Deck 13: Amniotic Fluid

Question 1

Analysis of amniotic fluid bilirubin levels is performed using:

A) Fluorescence polarization
B) Spectrophotometry
C) Thin-layer chromatography
D) Immunoassay

Answer 1

B

Question 2

Which of the following alpha fetoprotein results would be of concern?

A) 3.0 MoM in amniotic fluid
B) 4.0 mg/dL in amniotic fluid
C) 1.0 MoM in maternal serum
D) 2.0 mg/dL in maternal serum

Answer 2

A

Question 3

Measurement of amniotic fluid creatinine levels can be used to:

A) Determine approximate fetal weight
B) Diagnose hydramnios
C) Differentiate between amniotic fluid and maternal urine
D) Differentiate between maternal and fetal urine

Answer 3

C

Question 4

The foam,or shake,test is a screening test for amniotic fluid:

A) Bilirubin
B) Surfactants
C) Alpha fetoprotein
D) Phosphatidyl glycerol

Question 5

The purpose of plotting amniotic fluid bilirubin on a Liley graph is to:

A) Detect possible fluid contamination
B) Detect exposure to light
C) Determine the optical density difference
D) Determine further treatment

Question 6

Amniotic fluid is formed by all of the following except:

A) Fetal urine
B) Fetal cell metabolism
C) Fetal swallowing
D) Transfer of water across the placenta

Question 7

The A??? of an amniotic fluid is plotted in zone 3 of a Liley graph.The physician should:

A) Repeat the testing in 3 weeks
B) Immediately induce labor
C) Request testing for fetal lung maturity
D) Tell the mother that the pregnancy is normal

Question 8

To differentiate between maternal and fetal blood in blood-streaked amniotic fluid,the fluid is tested for:

A) Maternal hemoglobin
B) Fetal hemoglobin
C) Maternal plasma
D) Fetal bilirubin

Question 9

Amniotic fluid for fetal lung maturity testing should be preserved:

A) In the refrigerator
B) At room temperature
C) In a dark container
D) At 37?C

Question 10

An increased level of alpha fetoprotein in amniotic fluid should be further tested for:

A) Bilirubin
B) Abnormal chromosomes
C) Acetylcholinesterase
D) Phosphatidyl glycerol

Question 11

A dark green amniotic fluid is associated with:

A) Meconium
B) Infection
C) Fetal death
D) Oxidized bilirubin

Question 12

An amniocentesis is performed on a woman whose last two pregnancies have resulted in stillbirths due to hemolytic disease of the newborn.A screening test performed at the hospital is positive for bilirubin,and the specimen is sent to a reference laboratory for a bilirubin scan.Doctors are concerned when the report comes back negative,and they question if the:

A) Correct specimen was sent
B) Specimen was refrigerated
C) Specimen was exposed to light
D) Specimen reached the reference laboratory within 30 minutes

Question 13

The presence of a fetal neural tube disorder may be detected by:

A) Increased amniotic fluid bilirubin
B) Increased maternal serum alpha fetoprotein
C) Decreased amniotic fluid phosphatidyl glycerol
D) Decreased maternal serum acetylcholinesterase

Question 14

Hemolytic disease of the newborn is caused by:

A) Abnormal maternal hemoglobins
B) Abnormal fetal hemoglobins
C) Maternal antibodies
D) Fetal antibodies

Question 15

The volume of amniotic fluid increases after the first trimester as a result of:

A) Increased maternal blood flow to the fetus
B) Diffusion of interstitial fluid
C) Production of fetal urine
D) Increased fetal swallowing

Question 16

Hemolytic disease of the newborn endangers the fetus by:

A) Delaying production of red blood cells (RBCs)
B) Affecting liver function
C) Destroying fetal bone marrow
D) Destroying fetal RBCs

Question 17

A dark yellow amniotic fluid is caused by:

A) Meconium
B) Bilirubin
C) Phospholipids
D) Urine

Question 18

Alpha fetoprotein is produced by the fetal:

A) Spinal cord
B) Kidneys
C) Bone marrow
D) Liver

Question 19

Interference with the amniotic fluid bilirubin analysis on centrifuged fluid is most likely caused by:

A) Fetal cells
B) Oxyhemoglobin
C) Albumin
D) Creatinine

Question 20

A primary function of amniotic fluid is to:

A) Provide nourishment to the fetus
B) Provide protection for the fetus
C) Remove waste products from the fetus
D) Facilitate oxygen and carbon dioxide exchange

Question 21

An amniocentesis is performed on a woman believed to be at approximately 15 weeks gestation.A possible abnormality has been observed on her sonogram,and her serum alpha fetoprotein is elevated.
Using the information provided,define the units in which the alpha fetoprotein test is reported?

A) Multiples of median
B) Milliliters of median
C) Milliliters of maxim
D) Measurement of median

Question 22

The method of choice for testing amniotic fluid contaminated with hemoglobin for fetal lung maturity is:

A) Bilirubin levels
B) Amniostat
C) Thin-layer chromatography
D) Foam stability

Question 23

The test of choice for testing amniotic fluid from a diabetic patient for fetal lung maturity is the:

A) Lamellar body count
B) L/S ratio
C) Foam stability index
D) Amniostat-FLM

Question 24

The most frequent concern of premature delivery is underdevelopment of the:

A) Liver
B) Kidneys
C) Nervous system
D) Lungs

Question 25

A second amniocentesis is performed on a diabetic woman believed to be at approximately 35 weeks gestation.She is pregnant with her second child,and the bilirubin A??? on the first amniocentesis was in zone 2 of the Liley graph.
Based on the information provided,should an L/S ratio or an Amniostat test be performed?

A) L/S ratio
B) Amniostat

Question 26

An amniocentesis is performed on a woman believed to be at approximately 15 weeks gestation.A possible abnormality has been observed on her sonogram,and her serum alpha fetoprotein is elevated.
Using the information provided,what is the normal value of amniotic fluid alpha fetoprotein?

A) 0.5 MoM
B) 1.0 MoM
C) 1.5 MoM
D) 2.0 MoM

Question 27

Amniotic fluid tests for determining fetal lung maturity include:

A) Bilirubin and urea
B) Bilirubin and lecithin/sphingomyelin (L/S) ratio
C) L/S ratio and lamellar bodies
D) Creatinine and urea

Question 28

Which of the following fetal lung maturity test results correlate?

A) L/S ratio: 1.0, surfactant/albumin ratio: 80
B) L/S ratio: 2.5, foam stability index: 43
C) L/S ratio: 2.2, surfactant/albumin ratio: 75
D) L/S ratio: 1.5, foam stability index: 49

Question 29

A second amniocentesis is performed on a diabetic woman believed to be at approximately 35 weeks gestation.She is pregnant with her second child,and the bilirubin A??? on the first amniocentesis was in zone 2 of the Liley graph.
Based on the information provided,if the bilirubin A??? is now in zone 3,what additional testing should be performed?

A) Alpha fetoprotein
B) Lamellar bodies
C) Maternal antibody screen
D) Fern test

Question 30

The principle of the shake test and foam stability index is that phospholipids:

A) Reduce the surface tension of an alcoholic solution
B) Increase the surface tension of an alcoholic solution
C) Release carbon dioxide in an alcoholic solution
D) Release carbon dioxide when agitated

Question 31

An amniocentesis is performed on a woman believed to be at approximately 15 weeks gestation.A possible abnormality has been observed on her sonogram,and her serum alpha fetoprotein is elevated.
Using the information provided,what type of fetal distress is suspected?

A) Hemolytic disease of the newborn
B) Polyhydramnios
C) Oligohydramnios
D) Neural tube disorder

Question 32

A second amniocentesis is performed on a diabetic woman believed to be at approximately 35 weeks gestation.She is pregnant with her second child,and the bilirubin A??? on the first amniocentesis was in zone 2 of the Liley graph.
Using the information provided,why was a second amniocentesis performed?

A) She is diabetic
B) To determine fetal antibodies
C) To monitor the bilirubin concentration
D) This is her second pregnancy

Question 33

An amniocentesis is performed on a woman believed to be at approximately 15 weeks gestation.A possible abnormality has been observed on her sonogram,and her serum alpha fetoprotein is elevated.
Based on the information given,what additional test could be performed if the alpha fetoprotein is elevated?

A) Phosphatidyl glycerol
B) Lamellar body
C) Acetylcholinesterase
D) Optical density

Question 34

In the determination of fetal lung maturity,which of the following components is produced by the body at the 35th week of gestation?

A) Lecithin
B) Phosphatidyl glycerol
C) Lamellar body
D) Acetylcholinesterase

Question 35

Decreased levels of phosphatidyl glycerol in amniotic fluid can be associated with:

A) Hemolytic disease of the newborn
B) Toxemia of pregnancy
C) Hyaline membrane disorder SS
D) Intrauterine death

Question 36

When an L/S ratio by thin-layer chromatography is performed,a mature fetal lung will show:

A) Sphingomyelin twice as concentrated as lecithin
B) No sphingomyelin
C) Lecithin twice as concentrated as sphingomyelin
D) Equal concentrations of lecithin and sphingomyelin

Question 37

Lamellar bodies contain:

A) Albumin
B) Amniotic fluid
C) Phospholipids
D) Pneumocytes

Question 38

An amniotic fluid optical density at 650 nm of 0.180 correlates with:

A) A lamellar body count over 32,000/L
B) A lack of phosphatidylglycerol
C) Hemoglobin contamination in the specimen
D) An L/S ratio of 1.5

Question 39

The test for amniotic fluid lamellar bodies uses which of following?

A) Fluorescence
B) Polarizing microscopy
C) A spectrophotometer
D) An automated cell counter

Question 40

The Amniostat agglutination test is performed on amniotic fluid from pregnant women to detect the presence of:

A) Lecithin
B) Phosphatidyl glycerol
C) Sphingomyelin
D) Creatinine

Question 41

Acetylcholinesterase testing can be performed on amniotic fluid containing blood,if the specimen is centrifuged.

Question 42

Most laboratories detect the presence of phosphatidylglycerol using thin-layer chromatography.

Question 43

Amniotic fluid for cytogenetic analysis should be delivered to the laboratory in ice.

Question 44

Pneumocytes in the fetal lungs produce lamellar bodies.

Question 45

Meconium is composed of bowel constituents.

Question 46

Failure of the fetus to begin swallowing will result in:

A) Oligohydramnios
B) A positive fern test
C) Polyhydramnios
D) Umbilical cord compression

Question 47

A fern test is performed to differentiate between:

A) Phosphatidyl glycerol and lecithin
B) Urine and amniotic fluid
C) Sphingomyelin and phosphatidyl glycerol
D) Lamellar bodies and meconium

Question 48

A second amniocentesis is performed on a diabetic woman believed to be at approximately 35 weeks gestation.She is pregnant with her second child,and the bilirubin A??? on the first amniocentesis was in zone 2 of the Liley graph.
Based on the information provided,the presence of what substance is of particular concern prior to inducing labor?

A) Lecithin
B) Sphingomyelin
C) Acetylcholinesterase
D) Phosphatidyl glycerol

Question 49

Lamellar bodies are approximately the same size as red blood cells.

Question 50

Production of both lecithin and sphingomyelin increases after 35 weeks gestation.

Question 51

When performing the foam stability index,amniotic fluid is mixed with ethanol.

Question 52

The volume of amniotic fluid is regulated by fetal swallowing.