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24 Cards in this Set
- Front
- Back
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ACE inhibitors
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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
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Alcohol
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Growth restriction CNS involvement, (intelligence & behavior) Characteristic facial features such as ptosis, short palpebral fissures, smooth philtrum and thin upper vermilion, microcephaly, flat nasal bridge
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Anticonvulsants
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6-15% risk for major malformations Hypertelorism Broad depressed nasal bridge Short nose with anteverted nares “Cupid’s bow” lip Fingernail hypoplasia Meningomyelocele Oral clefts Congenital heart defects Limb defects Developmental delay, most significantly with valproic acid
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Carbamazepine (Tegretol)
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Spina Bifida (1%), craniofacial anomalies, dev delay?
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Cigarettes
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Infertility, ectopic pregnancy, miscarraige, placental abruption, placental previa, fetal growth restriction (dose dependant), preterm delivery, SIDS, orofacial clefts, abnormal placentation, decreased childhood pulmonary fxn, ADHD, food allergies
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Cocaine
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Premature labor/birth, abruption, uterine rupture, cerebral infarction (stroke), brain disruptions, Sab, behavioural abnormalities
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Coumadin
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stippling dysplasia of 2ndary epiphysis, nasal hypoplasia, distal digital hypoplasia, growth retardation & low birth weight, CNS (sz, MR), eye anomalies, hearing loss, (heart defects less common)
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Cytomegalovirus (CMV)
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MOST asymptomatic HEARING LOSS Some growth restriction, cerebral periventricular calcifications, ocular abnormalities and hepatosplenomegaly, ventriculomegaly, blueberry muffin rash, SNHL, chorioretinitis/retinal lesions Maternal infection -> Fetus 30-40%,
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Diethylstilbestrol (DES)
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clear-cell vaginal adenocarcinoma in women prenatally exposed (90% after age 14), women had more SAbs & Premies, structural defects of cervix, vagina, uturus, tubes, (25% males epididymal cysts & hypotrophic testes, 32% abnormal sperm)
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Fluconazole
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LARGE DOSE: craniofacial, limb and cardiac anomalies, a phenocopy of Antley-Bixler syndrome
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hyperphenylalaninemia
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Microcephaly, MR, microsomia, CHD, strabismus, hip dislocation, facial dysmorphism
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Hyperthermia (High Fever)
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NTD, Abdominal Wall Defects, cardiac anomalies
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Insulin-Dependent Diabetes
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hyper/hypoglycemia, hyperketonemia, hypoxia, hyperbilirubinemia, low calcium, skeletal, cardiovascular, CNS (NTD, holoprosencephaly), Caudal regression, GU, GI, anencephaly, meningomyelocele
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Lithium
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30x Ebstein's anomaly (heart valves), CHD
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Radiation
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Microcephaly Mental retardation Seizures Growth restriction Minor anomalies of the eyes Controversial increase in carcinogenesis
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Retinoids (Accutane, Vitamin A)
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CNS anomalies Ear anomalies Cardiovascular defects Thymus anomalies Occurs in 20-30% of exposed babies Intellectual deficiency can be seen in 30-60% of exposed even in the absence of anomalies, more SAbs & Premies, NEURAL CREST DERIVED
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Rubella
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miscarraige, sequelae, 1st Tri: multiple congenital anomalies,cataracts, cardiac, 2nd Tri: deafness or "salt and pepper" retinopathy, MR, diabetes, IUGR, ID, swollen lymphs, hepatosplenomegaly, hepatitis, jaundice, hemolytic anemia, pneumonitis, meningoencephalophalitis, clouded corneas, metaphyseal radiolucencies, diarrhea, thrombocytopenic purpura with petechiae and "blueberry muffin" lesions (focal areas of erythropoiesis): permanent: endo, immuno, audio, ocular, vascular, CNS disease
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SSRI
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neonatal adaptation syndrome
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Tetracycline
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stained teeth, enamel hypoplasia
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Thalidomide
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20-50% of exposed babies with severe limb reduction defects PHOCOMELIA, ear anomalies, facial hemangiomas, esophageal, duodenal atresia
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Toxoplasmosis
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visual or hearing impairment, learning disabilities, ID apparent several months-1yr later, chorioretinitis, blindness, epilepsy, intracranial diffuse calcifications, hydrocephalus, microcephaly, encepalitis, sz, anemia, thrombocytopenia, hepatospleomegaly, jaundice, lympadenopathy, pneumonia, maculopapular rash, petechiae MOST ASYMPTOMATIC @ BIRTH
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Valproic Acid (Depakene)
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Neural tube defects, dysmorphic face, 1-2% lumber meningomyecele, nail hypoplasia
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Varicella (Chicken pox)
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cicatrix (zigzag scarring), limb interruptions, eye and brain involvement, MR, Sz, IUGR, chorioretinitis, limb hypoplasia, rudimentary digits
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Warfarin
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Nasal hypoplasia Stippled epiphyses Limb hypoplasia in 1/3 GR,CNS and opthalmic abnormalities Hearing loss, Sab, stillbirths, prematurity if in 2nd,3rd tri
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