Chapter 10 Flashcards by David Rendon

What are the time frames for infant and childhood development?

Neonatal period: first 4 weeks of life
Infancy: 1st year of life
Toddler/preschool: 1-4 years
School age: 5-14 years

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In children younger than 1 (infants), what is the primary cause of death?

How does it change as the child ages?

1. Congenital malformation and chromosomal abnormalities.

Premature bbs: Disorders d/t short gestation and low birth weight

3. Sudden infant death syndrome (SIDS)

*Respiratory distress of the newborn is another cause

As the child ages, it falls off off

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In children 1-4 (toddler/preschool) what is the primary cause of death?

How does it change as the child ages?

What conditions start to show as a major cause of death?

1. Accidents

Congenital malformations and chromo abnormalities - falls

accidents become and remain most common cause of death until 14.

malignant neoplasms become a common cause

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Why do congenital malformation, which are anatomic defects present at birth, still are among the top causes of death until 14?

they may not be clinically apparaent until years later

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In children 5-9, what is the primary cause of death?

How does it change as the child ages?

1. accidents

2. malignant neoplasms

3. congenital malformations

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In children 10-14, what is the primary cause of death?

what do we see appear?

accidents
malignant neoplasms

3. SUICIDE

congenital malformation drops to number 5

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Primary errors of morphogenesis (formation of orans), in which there is an intrinsically abnormal developmental process defines? (inherited

ex.

malformations

ex. cyclopsia

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External event (secondary destuction) that affects an already well-developed organ.

Is it inherited?

Ex.

Disruption; not inherited

Ex. Amniotic band: rupture of amnion d/t “bands” that encircle, compress, or attach to parts of developing fetus

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localized or generalized compression of the gorowing fetus by abnormal biochemical force.

“abnormal biomechanical forces”

deformations

Ex. endometrial tumors

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What is the most common underlying factor for the development of deformations in newborns?

Example of common deformation seen in Potter sequence?

- Uterine constraint:size of fetus gets bigger than growth of uterus (35th-38th week)

Deformations are caused by abnormal biomechanical forces

- Club feet is deformation seen in Potter sequence

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What is a squence?

cascade of anomalies triggered by 1 irritating event.

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What is the classic example of a sequence?

Due to what and what abnormalities are produced?

(Potter) sequence

[amnoitic leak, renal agenesis/other]=> Decreased amniotic fluid (oligohydromnois]–> fetal compression=>

flattened facies
positional abnormalities of hands and feet;
dislocated hips;
hypoplastic lungs; al
so seen in amnion nodous

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in potter sequence, what is the initiating aberration?

oligohydromias

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What is often seen in Potters squence?

NODULES IN THE AMOIN

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Malformations, disruptions, or deformations that set into motion secondary effects in other organs is known as?

sequence

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are disruptions assx with a risk of recurrence in next pregnancies?

no bc not heritable

Differentiate agenesis from aplasia

Agenesis: complete absence of an organ AND is associate primordium.
- no primoridium => no organ
Aplasia: organ fails to grow from the EXISTING primordium.
- primordium => no organ

what is atresia?

absence of a opening

________, __________, _________ are the 3 major categories of congenital abnormalities in humans.

1. Genetic factors
2. environmental
3. multifactorial (20-25%

What are the 2 most common genetic problems we see in congennital abnormalities and %

1. Chromosomal aberration (10-15%)

Mendelian inheritance (2-10%)

what are the most common causes of environemtal causes of congenital aanomliaes?

Maternal and placenta linfection (2-3%
Maternal disease states (6-8)

3 drugs /chemical (1)

irradiation (1)

______ is a major teratogen used in the treatment of acne.

retanoic acid

thalidomide caues

limb malformations

alochol during preg caues

FAS => growth retardation, microcephy, ASD, short palpebral fissures and maxillary hypoplasia

maternal smoking does what

**low birth rate** **increase risk of SIDS**

many ofcongenital anomalies that **cannot** be explained on the basis of a single, localized, initiating defect

Malformation syndrome

what is an example of a malformation syndrome?

diabetic embryopathy

What causes sudden infant death syndrome?

**-- no explanation even after autosopy**

* Most common **microbes** to cause congenital abnormalities during development

**TORCH** **toxoplasmosis, other, rubella, CMV, herpes/IVX**

What are the 2 general principles of developmental pathology?

1. TIMING of teratogen IMPORTANT 2. Terotogens and genetic defects can act on the SAME developmental pathways nad result in SIMILAR anomomlies

a. _____ (inhibits \_\_\_\_\_) and _____ mutations → h**oloprosencephaly** b. _____ (inhibits \_\_\_\_) and ____ mutations → **limb/vert/craniofacial issues** c. Excessive\_\_\_\_\_\_ (\_\_\_\_ deregulation) and ____ mutations → **cleft lip/palate**

a. Cycopamine (inhibits hedgehog) and hedghog mutations → holoprosencephaly b. valproix acid (inhibits HOX) and HOX mutations → limb/vert/craniofacial issues c. Excessive retanoid acid (TGF-B deregulation) and TGFB-3 mutations → cleft lip/palate

Major **morphological** abnormalities occur during which weeks of embryonic development? Between which weeks is the embryo extremely susceptible to **teratogenesis**? Peak sensitivity when?

**3-8 wk** ## Footnote 3-9 wks **4-5 wks**

**Teratogens** during the 4/5 weeks of gestation affect every body system except for the **\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_** which begin to develop later

teeth palate genitalis

prematurity is when **2n**d most common cause of?

Less than 37 weeks neonatal mortality (1-4 weeks)

Infants born to mothers treated with **retinoic acid for severe acn**e have which predictable phenotype (**retinoic acid embryopathy**)?

**CNS** **Cardiac** **craniofascial defects (cleft lip and palate**

The craniofacial defects (cleft lip and palate) which result from retinoid acid embryopathy are a result of?

the TGF-B signaling pathway

What are the 4 risk factors associated with prematurity?

1) PPROM (before 37 weeks = most serious) - premature-preterm-rupture of member 2) Intrauterine infections (major cause) 3) Structural abnormalities (uterine, placental, and cervical) 4) Multiple gestations (twin pregnancy)