W11_11 teratogens and therapeutics in pregnancy Flashcards Preview

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Flashcards in W11_11 teratogens and therapeutics in pregnancy Deck (25)
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1
Q

define teratogen

A

any agent that may have harmful effects on the fetus

2
Q

what’s the baseline risk of a major malformation in the general population?

A

1-3%

3
Q

when’s the “all-or-none” period?

A

12 days following ovulation

4
Q

when’s the major time period of organogenesis?

A

first 8 or 9 weeks

5
Q

when does the placenta first become significant?

A

about 5 weeks gestation

6
Q

note: uncontrolled diabetes prior to pregnancy increases risk of major malformations to 5-9%

A

ok

7
Q

how does maternal hypothyroidism affect the fetus?

A

severe maternal hypothyroidism can affect the baby’s IQ

8
Q

what’s the TORCH infections?

A

toxoplasmosis;
other (syphillis, varicella);
rubella;
cytomegalovirus;
herpes simplex

9
Q

what is isotretinoin (accutane) used for and what teratogenic effects does it have?

A

used for acne treatment;
micrognathia;
microtia;
cardiac issues;
neurologic issues

10
Q

recall thalidomide

A

ok

11
Q

what’s fetal warfarin syndrome?

A

nasal hypoplasia;
stippled epiphyses;
IUGR?;
CNS damage?;
eye defects and hearing loss

12
Q

which two drugs can cause risk of neural tube defects?

A

carbamazepine;
valproic acid

13
Q

note: dilantin can cause craniofacial abnormalities

A

ok

14
Q

why do ACE inhibitors have teratogenic effects (note only in 2nd,3rd trimesters)?

A

decrease baby blood pressure.
Damage kidneys;
oligouria
hypocalvaria (thinning of skull plate bones)

15
Q

what does lithium cause in the fetus?

A

ebstein’s anomaly

16
Q

what’s ebstein’s anomaly?

A

insertion of the tricuspid valve is displaced, affecting right ventricular function

17
Q

what’s the number 1 cause of maternal death in pregnant women in the UK?

A

cardiac disease; then
infection;
indirection neurological conditions

18
Q

what’s the safest drug for anticoagulation in pregnant women

A

heparin (low molecular weight)

19
Q

note: bronchodilators (beta2 agonists) and inhaled steroids are safe in pregnancy

A

systemic steroids po, IV - might be more risky of growth and cleft lip/palate

20
Q

what’s the teratogenic amount of radiation?

A

5-15 rad (50-150 mSv)

21
Q

which is the biggest radioactive risky test that you cannot do in a pregnant woman?

A

radioactive thyroid uptake scan (collects in the fetal thyroid)

22
Q

note: organic solvents MAY be associated with neurological and colour vision defects

A

ok

23
Q

note: mercury can cause disease in the fetus

A

ok

24
Q

what’s the triad of fetal alcohol syndrome?

A

growth retardation;
dysmorphic facies;
decreased IQ/behavioural abnormalities

25
Q

who should be taking 5mg of folic acid?

A

people with history of NTD;
BMI > 35, epilepsy, diabetes, certain ethnic groups, suspected poor complicance

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