MCN Semifinals: Teratogens 2

teratogen

Is any factor, chemical or physical, that adversely affects the fertilized ovum, embryo or fetus

teratogen

an agent or factor that causes malformation of an embryo.

radiation

concentration of teratogens where a woman is exposed

before implantation

either the zygote is destroyed or it appears unaffected

2nd to 8th week

the main body systems are being formed during?

2nd to 8th week

fetus is very vulnerable to injury

last trimester

the potential for harm again decreases because all the organs of a fetus are formed and are merely maturing.

lead and mercury

attack and disable nervous tissue

thalidomide (immunoprin)

targets the extremities
----originally used to treat nausea in pregnancy, is now prescribed for cancer therapy, and it may cause limb defects.

tetracycline (apo-tetra)

targets the bones
-----a common antibiotic, causes tooth enamel deficiencies and, possibly, long-bone deformities.

eyes, ears, heart, and brain

what are the four most commonly attacked organs by the rubella virus?

pinocytosis

a process from which viruses, bacteria, and protozoan organisms cross the placenta from mother to fetus

malaria

caused by intraerythrocytic protozoa of the genus Plasmodium transmitted to humans by the bite of an infected female Anopheles mosquito.

malaria

Healthcare providers can contract it from infected blood products

t

During pregnancy, women can transmit malaria to a fetus. (t/f)

chloroquine (aralen)

used for the tx of malaria in the first tri

mefloquine (lariam)

used for the tx of malaria in the second and third tri

2 weeks

Women who will be visiting an area known to be epidemic for malaria can begin treatment as prophylaxis up to_____ before travel

Toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes virus

TORCH stands form?

syphilis, HBV, and HIV

"other infections" include?

uncooked meat, handling of cat stool in soil or cat litter

toxoplasmosis is commonly contracted through?

CNS damage, hydrocephalus, microcephaly, intracerebral calcification, & retinal deformities.

If the infection crosses the placenta, the infant may be born with ? (toxoplasmosis)

pyrimethamine

an antifolic acid drug and an antiprotozoal agent is used cautiously early in pregnancy to prevent reducing folic acid levels

Fetal damage from maternal infection with rubella (german measles)

1) deafness
2) mental and motor changes
3) Cataracts
4) cardiac defects 5) retarded intrauterine growth
) 6) thrombocytopenic purpura
7) dental & facial clefts, such as cleft lip & palate

cardiac defects

most commonly patent ductus arteriosus & pulmonary stenosis

retarded intrauterine growth

small for gestational age

thrombocytopenic purpura

patches of purplish discoloration

because the vaccine contains a live virus that would have effects similar to those occurring with a subclinical case of rubella

A woman who is not immunized before pregnancy cannot be immunized during pregnancy because?

3 months

After a rubella immunization, a woman is advised not to become pregnant for _______ until the rubella virus is no longer active.

f

all pregnant women should not avoid contact with children with rashes (t/f)

t

Nurses who care for pregnant women or newborns should receive immunization against rubella (t/f)

t

All women w/ low rubella titers should be immunized to provide protection against rubella in future pregnancies (t/f)

greater than 1:8

titer that suggests immunity to the disease

less than 1:8

titer that suggests a woman is susceptible to viral invasion

recent infection has occurred

A titer that is greatly increased over a previous reading or is initially extremely high suggests that a?

cytomegalovirus

a member of the HSV family

cytomegalovirus

can cause extensive damage to a fetus while causing few symptoms in a woman

cytomegalovirus

not sexually transmitted but spreads from person to person by droplet infection such as occurs with sneezing.

severe neurologic challenges
eye damage
hearing impairment
chronic liver disease
skin may be covered with large petechiae

If a woman acquires a primary CMV infection during pregnancy and the virus crosses the placenta the infant may be born with?

blood culture

Diagnosis in the mother or infant can be established by the isolation of CMV antibodies in blood serum (cmv)

cytomegalovirus

there is NO TREATMENT for this infection even if it presents in the mother with enough symptoms to allow detection

routine screening

Because there is no treatment or vaccine for the disease,__________ for CMV during pregnancy is not recommended

viremia

viruses in the blood

1ST TRI

congenital anomalies or spontaneous miscarriage may occur. (HSV)

2ND OR 3RD TRI

high incidence of premature birth, intrauterine growth retardation, & continuing infection of the newborn birth (HSV)

T

If genital lesions are present at the time of birth, a fetus may contract the virus from direct exposure during birth (HSV) (T/F)

cesarean birth

it is usually advised to reduce the risk of HSV infection

acyclovir (zorivax) or valacyclovir (valtrex)

can both be safely administered to women who develop lesions during pregnancy as well as to their newborns at birth

disease prevention

the primary mechanism for protecting a fetus?

practice safe sex

how to mitigate HSV?

syphilis

a sexually transmitted infection

treponema pallidum

cannot cross the placenta when cytotrophoblast layer of chorionic villi is still intact

cytotrophoblast layer of the chorionic villi

this layer atrophies at 16th - 18th week and treponema pallidum can then cross the placenta and cause extensive damage.

serologic screening

done during the first prenatal visit ( syphilis)

venereal disease research laboratory, rapid plasma reagin test

serologic screening for syphilis may be conducted through?

benzathine penicillin

If treated with _______________ in the 1st trimester, fetus is rarely affected
(syphilis)

Hearing impairment
Cognitive challenge Osteochondritis
Fetal death

If syphilis is left untreated beyond 18th week, it may lead to?

200 days

Even when a woman has been treated with antibiotics, the serum titer remains high up to how many days?

3 months

In an infant born to a woman with syphilis, the serologic test for syphilis may remain positive for up to___________ even though the disease was treated during pregnancy.

rubeola

known as measles

coxsackievirus

human enterovirus A,B,C

infectious parotitis

the medical term for mumps

varicella

another name for chicken pox

teratogenic

Rubeola (measles), coxsackievirus (human enterovirus A,B,C), infectious parotitis (mumps), varicella (chickenpox), poliomyelitis, influenza, and viral hepatitis all may be ?

t

women are advised to be vaccinated against influenza before pregnancy. (t/f)

parvovirus b19

the causative agent of erythema infectiosum; a common viral disease in school-age children, contracted during pregnancy

fifth disease

parvovirus b19 is also called as?

fetal death

infection with parvovirus b19 during EARLY PREGNANCY is associated with?

severe anemia and congenital heart disease

infection with parvovirus b19 during LATE PREGNANCY is associated with?

LYME DISEASE

a multisystem disease caused by the spirochete Borrelia Burgdorferi, is spread by the bite of a deer tick.

erythema chronicum migrans

large, macular lesions with a clear center

tetracycline and doxycycline

tx for lyme disease in np woman

penicillin

tx for lyme disease in pregnant woman

Measles, Mumps, rubella and poliomyelitis (sabin type)

are contraindicated during pregnancy because they may transmit the viral infection to the fetus

Measles, Mumps, rubella and poliomyelitis (sabin type)

live virus vaccines such as?

alcohol

a common drug abused by women of childbearing age

t

Infants born to alcoholic mothers demonstrate prenatal and postnatal growth deficiency, mental retardation, and other malformations (t/f)

vitamin b deficiency and neurologic damage

Fetuses cannot remove breakdown products of alcohol from their body leading to?

short palpebral features, maxillary hypoplasia, a smooth philtrum, congenital heart disease

what are the subtle but classical facial features associated with fetal alcohol syndrome?

growth retardation, sudden infant death syndrome, low birth weight

cigarette consumption during pregnancy may result to?

metal and chemical hazards

pesticides& carbon monoxide are considered as?

radiation

has been proven to be a potent teratogen to unborn children because of high proportion of rapidly growing cells present.

hyperthermia

maybe detrimental to growth because it interferes with cell metabolism