Teratogens & Exposures during Pregnancy

Question 1

ACE inhibitors

Answer 1

renal anomalies/potter sequence, IUGR, skull ossification defects, oligohydromas
Critical period: 2nd + 3rd trimester

Question 2

Alcohol

Answer 2

learning and behavioral differences; ptosis; short palpebral fissures, smooth philtrum

Question 3

Anti-convulsants

Answer 3

ONTDS, clefting, CHD, limbs, DD
i.e. Valporic acid has most significant impact

Question 4

Maternal Diabetes

Answer 4

Caudal regression

Question 4

Lithium

Answer 4

Ebstein anomaly

Question 5

Maternal PKU

Answer 5

Pregnancy loss, Microcephaly, ID, heart defect

Question 6

Mercury

Answer 6

Minimata disease (neurological disorder)

Question 7

Radiation (>5 rads)

Answer 7

Fetal malignancy, miscarriage, IUGR, ID

Question 8

SSRIs examples and fetal outcomes

Answer 8

medications to treat depression; Temporary neonatal jitteriness, irritability, respiratory distress

Question 9

Thalidomide

Answer 9

limb reduction

Question 10

Androgens and high doses of nor-progesterones

Answer 10

masculinization of external genitalia

Question 11

Diethylstilbestrol

Answer 11

vaginal adenosis/adenocarcinoma; cervical erosions and ridges

Question 12

Warfarin

Answer 12

Nasal Hypoplasia, stippled epiphyses, CNS defects

Question 13

Hydantoin

Answer 13

Dysmorphic features, hypo plastic nails, growth-restriction, ID

Question 14

Trimethadione

Answer 14

DD, dysmorphic facies

Question 15

Methotrexate

Answer 15

pregnancy loss, hydrocephalus, low birth weight, dysmorphic features

Question 16

Streptomycin

Answer 16

hearing loss

Question 17

Tetracycline

Answer 17

stained teeth, enamel hypoplasia

Question 18

Isotretinion / Accutane

Answer 18

Pregnancy loss, hydrocephalus, other CNS defects, small/absent thymus, microtia/anotia, conotruncal heart defects

Question 19

Antithyroid Drugs

Answer 19

hypothyroidism, goiter

Question 20

Penicillamine

Answer 20

cutis laxa

Question 21

Carbamazepine

Answer 21

Neural tube defects

Question 22

cocaine

Answer 22

pregnancy loss, placental abruption, growth restriction, microcephaly

Question 23

Toxoplasmosis

Answer 23

hydrocephalus, blindness, ID

Question 24

Varicella

Answer 24

Skin scarring, limb reduction defects, muscle atrophy, ventriculomegaly

Question 25

Syphilis

Answer 25

snuffles, hutchinson teeth, saber shins, saddle nose

Question 26

Cytomegalovirus

Answer 26

Growth restriction, ID, microcephaly, hearing loss, ocular anomalies

Question 27

Herpes

Answer 27

no prenatal issues; exposed at birth can develop CNS and organ damage

Question 28

Pre-gestation DM

Answer 28

Congenital heart defects, caudal deficiency, NTDs, limb defects, holoproscencephaly, pregnancy loss

Question 29

Rubella

Answer 29

deafness, CHDs, CNS; blueberry muffin rash; salt and pepper retinopathy later onset: DM, thyroid, panencephalitis

Question 30

Toxoplasmosis (raw meat, soil, raw veggies, cat feces)

Answer 30

Hydrocephalus, HL, VL, intracranial classifications, seizures, DD

Question 31

Hepatitis

Answer 31

can infect fetus; 70-90% will be chronic carriers w/ increased risks for HCC and cirrhosis

Question 32

Parvovirus B19 (Fifth disease)

Answer 32

fetal hydrops, anemia

Question 33

zika

Answer 33

10-15% w/ defects: microcephaly, lissencephaly, cerebral calcs, ventriculomegaly, eye anomalies, HL, CP, brainstem and cerebellar hypoplasia, growth restriction, dysphagia

Question 34

West Nile virus

Answer 34

on study of 28 infected pregnancies only 1 w/ encephalopathy

Question 35

When to consider TORCH screening ; sample types

Answer 35

IUGR, microcephaly, intracranial calcifications, hearing loss, seizures, and cataracts infant blood, maternal blood, amnio sample

Question 36

IgM antibodies present in TORCH screen indicates

Answer 36

recent infection, there is risk to baby

Question 37

IgG antibodies present in TORCH screen indicates

Answer 37

past infection / vaccination (likely before pregnancy)

Question 38

What infections can TORCH screen for

Answer 38

Toxoplasmosis O- Syphilis, Parovirus, Varicella R- Rubella C- Cytomegalovirus H - Herpes