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Flashcards in Environmental Influences on Human Development Deck (101):
1

Toxic or infectious insults occurring in the first few weeks of development are likely to be

Fatal

2

States that if an action or policy has a suspected risk of causing harm to the public or environment, even in the absence of scientific consensus, the burden of proof that it is NOT HARMFUL falls on those taking action, such as the introduction of a chemical or a pharmaceutical

Precautionary Principle

3

What are three highly potent xenobiotic teratogens?

1.) Alcohol
2.) Cocaine
3.) Smoking

4

Begins to form in week three an is particularly vulnerable up to week 8 or 10

Heart

5

Rubella infection between weeks 3-8 of embryonic development results in

Cardiac defects

6

Can lead to cardiac defects, eye abnormalities, and deafness

Rubella infection during pregnancy

7

Points in development at which an insult (pharmaceutical, toxic, or infectious) may have a specific, profound impact on certain targets that are vulnerable at that time

"Critical periods" or "Sensitive Windows"

8

Teratogenesis is defined as

Birth defects

9

Two of the most pervasive in utero toxicants are

Tobacco smoking and alcohol

10

Are among the most important child health problems in the US

Developmental disabilities

11

What precentge of children have some developmental disability

17%

12

What percentage of children have ADHD?

3-7%

13

About 7-12/1,000 children have some form of

Autism spectrum disorder

14

Occur in a complex context shaped by genetic determination or predilection (susceptibility), social circumstances, and personal lifestyles

Environmental exposures

15

The fair treatment and meaningful involvement of all people regardless or race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies

Environmental Justice

16

The process resulting in defects apparent at birth due to some interference with normal development

Teratogenesis

17

Agents that have been identified to cause birth defects such as Rubella, alcohol, mercury, lead, etc are called

Teratogens

18

A vitamin that is not manufactured in the body and must be consumed in the diet. It is associated with anemia in adults

Folic acid

19

During fetal development, folic acid deficiency has been associated with a spectrum of neural tube defects such as

Spina bifida

20

The extreme case of folic acid deficiency during pregnancy is

Anencephaly

21

When is the vulnerable period for folic acid deficiency in pregnancy?

-when the neural tube is forming and then closing

First trimester

22

At birth, small skull circumference and flattened skull are evidence of this severe, usually fatal defect

Anencephaly

23

Should be taken as a supplement before and during pregnancy

Folic acid

24

What percentage of developmental defects in man are thought to be caused by drugs and environmental chemicals?

4-5%

25

Relative teratogenicity is influenced by

Maternal factors

26

Developmental defects increase with frequency and degree as a function of

Fetal dose of teratogen

27

Teratogenic susceptibility is greatest during

Organogenesis

28

What is one example of a human condition that was not predicted by animal studies?

Congenital Rubella Syndrome (CRS)

29

Animal studies predicted some but not all

Thalidomide toxicity

30

A drug used to prevent miscarriage

Diethylstilbestrol (DES)

31

In the case of diethylstilbestrol (DES), animal studies did not show

Vaginal legions in F1 offspring

32

What does the acronym TORCH stand for?

T = Toxoplasma
O = Other (Zika, chicken pox, syphillis, etc)
R = Rubella
C = Cytomegalic virus
H = Herpes

33

Most cause mild maternal morbidity, but have serious fetal consequences

TORCH infections

34

The treatment of maternal TORCH infection typically has no impact on

Fetal outcome

35

What are two examples of fetal outcomes from TORCH infections?

Microcephaly and mental retardation

36

What is the critical window for Rubella and Zika?

3-16 weeks

37

Caused by the togovirus and generally show mild flu-like symptoms + rash in children

Rubella (German measles)

38

The incubation period for Rubella is

2-3 weeks

39

When Rubella occurs during pregnancy, the highest risk percentage for developing Congenital Rubella Syndrome (CRS) is during the

1st trimester (50-90% results in CRS)

40

What percentage of Rubella infection during the 2nd trimester results in CRS?

25%

41

What are the critical or sensitive developmental periods for the
1.) Ears and eyes
2.) Upper limbs
3.) Lower limbs

1.) 20th-25th day
2.) 26th-30th day
3.) 31st-36th day

42

Congenital Rubella Syndrome (CRS) presents as a classic triad of

1.) Sensorineural deafness (60%)
2.) Congenital heart disease (50%)
3.) Ocular abnormalities (45%)

43

The reason the MMR vaccine was developed

Congenital Rubella Syndrome (CRS)

44

The MMR vaccine is contraindicated during

Pregnancy

45

Flavivirus spread primarily by the bite of infected Aedes aegypti or Aedes albopictus

Zika Virus

46

Many adults with this virus are asymptomatic or have mild flu-like symptoms

Zika Virus

47

However, Zika can cause

Severe birth defects, stillbirths, and miscarriages

48

The flavivirus was first recognized in Brazil in early

2015

49

The zika virus has been directly correlated to

Microcephaly

50

Characterized by fetal death, still birth, neonatal death, and developmental impairment

Congenital Zika Syndrome

51

Results in severe thinning of cortex

Zika

52

Unlike other flaviviruses, Zika can also be detected in high quantity in

Semen

53

Can be transmitted sexually from male to pregnant female

Zika

54

Vitamin needed for DNA synthesis

Folate (Vitamin B-9)

55

Lack of animal protein and green vegetables in the diet, maternal smoking, alcohol, and kidney dialysis can all cause

Folate deficiency

56

What is the most common cause of preventable mental retardation?

Fetal Alcohol Syndrome

57

What is the incidence of fetal alcohol syndrome?

5-12K births / year

58

Characterized by facial abnormalities, marked hyperactivity, delayed gross and fine motor skills, delayed learning and language skills,and hearing loss

Fetal Alcohol syndrome

59

How many drinks per day during pregnancy essentially guarantees fetal alcohol syndrome?

4-5 drinks per day

60

Clinically significant deficits are not common in children whose mothers drank less than approximately

5 drinks per occasion, once a week

61

A sedative used for morning sickness that showed no toxicity in animal studies but causes major problems in human births

Thalidomide

62

In adults, thalidomide toxicity leads to

Neuropathy, GI stasis, and dizziness/disorientation

63

As a teratogen, leads to phocomelia, amelia, syndactyly, and ear and eye defects

- > 10,000 affected children worldwide (less than 100 in US)

Thalidomide

64

In 2010, it was suggested that the mechanism of action of thalidomide teratogenicity was the arrested development of

Critical blood vessels

65

Thalidomide has recently been shown to have beneficial uses and has been used for

Multiple myeloma, Leprosy, and difficult dermatology cases

66

Thalidomide has been used to manage leprocy in

Brazil

67

One of the most dramatic examples of drug interference during development comes (FOAD) from the experience with which drug that was widely used in pregnant women with “threatened abortion” from the 1940s through the 1960s

Diethylstilbesterol (DES)

68

Diethylstilbesterol (DES) was used to prevent

Miscarriages

69

Researchers then discovered that DES caused

Vaginal tumors in female offspring

70

DES sons are at risk for

Non-cancerous epidermal cysts

71

Female offspring of DES-treated mothers developed clear-cell adenocarcinoma of the vagina shortly after the onset of the

Menarche

72

What is the critical period of maternal exposure to DES?

1st trimester

73

DES causes problems because there are Estradiol sensitive adenomatous tissues in the

Vagina

74

Researchers learned that the placenta is NOT a

Complete barrier

75

Studies showed that fetal susceptibility is maternally determined and is dependent on

Gestational stage

76

In utero, toxicity can be manifested at what four stages?

1.) At birth
2.) Shortly after birth
3.) Delayed until puberty
4.) Decades after birth

77

How many generations can show toxicity in utero?

F2+n generations

78

Probably the only known example of F2 effects in humans are

DES effects

79

Many teratogens cause restriction of

Intrauterine growth

80

Showed how prenatal and infant events or exposures can program an individual for adult disease

Fetal Origins of Adult Disease (FOAD)

81

FOAD showed that birth size (small babies that become obese children) predicts

Hypertension, cardiovascular disease, glucose intolerance, and dyslipidemias

82

Chronic stress and corticoid stimulus leads to

Intrauterine Growth Restrictions (IUGR)

83

The Dutch famine of 1944-45 showed that first trimester exposure had no effect, but third trimester exposure led to

Glucose intolerance

84

Intrauterine growth restriction (IUGR) occurs during which weeks of the fetal period?

16-38

85

Substances that interfere with normal hormone functions cause

Endocrine Disruption

86

Can be do to up or down regulation of hormone production, release, or receptor expression

Endocrine disruption

87

Hormone agonists or antagonists can lead to

Endocrine disruption

88

All forms of this element are toxic to all animals

Mercury

89

Used as an antiseptic, a biocide in paints and on crops, and as a diuretic

Mercury

90

What are the three main forms of mercury

1.) Elemental mercury (quicksilver)
2.) Inorganic mercury (mainly pigments)
3.) Organic mercury

91

What are the two organic forms of mercury

1.) Ethyl mercury (Thimerosal)
2.) Methyl mercury (mainly from fish)

92

People who eat fish that are high on the food chain several times a week are susceptible to

Methylmercury poisoning

93

Elemental and inorganic mercury are mainly a problem
for

Industrial exposures

94

The more highly toxic form of mercury

-Targets the CNS

Methylmercury

95

A ubiquitous contaminant that is mainly of concern for fetal development if mothers consume large amounts of fish that are high on the food chain

Mercury

96

An amount of a substance that can be consumed on a daily basis without causing adverse effects

Reference dose

97

Merely exceeding a reference dose does not predict

-would have to exceed by a lot

Harm

98

There were two conflicting studies done on mercury in fish, one by Harvard and one by Rochester university. The EPA decided to base it's reference dose on the

Harvard study (0.1 ug/kg body weight)

99

The FDA decided to base it's allowable daily intake on the Negative findings from the Rochester study and set it at

0.3 ug/kg body weight

100

The Rochester study in the Republic of Seychelles measured maternal hair samples for Hg during pregnancy. The study showed no significant impact from prenatal exposure of Hg on

Neurodevelopment

101

Since the reference dose of Hg is 0.1 ug/kg body weight/day, this means that during pregnancy, if mercury intake is below 0.1 ug/kg body weight/day, there should be

NO adverse effects

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