uWISE Tertogens

Question 1

yellow-brown deciduous teeth

Answer 1

tetracyclines (doxycycline, minocycline)

Question 2

hyperbilirubinemia via displacement of bilirubin from protein binding sites

Answer 2

sulfonamides (avoid near delivery)

Question 3

hemolytic anemia in g-6-p deficiency (theorietical)

Answer 3

nitrofurantoin

Question 4

irreversible arthropathy, cartilage erosion in animals

Answer 4

quinolones

Question 5

metronidazole?

Answer 5

not tertogenic in first trimester

Question 6

crosses placenta! nasal and midface hypoplasia, stippled vertebral and femoral epiphyses, later hemmorage and hydrocephalus

Answer 6

warfarin! use newer LMWH

Question 7

abnormal facies, cleft lip or palate, growth deficiency, hypoplastic nails and distal phalanges

Answer 7

phenytoin

Question 8

1-2% risk of NTDs or spina bifida

Answer 8

valproate and carbamazepine

Question 9

increased ventral and atrial septal cardiac defects

Answer 9

paroxetine (SSRI)

Question 10

neonatal behaviors syndrome (increased muscle tone, irritability, jitteriness, respiratory distress)

Answer 10

all ssRIs

Question 11

growth restriction, limb contractures, abnormal cavarum developement

Answer 11

ACE inhibitors

Question 12

near delivery, thrombocytopenia w/associated bleeding and electrolyte disturbances

Answer 12

thiazide dieurtics

Question 13

may interfere with breast milk production

Answer 13

all diuretics

Question 14

ca blockers?

Answer 14

safe

Question 15

methyldopa and hydralzine?

Answer 15

safe

Question 16

in first trimester, missing or hypoplastic digits in the hands and feet

Answer 16

cyclophosphamide

Question 17

alters folic acid metabolism, high doses lead to IUGR, severe limb abnormality, posterior rotates ears, micrognathia, hypoplastic supraorbital ridges

Answer 17

methotrexate

Question 18

between 7-12w, can cause full masculinization, later partial

Answer 18

androgens

Question 19

labioscrtoal fusion, phallic enlargement

Answer 19

testorestone, anabolic steroids

Question 20

clitoromegaly, urogential sinus malformation, labioscrotal fusion

Answer 20

danazol

Question 21

theoretical risk of premature ductus arteriosus closure

Answer 21

aspirin (tylenol is ok)

Question 22

tocolytic, constricts fetal ductus areriosis, neonatal PHTN if used near delivery

Answer 22

indomethacin (other NSAIDs okay for short-term use)

Question 23

gastroschisis (bowel protrudes near umbilical cord) in first trimester use

Answer 23

pseudoephendrin

Question 24

transient withdrawal

Answer 24

benzos

Question 25

CV malformations, limit exposure until after 8w

Answer 25

lithium

Question 26

congenital abnormalities at high doses

Answer 26

vit A

Question 27

significant fetal loss and malformation w/first trimester use

Answer 27

isotretinoin

Question 28

topical gel, unclear effect, avoid if pregnant

Answer 28

tretinoin

Question 29

pre-preg eval for thalassemia and sickle cell

Answer 29

hemoglobin electophoresis and CBC