Developmental delay
Mild neurological abnormalities
Microcephaly and severe brain damage

76
Q

This psychiatric medications can cause Ebstein anomaly

A

Lithium

77
Q

Lithium can cause transient neonatal toxicity such as:

A 
Hypothyroidism
Diabetes insipidus 
Cardiomegaly
Bradycardia
ECG abnormalities
Cyanosis
Hypotonia
78
Q

This psychoactive drug can cause cardiovascular anomalies, omphalocele, craniosynostosis, and anacephaly

A

Paroxetine

Fluoxetine

79
Q

Neonatal behavioral syndrome includes the following:

A 
Jitteriness
Shivering
Increased muscle tone
Feeding or digestive distrubances
Irritability or agitation
Respiratory distress
80
Q

Maternal use of SSRI can cause persistent _____ in newborn

A

Persistent pulmonary hypertension

81
Q

Two forms of vitamin A

A

Beta carotene

Retinol

82
Q

A precursor of provitamin A found in fruits and vegetables and has never been shown to cause birth defects

A

Beta carotene

83
Q

Preformed vitamin A uncertain whether a high dose of vitamin A are teratogenic

A

Retinol

84
Q

Constriction of the fetal ductus arteriosus and persistent fetal circulation and pulmonary hypertension in neonate

A

Indomethacin and other PGI

85
Q

With prolonged used of Indomethacin and other PGI, this will ___ urine output and amniotic fluid volume

A

Decreased

86
Q

NSAIDS are not considered teratogenic but may have reversible fetal effects during the ___ trimester

A

3rd

87
Q

These are the greatest risk if infant is born within 48 hours after starting the NSAID therapy

A

Intraverntricular hemorrhage
Pulmonary dysplasia
Necrotizing enterocolitis

88
Q

This can precipitate as neonate withdrawal syndrome

A

Narcotic analgesic

89
Q

Butorphanol can cause the following:

A

Respiratory distress

Neonatal withdrawal with sinusoidal heart pattern

90
Q

Exposure during pregnancy is generally brief and not at toxic levels

A

Local analgesia and anesthesia

91
Q

This is a pyrimidine synthesis inhibitor used in the treatment of RA

A

Leflunomide

92
Q

Leflunomide is contraindicated in pregnancy because this shows ___ in animal experiments

A

Hydrocephalus
Eye anomalies
Skeletal abnormalities
Fetal death

93
Q

Valuable as the first line anti malarial treatment and for chemoprophylaxis

A

Chloroquine

94
Q

This is reserved for severely ill women and chloroquine resistant malaria

A

Quinine and quinidine

95
Q

Are there any occurrence of congenital anomalies in mothers using anti malarial drugs in therapeutic dose?

A

None

96
Q

Daily use of chloroquine for lupus and connective tissue disease has been shown to cause ___

A

Maternal retinopathy

97
Q

This is used for a symptomatic malaria treatment

A

Mefloquine

98
Q

This is associated with a five fold increased risk for STILLBIRTH

A

Mefloquine

99
Q

Dose exposure to quinine and quinidine can cause

A

CNS anomalies
Limb and Urogenital anomalies
Induce abortions

100
Q

This can cause yellowish discolorization of the deciduous teeth

A

Tetracycline

101
Q

This drug can cause deposition in the fetal long bones

A

Tetracyclines

102
Q

This drug can cause CN 8 damage

A

Streptomycin

103
Q

This drug has a 1-2% risk of having ototoxicity

A

Streptomycin

104
Q

Hyperbilirubinemia if used near delivery of a preterm infant

A

Sulfonamide

105
Q

Alkylating agent that cause cell death or heritable DNA alterations in surviving cells

A

Cyclophosphamide

106
Q

This is commonly reported in cyclophosphamide used:

A

Hypoplastic digits on hands and feet

107
Q

Cyclophosphamide can be given during ___ but not during ___

A

2nd and 3rd trimester

1st trimester

108
Q

Anomalies seen in cyclophosphamide:

A 
Cleft palate
Single coronary artery
Imperforated anus
Fetal growth restriction
Microcephalic
109
Q

What is the Methotrexate and Amniopterin syndrome:

A 
Growth restriction
Failure of calvarial ossification 
Craniosynostosis 
Hypoplastic supra orbital ridges
Small posteriorly of rotated ears
Micrognathia
Severe limb anomalies
110
Q

Antiviral drug used as an inhalational agent for RSV infection in children

A

Ribavirin

111
Q

Ribavirin is contraindicated in pregnancy because it can cause

A

Hydrocephalus

Limb deformities

112
Q

This is an endothelin receptor antagonist used to treat pulmonary hypertension

A

Boss tan

113
Q

Bosentan cause abnormalities in the ___, ____ and _____

A

Head
Face
Large coronary artery

114
Q

Dose higher than the recommended daily allowance of ___ of vitamins A should be avoided

A

5000 IU

115
Q

An anti-acne medication considered one of the most POTENT teratogen in common use

A

Isotretinoin

116
Q

1st trimester the exposure to isotretinoin can cause craniofacial anomaly: _____ and cardiac anomaly: _____, CNS: _____, Thymus:____

A
  • bilateral, symmetrical microtia, anotia, agenesis, stenosis of external ear canal
  • conotruncal
  • hydrocephalus
  • agenesis, aplasia, hypoplasia of the thymus
117
Q

An antipsoriatic drug similar anomalies to isotretinoin but does so even when conception occurs after drug discontinuation

A

Eat retinae

118
Q

It is recommended that woman stop the use of etretinate for at least ___ years prior to attempting conception

A

2 years

119
Q

This is an all trans retinoids acid usually prepared in gel treatment of acne vulgaris

A

Tretinoin

120
Q

Anxiolytics and sedative agent that is notorious teratogen producing limb reduction defects

A

Thalidomide

121
Q

Thalidomide affect structures derived from the mesodermal layer this includes:

A

Limbs
Ear
Cardiovascular system
Bowel musculature

122
Q

Days of upper limb phocomelia

A

Day 27-30

123
Q

Days of lower limb phocomelia

A

Days 30-33

124
Q

Warfarin exposure during this age will cause warfarin embryopathy

A

6-9th week

125
Q

What is the components of warfarin embryopathy

A

Nasal hypoplasia

Stippled vertebral and femoral epiphyses

126
Q

Mechanism of warfarin embryopathy:

A

No posttranslational carboxylation of coagulation protein

127
Q

Warfarin exposure at 2nd and 3rd trimester can cause:

A 
Dorsal midline CNS dysplasia
Micropthalmia
Optic atrophy
Blindness
Developmental delay and mental retardation
128
Q

Sympathomimetic agent associated with symmetrical growth restriction, minor congenital anomalies

A

Amphetamines

129
Q

This drug has vasoactive and hypertensive effect

A

Cocaine

130
Q

Risk of vascular interruption is highest after 1st trimester can cause placental abruption

A

Cocaine

131
Q

Miscellaneous drugs that can manifest with jitteriness, tremors, and irritablity

A

Phenycyclidine

132
Q

Miscellaneous drug that can cause chromosomal breakage

A

Lysergic Acid Diethylamide

133
Q

This drug is best documented reproductive effect that cause fetal growth restriction

A

Tobacco

134
Q

Preterm fetuses exposed to this drug can cause gray baby syndrome

A

Chloramphenicol

135
Q

This drug when used in the 1st trimester has been associated limb defects and fetal cardiac depression and arrest

A

Verapamil

136
Q

This drug is associated with neonatal thrombocytopenia, bleeding and electrolyte disturbance

A

Thiazides diuretics

137
Q

This may stimulate renal PGE2 production that cause patent ductus arteriosus

A

Furosemide

138
Q

Maternal therapy associated with neonatal hematologic abnormalities such as fatal pancytopenia

A

Azathioprine

OB GYN (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions