This is any agent that causes a structural abnormality following fetal exposure during pregnancy.
T/F. An increased prevalence of a particular birth defect is usually what leads to the discovery of a teratogenic agent.
Methyl mercury was found to be a teratogen when it was dumped into the bay from a local factor (Chisso) and mother's ate the contaminated fish during pregnancy. It lead to increased incidence of birth defects that lead to an investigation. What was the name of this disease?
In what trimester is a baby most vulnerable to teratogens?
This is a known teratogen that is used to treat skin problems and nausea. It was originally given for nausea during pregnancy, but it caused face and limb abnormalities.
This is a known teratogen that was a therapeutic (antibiotic) that caused damage to developing LONG BONES and dental tissue.
T/F. Alcohol, nicotine, crack, methamphetamine, LCD, or PCP are NOT known teratogens.
False, they are
This is an infectious agent also known as the German Measles that can cause deafness and microcephaly.
This is an infectious agent (VIRUS) that is a known teratogen to cause hearing loss.
Name four other infectious agents that are important fetal teratogens.
Name three maternal diseases (mother has them) that can be fetal teratogens.
T/F. Environmental agents such as organic compounds, mercury, PCB, herbices, and solvents are all important fetal teratogens.
When a fetus is exposed to a tertaogen, what two things are often the determining factor for the severity and the type of defect?
Time they were exposed (what trimester)
Dose of exposure
Dose Response: The greater the dose the _________ the effect.
Certain stages of development are more vulnerable than others. In general, which is the more vulnerable trimester?
Repeat: This antibiotic causes irreversible tooth defects and diminished growth of LONG BONES.
Repeat: This anti-nausea drug causes limb deformities and CVD (cardiovascular disease).
Streptomycin is known to cause?
Warfarin (anticoagulant) is known to cause mental retardation and what eye problem?
T/F. Trimethadione and Phenytoin (Seizure meds) are known to cause IUGR (inuteral growth retardation), MR, and CV defects.
T/F. Accutane is not known to cause microphthlamia, brain and heart defects.
False, it is!
Mercury can cause CNS defects, MR, and ______.
True/Flase. Lithium can cause congenital cardiac/large vessel abnormalities.
Nicotine is known to cause IUGR and this eye problem!
What syndrome are oral contraceptives known to cause?
Vacteryl Syndrome (Mermaid syndrome)
T/F. Alcohol cannot cause FAS, IUGR, or MR.
False, it can
What is the relationship of the following to the incidence of strabismus?
1. Coffee: No relationship
2. Tea: No relationship
3. Alcohol: INVERSE relationship
4. Smoking: DIRECT relationship
What is the greatest risk to fetus from 2nd hand smoke? (i.e. What does it cause?)
Patients taking this acne medicine are required to take a pregnancy test before Rx is given (and monthly thereafter), pledge that they will not get pregnant during time of use, and have proof of contraception during use.
Repeat: What is the main issue for second hand smoke?
T/F. Non-smoking women ofter the age of 30 living with a smoker had much greater chance of delivering a premature baby.
What are two consequences of premature birth (socially)?
May be hard on child later
About how many pregnancies could be affected by second hand smoke?
Fetal Alcohol Syndrome: Patient can develop IUGR (slow fetal growth), MR, _______, small _____ _____ (width, not height), and _______. They may also have no philtrum, a thin ______ lip and BEHAVIORAL problems.
Microcephaly (Small head)
Small Palpebral Fissures
What are the six main malformations caused by the VACTERL syndrome (due to oral contraceptive use during pregnancy).
Name the five TORCH infectious diseases.
Others (Syphilis, HIV)
What is the most common cause of posterior uveitis?
If a child is infected with toxoplasmosis in the first trimester, what is the result?
What are two ways a pregnant individual can contract toxoplasmosis?
Handling/Consuming Contaminated Meat
What is the most common ocular sign of toxoplasmosis infection? Is it bilateral or unilateral? Is it peripheral or posterior pole?
Chorioretinitis (posterior uveitis)
Bilateral, posterior pole
Congenital Toxoplasmosis Syndrome: Patients may have ocular signs that include _____, cataract, and ______. They may present with systemic intracranial calcifications, seizures, hydrocephalus, _____, and deafness.
When should we be concerned with a fetus contracting syphalis from the mother?
After the 18 week (before that it is not problematic)
Congenital Syphilis: Ocular signs include chorioretinits, _______ _____, and optic atrophy. Patient may also present systemically with _____ abnormalities, deafness, hydrocephalus, MR, nasal abnormalities and this pathongnomic sign (specific). Patient may also have a _________ ______ found on the soles of feet, trunk and palms.
Hutchinson's teeth (****)
What is the prevalence of congenital syphilis among live births?
What organism is responsible for congenital syphilis?
What are three main modes of transmission of congenital HIV?
T/F. HIV is found in tears (but infection from tears has not been reported).
Congenital HIV: Ocular signs include HIV _________, CMV retinitis, _____, _______ sclera, and long palpebral fissures. Systemically the child may have a failure to thrive and be open to opportunistic infections.
Hypertelorism (Wide Telocanthus)
What is the incidence of congenital HIV among live births?
Rubella: Also called what? It may produce the following ocular signs: _____, _____, rubella retinopathy, and corneal and chorioretinits. Systemically the child may have heart defects, cerebral calcifications, MR, deafness, maculopapular rash, and ______ and ______.
Wat is the incidence of rubella among live births?
1/1,000,000 (very rare)
When rubella is contracted in the 1st trimester it has an 85% chance of leading to what? (Rubella-specific IgM persists in these infants).
CRS (Congenital Rubella Syndrome)
When CRS (congenital rubella syndrome) occurs in an infant and they develop cataracts are these usually bilateral or unilateral?
(25% unilateral with microphthalmos)
T/F. A very young infant with CRS and large hazy corneas may develop glaucoma (10%). What is the treatment for this?
What is the incidence of the cytomegalovirus among live births?
Cytomegalovirus (CMV): Patient may have keratitis, chorioretinits, or be _______. What is unique about this disease in terms of ocular signs? Systemically the patient may have IUGR, cerebral calcification, MR, deafness, and _____.
Ocular damage is rare
How does a fetus contract herpes simplex virus?
Mother must have genital herpes simplex infection.
T/F. Herpes simplex produces more ocular morbidity than other child keratitis infections.
Herpes Simplex: Child may have acute ___________, HSV _____, chorioretinits, CAT, and microphthalmos. Systemically they may have a skin rash, _____ or _____.
What is the pathognomonic sign for Herpes simplex in a fetus? Should you treat it with steroids?
Dendritic lesions on the cornea