Teratogens for the Genetic Counseling Board Exam (A+ GRADED)
ACE inhibitors correct answers "the only anti-hypertensive medications associated with structural defects, Renal tubular dysplasia -> oligohydramnios, Potter's sequence, and pulmonary hypoplasia IUGR Hypocalvaria manifested by large anterior fontanel, vasodilation, severe fetal hypotension, anuria/oligura" Critical Period: 2nd-3rd trimesters Alcohol correct answers "Growth restriction CNS (intelligence & behavior) Characteristic facial features such as ptosis, short palpebral fissures, smooth philtrum and thin upper vermilion, microcephaly, flat nasal bridge" NO SAFE LEVEL/AMOUNT Aminopterin correct answers (50%) IUGR, Short stature, delayed calvarial ossification, craniosynostosis, hydrocephalus, abnormal auricles, ocular hypertelorism, microignathia, Cleft Palate, limb & digital anomalies, NTDs Amphetamines correct answers heart defects and CL in some mice Anticonvulsants correct answers "6-15% risk for major malformations Anti-convulsant embryopathy: hypertelorism, Broad depressed nasal bridge, Short nose with anteverted nares, "Cupid's bow" lip, FINGERNAIL HYPOPLASIA, Meningomyelocele, Oral clefts, CHDs, Limb defects Developmental delay, most significantly with valproic acid" older anticonvulsants: Phenytoin, trimethadione, carbamazepine, valproate, barbiturates. Risks w/ new meds are probably less, not enough studies to be sure. Aspirin correct answers inc SAb risk when exposed around conception, avoid in late pregnancy due to concerns for premature constriction of ductus arteriosus & bleeding abnormalities Benzodiazepines correct answers Treatanxiety "Clefting?neonatal adaptation syndrome" Carbamazepine (Tegretol) correct answers Spina Bifida (1%), craniofacial anomalies, dev delay? Cigarettes correct answers Infertility, ectopic pregnancy, miscarraige, placental abruption, placental previa, fetal growth restriction (dose dependant), preterm delivery, SIDS, orofacial clefts (genetic susceptibility??), abnormal placentation, decreased childhood pulmonary fxn, ADHD, food allergies Cocaine correct answers Premature labor/birth, abruption, uterine rupture, cerebral infarction (stroke), brain disruptions, Sab, behavioural abnormalities
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