<prompt> Cleft lip is caused by which of the following drug?LevatiracetumPhenytoinSodium ValporatePhenobarbitone  <response>: ANSWER: B PhenytoinREF: KDT 6th edition page 405, Katzung 12 th edition page 409See APPENDIX-32 below TERATOGENSTERATOGENGROUPCRITICALPERIODEFFECTTHALIDOMIDEsedative34-51 days after LMPExternal ear deformity earliest,PHOCOMELLA MC-four groups: 4-limb phocomelia, Upper limb phocomelia, Predominantly Upper-limb phocomelia, Predominantly lower limb defects, Facial Hemangioma, Esophageal atresia, TOF, Renal agenesisRETINOIC ACIDVitamin3-5 weekRetinoic add embryopathy; cranio-facial abnormalities, MicrotiaAnotia deafnessMissing jaw or one that is too smallDisorders of jaw formation split jawDisorders of formation of aortic archThymic aplasia hypoplasiaDeformities in the CNS MC- hydrocephalusDIETHYLSTIL-BOESTROLHormone vaginal adenosis, erosions of the cervix and transversal cleavages in the vaginaALCOHOLRecreational Fetal alcohol syndrome: ASD, VSD, LBW, microcephaly, maxillary hypoplasia, flatnasal bridge, micrognathia, microphthalmia, hypoplastic upper lip, broad lower lip.COCAINERecreational Narcotic addiction in the child, retarded growth, to malformations of the circulatory systemPHENYTOINAntiepileptic Fetal hydantoin syndrome: VSD, ASD, coarctation of aorta, PDA, Hypoplasticphalanges, Syndactyly, deft palate, clefthare lip, microcephaly - caused by areneoxide metaboliteVALPROATEAntiepileptic Neural tube defects, Coarctation of aorta, hypoplastic left side of heart, aortic stenosis, pulmonary atresia, VSDLITHIUMAntipsychotic3-8 weeksEbstein anomaly me, cleft palate inexperimental animalsSTREPTOMYCINAminoglycosides4-8 weeksdamage of the 8th cerebral nerve- deafnessWARFARINAnticoagulant1st trimesterHypoplastic nasal bridge , chondrodysplasia 2ndtrimesterCNS malformation 3rd trimesterRisk of bleeding APPENDIX - 32TeratogensTeratogenGroupCritical periodEffectThalidomidesedative34-51 days after LMPExternal ear deformity earliest, PHOCOMELIA MC- four groups: 4-limb phocomelia, Upper limb phocomelia, Predominantly Upper-limb phocomelia, Predominantly lower limb defects, Facial Hemangioma, Esophageal atresia, TOF, Renal agenesisRetinoic AcidVitamin3-5 weekcranio-facial abnormalitiesMicrotiaAnotia deafnessMissing jaw or one that is too smallDisorders of jaw formation split jawDisorders of formation of aortic archThymic aplasiahvpoplasiaDeformities in the CNS mc-hydrocephalusDiethvlstil-boestrolHormone vaginal adenosis, erosions of the cervix and transversal cleavages in the vaginaAlcohol fetal alcohol syndromeRecreational LBW, microcephaly, maxillary hypoplasia, flat nasal bridge, micrognathia, microphthalmia, hypoplastic upper lip, broad lower lip.CocaineRecreationalNarcotic addiction in the child, retarded growth, to malformations of the circulatory systemLithiumAntipsychotic3-8 -weeksEbstein anomaly me, cleft palate in experimental animalsStreptomycinAminoglycosides4-8 weeksdamage of the 8th cerebral nerve- deafnessWarfarinAnticoagulant1st trimesterHypoplastic nasal bridge , chondrodysplasia 2nd trimesterCNS malformation 3rd trimesterRisk of bleedingRubellaViral1st trimestercardiac defects, cataracts and deafnessCytomegalovirusViralspontaneous miscarriage in 1st trimester, anomalies from 2nd trimesterRetarded growth, changes in the CNS microcephaly, cerebral atrophy, hydrocephaly, cerebellar hypoplasia, chorioretinitis, atrophy of the eyes and hepatosplenomegalyHerpes SimplexViralAs a rule, HSV occurs in late pregnancyMental deficiency, Microcephaly, Myocardiopathy, Spasticity, Retinal dysplasiaVaricellaViralOnly up to the 20th week.muscle atrophy, hypoplasia of the limbs and fingers, abnormalities of the eyes and the brain mental deficiencyToxoplasmosisToxoplasmaGondi.intracellularparasite cerebral calcification, microcephaly, microphthalmia, chorioretinitis, microphthalmia, hydrocephalusCongenitalSyphilis Mental deficiency, hydrocephalus, deafness, blindness, bone malformations, Hutchinsons teeth pathognomicCritical Period:Before the 14th day an insult injury to the embryo will not cause an abnormality because the embryo either repairs the damage or dies spontaneous miscarriageEmbryonic period, during which numerous mitotic divisions and organogenesis occur, the embryo is very vulnerable and most congenital abnormalities happen thenFetopathies are the abnormalities that occur after the 8th week and up to delivery. The sensibility to injurious substances is clearly reduced in the last two trimesters of pregnancy.In infectious etiology critical period might not coincide with the effects they cause as there critical period might be different from the incidence of infection in the pregnancy trimester. 