Diaz - Week 10

Front 1

Human development ______ can be divided into three time periods, called _______, each about three months long.

Back 1

in utero

trimesters

Front 2

1. Most dramatic changes occur in which trimester?
2. the two-celled organism (zygote) undergoes division to become a ball of cells called the ___2___.

The ___2____ then turns into a hollow ball of cells called the ___3_____. All of this happens in the first ___4___ days of gestation and before ___5___.

Back 2

-FIRST

2. morula

3. Blastula

4. five

5. implantation

Front 3

The organs and the limbs are formed during the first trimester. Any disruption of this time period may result in malformations. What is this phase of development called?

Back 3

Organogenesis

Front 4

What is the study of factors that disrupt normal gestation called?

Back 4

Teratology

Front 5

What is the drug, which if ingested during the first trimester, results in birth without limbs (or severely deformed limbs)?

Back 5

Thalimide

Front 6

The organs have formed by the first trimester. No new organs will be formed after this. What happens to the organs in the 2nd and 3rd trimesters?

Back 6

Growth and the development of the functional capacity

Front 7

List the phases of human development, not from the chronological point of view, but in regards to the functional phases of development:

Back 7

1) organogenesis
2) histogenesis
3) the development of function

Front 8

what occurs during histogenesis?

Back 8

cells become tissue-specific

example, kidney cells begin to form shape and size of kidney

Front 9

explain what happens during the third functional phase of developent: the development of function.

Back 9

the kidney which only looked like a kidney actually begins to perform the functions that a kidney would perform...

Front 10

When is the duration of the human brain growth spurt?

Back 10

mid-gestation = half-way through second trimester

to

fourth post-natal year

Front 11

During the brain growth spurt, what are the cells that are developing so quickly?

Back 11

glial cells

Front 12

What are the three main events that occur in the brain growth spurt?

Back 12

1. Rapid proliferation of glial cells, specifically of oligodendrocytes
2. rapid myelination
3. a dramatic increase in the number of synapses - this is the most important in terms of expression of behavior. This is the formation of the wiring. Get the wiring wrong... you get the behaviors coming out all wrong too.

Front 13

what does the term 'behavioral teratology' mean?

Back 13

disruption of normal brain development such that the individual expresses abnormal behavioral patterns

Front 14

Is there a direct connection between the mother's circulation and the fetal circulation?

Back 14

No. the fetus has its own circulation. nutrients and waste are exchanged by an elaborate diffusion system

Front 15

What is the location of the exchange of nutrients and waste between the two circulatory systems of a pregnant woman?

Back 15

Placenta

Front 16

How does the placenta offer protection for the fetus?

Back 16

It doesn't.

Front 17

What is the conundrum of the fetal kidneys filtering drugs?

Back 17

the kidneys will filter the circulating blood, and secrete drug molecules into the amniotic fluid, which the fetus normally swallows, resulting in a self-dosage.

Front 18

What are the three most frequently taken drugs during pregnancy are:

Back 18

1. nicotine
2. ethanol
3. marijuana
followed by opiates and cocaine

Front 19

what are the three general categories of malfunctions in fetal alcohol syndrome (FAS)?

Back 19

1. Central Nervous System Dysfunction

2. Growth Deficiency

3. Facial Abnormalities

Front 20

Fetal Alcohol syndrome causes CNS dysfunction. What are the properties of this malady?

Back 20

1. mild to moderate mental retardation (seen in over 80% of cases)

2. microcephaly - small brains (seen in over 80% of cases)

3. poor coordination (seen in over 50% of the cases)

4. irritability in infancy, possibly due to withdrawal (seen in over 80% of the cases)

5. hyperactivity in childhood (seen in over 50% of cases)

Front 21

Fetal Alcohol syndrome causes growth deficiency. What are the properties of this malady?

Back 21

1) pre-natal growth deficiency - a little less than 2 standard deviations below the means for body weight and length.

Front 22

Fetal alcohol syndrome causes facial abnormalities. Name some of these abnormalities.

Back 22

1. short eye slits
2. hypo-plastic philtrum - the grove under the nose is filled in
3. thin upper lip
4. flattened lip
5. droopy eyelids

Front 23

fMRI brain imaging data of the FAS inflicted brain suggests that:

Back 23

there is decreased blood flow in the cerebral cortex, not unlike Down's syndrome. The thalamus and basal ganglia are also smaller than normal, but this is not similar to down's.

Front 24

How long after birth do the effects of FAS last?

Back 24

permanent

Front 25

What are the distinguishing features of Fetal Alcohol Effects, in comparison with FAS?

Back 25

if a pregnant woman consumes a moderate amount of alcohol, effects similar to FAS

Front 26

What is the relationship between alcohol intake and spontaneous abortion?

Back 26

positive correlation.

Front 27

What are the two general effects of smoking on the circulatory system?

Back 27

1. reduces oxygen concentration in mothers blood (which means less oxygen available for the baby) and may introduce carbon monoxide into mother's bloodstream
2. decreases blood flow to the fetus (vasoconstriction due to sympathetic NS stimulation)

Front 28

What is hypoxia?

Back 28

decreased oxygenation of the blood

Front 29

Upon smoking, the resulting hypoxia, or decreased oxygen supply to the fetus results in three consequences. Explain them:

Back 29

1. growth deficiency, smaller infants (in both length and weight)

2. increased in the incidence of spontaneous abortions

3. increased delivery complications and neonatal death


4) increased risk for Sudden Infant Death Syndrome (SIDS)
5) increased risk for later lung related problems (like bronchitis, pneumonia)
6) perhaps poorer school performance
7) increased risk of hyperactivity

Front 30

It was found that children of mothers who had smoked ___ (a number) or more cigarettes a day during pregnancy had _____ (lower or higher) IQ scores than comparable control children at ages 3 and 4.

Back 30

10

and

lower

Front 31

A study found that mothers who smoked one to 10 cigarettes per day increased the risk of having a child with a toe or finger deformity by ____%.

-What is kind of relationship (correlation) exists between number of cigarettes smoked per day and risk of toe/finger deformity?

Back 31

29%

and

positive correlation.
-11 to 20 cigs = 38% risk
-21 or more cigs = 78%

Front 32

The overall incidence of marijuana use during pregnancy has been estimated to be from ___ and ___ percent.

Back 32

5 and 34

Front 33

What are the effects of prenatal exposure to marijuana?

Back 33

Not pronounced at all. maybe a small effect on overall length at brith.

-nothing like the abnormalities seen with FAE/FAS

Front 34

A study found that cannabis exposure during the ___ and ___ trimesters may lead to a decrease in body length at birth, while exposure only during the ____ trimester was found to be associated a increase in body length.

Back 34

-first
-second

and

-third

Front 35

There is no consensus concerning benign effects of marijuana. What have some studies found in regards to benign effects?

Back 35

-smaller head circumference that persisted for two years

-jitteriness at birth, but small effect

Front 36

1. In regards to marijuana use during pregnancy, a study on school age children that were exposed to cannabis during development were found to have the following the consequences:

2. However, when factors like maternal age at the time of delivery, mother's personality, and the quality of the home environment were controlled for, the effects seen were:

Back 36

1. behavioral problems, deficits in language comprehension, and increased distractibility .

2. no longer significantly different than the appropriate control groups

Front 37

Considering that the brain growth spurt continues from half way through the second trimester all the way to the fourth post-natal year, what concerns are present if the mother ingests delta9-THC during post-natal period.

Back 37

delta9-THC can transfer to mother's milk VERY EASILY, and at very high levels. So, the infant will also be receiving a large dose of THC if breast feeding

Front 38

Infants that received delta9THC via mother's milk during the first month of life were seen to have the following non-behavioral consequences:

Back 38

impaired motor development when they were tested at one year of age

Front 39

The topic of opiate use during pregnancy talks to which two opiates?

Back 39

Heroin, methadone

Front 40

Does dependency to heroin develop in an infant whose mother is ingesting heroin during gestation? Is there withdrawal then?

Back 40

Yes. Furthermore, the supply of drug ends upon birth and the infant experiences "neonatal narcotic withdrawal syndrome"

Front 41

What characterizes neonatal narcotic withdrawal syndrome?

Back 41

CNS irritablity, a persistent high pitch shrill crying, tremors, inabilty to sleep properly, hyperactive reflexes, vomiting and diarrhea, frantic first sucking which isn't related to hunger since these infants feed poorly, and in extreme cases convulsions. Can last up to 6 months, before normal behavior ensues

Front 42

Heroin exposure effects the overall size of the infant in which two ways?

Back 42

-decreased body weight
-decreased head circumferences

Front 43

What are some deficits observed later in life in children exposed to heroin during their gestation.

Back 43

no difference in IQ test scores, but show deficits in general cognitive abilities and many maladaptive behaviors are present: uncontrollable temper, and aggressiveness.

Front 44

When attempting to find a cause for the symptoms of aggressiveness and uncontrollable temper in children who were exposed to opiates during gestation, what confound is usually present?

Back 44

Mothers usually took more than one opiate. So its impossible to pin down the effects of just heroin, or just methadone

Front 45

At birth, infants of mothers who
only took methadone during their pregnancies had significantly ___1___ (larger/smaller) body weights compared to mothers that exclusively used heroin during their pregnancies but the methadone exposed infants were still significantly ___2___ (lighter/heavier) than non-drug exposed infant controls. The methadone infants' neonatal withdrawal was ___3___ (more or less) severe in comparison to the heroin infants but both groups had similar symptoms: hypersensitivity to stimuli, irritability, and sleep disturbances. The methadone exposed infants, like heroin exposed infants, had a ___4___ (high/low/neutral) frequency of small circumference which remains ___5___ (large/small) for at least a year and a half.

Back 45

1. larger

2. lighter

3. less

4. high

5. small

Front 46

1. At 18 months, children exposed to methadone during development show signs of:

2. At 3 years of age, these children are showing signs of:

Back 46

1. developmental delays and deficits in motor and mental functioning

2. poor learning behavior, aggression, anxiety. IQ scores are significantly lower.

Front 47

What are the pregnancy complications of using cocaine during pregnancy?

Back 47

1. increased first trimester spontaneous abortions

2. increased risk of sudden onset of contractions in the third trimester

3. increased risk of the placenta separating (abruptio placentae)

Front 48

Name the neonatal outcome effects following cocaine exposure during gestation. Six listed

Back 48

1) microcephaly (small brain)
2) growth deficiency
3) irritability and tremors in infancy
4) increased risk for SIDS
5) reduced ability of the infant to respond to faces and to interact with people
6) infants that are difficult to console

Front 49

Studies examing the long-term behavioral effects (learning and behavioral issues) of cocaine have been _____(conclusive or inconclusive)

Back 49

INCONCLUSIVE

Front 50

Cocaine passes into mother's milk easily. How long can it stay there?

Back 50

as long as 2 days

Front 51

What is the Fetal Hydantoin Syndrome (FHS)

Back 51

name for the constellation of effects seen in children exposed to anticonvulsants during gestation.

Front 52

a common anticonvulsant ___1(name of drug)___ is used to control seizures, which is usually given in conjunction with other anti-convulsants named:

Back 52

1. dilantin

2. barbiturates: phenobarbital, mephobarbital and carbamazepine

Front 53

"Fetal Hydantoin Syndrome" (FHS) effects fall into what
four general categories?

Back 53

1. deficiences of growth
2. deficits in developmental performance
3. facial abnormalities
4. limb malformations

Front 54

What are the facial abnormalities resulting from FHS?

Back 54

broad nasal ridge, droopy eyelids, prominent low set ears, and wide mouth with prominent lips, and finally pathologically small fingers and toes

Front 55

The most significant difference between FHS and FAS/FAE is?

Back 55

Severity. In FHS, the negative behavioral outcome is not as severe as the global mental retardation seen in FAS, but rather its a general deficit in cognitive abilities

Front 56

Moderate use of coffee is defined as?

Back 56

6 cups or less

Front 57

Does moderate use have significant negative effect on the infant?

Back 57

Nothing has been found to indicate so.

Front 58

What are some basic issues about using psych-meds during pregnancy, like anti-depressants?

Back 58

1. maybe the meds cause malformations?

2. maybe meds leave neonate with a withdrawal syndrome?

Front 59

The FDA has found what results in studies attempting to find the effects of psych-meds on infants?

Back 59

A. Controlled Studies show no risk
B. No evidence of risk in humans
C. Risk cannot be ruled out
D. Positive evidence of risk
E. Contraindicated in pregnancy -demonstration of positive evidence of fetal abnormalities or risk which clearly outweighs any possible benefit to the patient

Front 60

What are common withdrawal symptoms observed in the neonate, which last about a month post-birth?

Back 60

constant crying, shivering, eating and sleeping difficulties, and convulsions.

Front 61

what are some potential effects of drugs (like barbiturate and beznodiazapines) when given to neonates, based on animal studies?

Back 61

1) brain growth may be vulnerable to disruption even its late stages and (2) barbiturates may constitute a threat to normal brain growth

2)We conclude there may be a long-term adverse cognitive effect of phenobarbital on the developmental skills (language/verbal) being acquired during the period of treatment and no beneficial effect on the rate of febrile seizure recurrences or later non-febrile seizures.