Deck 4: Development and Teratogenesis

Question 1

During organogenesis the cells of the ICM (intercellular mass) create the ectoderm, mesoderm, and ectoderm. Which of the following organs and tissues are associated with development of the endoderm?

A) Bone, cartilage and blood
B) Brain, spinal cord and retina
C) Liver, pancreas, and blood vessels
D) Gallbladder, bladder, and respiratory system lining

Answer 1

D
Explanation: Gallbladder, Bladder and Respiratory Lining all line and all are formed from the endoderm. Bone, Cartilage, and Blood are all formed from the Mesoderm. Brain Spinal Cord are formed from the Ectoderm. The liver and pancreas are formed from the endoderm. However, the blood vessles are formed from the Mesoderm.

Question 2

When is the most critical time period for development and also the most dangerous time to use teratogens?

A) Three weeks prior to conception- Four weeks after last menstrual period
B) Four weeks after last menstrual period- Fifteen weeks after last menstrual period
C) Fifteen weeks after last menstrual period- 25 weeks after last menstrual period
D) The three weeks prior to the delivery of the baby

Answer 2

B
Explanation: Four weeks after last menstrual period- Fifteen weeks after last menstrual period. The stage of embryonic development most susceptible to teratogenesis is during the formation of primordial organ systems. The critical period for teratogenic effects is between 3 and 16 weeks of gestation. During this time period the CNS is being developed.

Question 3

Which of the following teratogens is most commonly known for stunted limb growth?

A) ACE Inhibitors
B) Thalidomide
C) Amphotericin
D) Isoretinoin

Answer 3

B
Explanation: A) This does not cause limb growth irregularities in pregnancy however it is a teratogen that can cause renal shutdown in the fetus.
B) Thalidomide commonly causes limb abnormalities because it is used between weeks 4 and 10 of pregnancy as an anti-nausea medication during pregnancy during the critical period for limb formation.
C) Amphotericin is most commonly known to cause cell death and crosses the placenta but is in pregnancy category B due to few reported abnormalities.
D) This can cause CNS and ocular abnormalities

Question 4

At time of delivery a 1-day-old female neonate on physical exam is found to have microcephaly and a diffuse spread red rash which of the following is highest on your differential diagnosis list?

A) CMV
B) FAS
C) Rubella
D) Roseola'

Question 5

What is the most common characteristic feature of a child whose mother ingested ethyl alcohol at some time during pregnancy and the child has FAS?

A) Craniofacial abnormality and Behavior disturbances
B) Spinal Defects and Increased Birth Weight
C) Cardiac Defects and Stunted Limb Growth
D) Behavior disturbances and Seizure activity

Question 6

DES was taken during pregnancies to alleviate high risks however it caused some severe side effects for the fetus. Which of the following accurately describes the side effect of Diethylstilbesterol use during pregnancy?

A) Microcephaly and Congenital Heart Defects
B) Structural abnormalities of Vagina, Cervix and Gonads
C) Absent Limbs or Stunted Limb growth
D) Low Birth weight and Single Palmar crease

Question 7

During embryonic development it describes the time period and cells made up from time period of fertilization until the embryo gets implanted into the uterine wall. Which of the following is a correct description of cells and timeline of embryogenesis?

A) After fertilization the zygote undergoes rapid division is called a blastocyst
B) The ICM cells flatten and become a ring of cells termed a morula
C) Fluid accumulates inside the rapidly cleaved cells and creates a hollow sphere called a blastocyte
D) The group of cells that develop further to deliver fetal nutrients is called a trophoblast

Question 8

What criteria must be met to have HELLP syndrome during pregnancy?

A) HTN, Elevated protein, Hemolysis, Elevated Liver Enzymes, and Low Platelets
B) Hemolysis, Ecchymosis, Lactate dehydrogenase deficiency and Low Platelets
C) High blood pressure, Elevated Protein, Seizure activity and Low Platelets
D) Hyperthermia, Elevated Proteins, and Low Platelets

Question 9

A 25-year-old Caucasian Female presents to the office and is going over her History she reports she does not remember her LMP and states she may be pregnant. She gives you a list of her Medications she is currently taking. Which of the following of her medications is a teratogen and needs to be discontinued?

A) Griseofulvin
B) Phenergan
C) Acetaminophen
D) Hydrocortisone cream

Question 10

What is the most frequently documented pregnancy complication for cocaine users?

A) Visual Defects
B) Placental Abruption
C) Loss of Reproducibility
D) Low Birth weight