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Clinical Science > Teratogens > Flashcards

Teratogens Flashcards

1
Q

Thalidomide effects

A

Amelia, meromelia, phocomelia

deafness
blindness
cleft palate
congenital heart disease
malformations of inner/outer ear
intellectual disability
autism
UG/GI defects
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2
Q

Thalidomide random facts

A

used for nausea/sedative

Led to Kefauver-Harris Drug Amendments Act in 1962

Increased length of process for drug approval

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3
Q

DES daughters

A

increased risk of vaginal clear cell adenocarcinoma
2x increase in vaginal/cervical intraepithelial neoplasm
structural defects in cervix/uterus/Fallopian tubes
Infertility
poor pregnancy outcomes
decreased endometrial thickness
reduced uterine perfusion

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4
Q

DES sons

A 
increased risk of epididymal cysts
microphallus
undescended testicle 
testicular hypoplasia
decreased sperm count
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5
Q

DES use

A

estrogen used to prevent SAB and PTL

widely supported though no benefits demonstrated

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6
Q

Vitamin A effects

A

cleft lip
cleft palate
hydrocephalus
cardiac deformities

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7
Q

Vitamin A teratogenic dose

A

> 10,000 units of Vitamin-A daily

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8
Q

Isotretinoin effects

A

increased risk of SAB
20-30% of neonates have abnormality

abnormalities can involve any organ system

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9
Q

ACE inhibitors effects if used in 2nd/3rd trimesters

A

growth retardation
renal dysfunction
fetal demise
oligohydramnios

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10
Q

ACE inhibitors effects if used in 1st trimester

A

risks unclear

CV and CNS abnormalities

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11
Q

SSRI effects

A

increased CV defects
may increase risk of SAB
inhibit serotonin signaling in heart development

late exposure–>increased transient newborn respiratory distress

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12
Q

Anticonvulsants effects

A 
cleft palate
cleft lip
atrial septal defects
spina bifida
developmental delay
limb abnormalities
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13
Q

NSAIDs 1st trimester use

A

increased risk of cardiac ventricular and septal defects

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14
Q

NSAIDs 3rd trimester use

A

pulmonary HTN in newborn

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15
Q

Warfarin effects if used in 1st trimester

A

skeletal abnormalities
nasal hypoplasia
long bone development abnormalities
limb hypoplasia

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16
Q

Benzodiazepines effects

A

neonatal withdrawal
hypotonia
cyanosis
floppy infant syndrome

17
Q

Alcohol effects in infants

A

Irritability
jitteriness
sleep disruption

18
Q

Alcohol effects on facial features

A 
small head
epicanthal folds
small eye openings
low nasal bridge
short nose
flat midface
thin upper lip
smooth philtrum
underdeveloped jaw
19
Q

Alcohol features on child

A 
railroad track ears
ptosis
decreased elbow pronation/supination
incomplete extension of digits
defects in palmar crease
20
Q

Alcohol deformities

A

growth retardation (pre and postnatally)
34% of FAS pts at or below 10th percentile for height/weight
atrial/ventricular septal defects
multiple skeletal abnormalities
renal dysplasia/aplasia
hearing loss
ocular and vision abnormalities

21
Q

Fetal alcohol syndrome

A

abnormal brain structure
reduction of brain volume in multiple structures
decreased impulse control and judgement
abnormal transfer of info b/w hemispheres
deficiencies in memory/learning/motor coordination
inability to work toward goal
abnormal time perception
diminished IQ
ADHD
inappropriate behavior/lack of social cues/skills

22
Q

Tobacco effects

A 
vasospasm
structural changes in placenta affecting gas exchange
carboxyhemoglobin
SIDS
LBW
PTB
preterm death
may increase chromosome instability
23
Q

Tobacco clinical effects

A 
cleft lip/palate
gastroschisis
anal atresia
limb reduction
cardiac defects
digital defects
renal aplasia/dysplasia

increased risk of infertility, placenta previa, PPROM, placental abruption

24
Q

Marijuana effects

A

minimal

may have some difficulty w/problem solving skills, learning, memory deficits

25
Q

Cocaine effects on mother

A 
MI
arrhythmias
aortic rupture
CVA
seizure
bowel ischemia
sudden death
26
Q

Cocaine effects on fetus

A 
SAB
fetal demise
placental abruption
premature birth
IUGR
27
Q

Cocaine effects on newborn

A 
neurobehavioral issues w/in 48-72 hrs of life
tremors
high pitched cry
irritability
excess suck
hyperalertness
apnea
tachypnea

long term behavioral issues w/aggression/attention span

28
Q

Opioids effects on neonate

A 
high pitched cry
poor feeding
irritability
altered sleep patterns
abnormal reflexes
hypertonicity
tremors
feeding difficulty
GI distress
seizures
small for GA
respiratory complications
autonomic dysfunction
29
Q

Opioids effects

A 
increased risk of fetal growth restriction
abruptio placentae
fetal death
PTL
meconium risk
30
Q

Other teratogens

A 
depo-provera
anti-thyroid meds
lithium
androgens
some hypoglycemics
estrogens/progestins
aspirin
bactrim

Clinical Science (4 decks)

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