Question 1

An Rh&#8722; mother delivers her first child,a boy who is Rh+.The mother intends to have several more children.What should you do as her physician to prevent future problems?&#10;A) Do nothing, as no action is recommended.&#10;B) Give the newborn child a transfusion of Rh&#8722; blood.&#10;C) Give the mother a transfusion of Rh+ blood.&#10;D) Administer anti-Rh antibodies (RhoGAM) to the newborn child.&#10;E) Administer anti-Rh antibodies (RhoGAM) to the mother.

Accepted Answer

Administering anti-Rh antibodies (RhoGAM) to the mother is the best course of action. This will prevent sensitization of the mother's immune system to the Rh factor in her baby's blood and subsequent production of anti-Rh antibodies that could attack future Rh+ fetuses. If the mother were to receive a transfusion of Rh+ blood or the newborn were to receive a transfusion of Rh- blood, it would not address the issue of sensitization and could potentially cause other complications.

Question 2

A woman in the third trimester of pregnancy is sent for an ultrasound because her uterus is abnormally large.A diagnosis of polyhydramnios is made.What could be the cause of this condition?&#10;A) Fetal spina bifida&#10;B) Fetal cleft palate&#10;C) Fetal anencephaly&#10;D) Posterior urethral valves&#10;E) Renal agenesis

Accepted Answer

C

Question 3

A baby is born to an HIV-positive mother.What statement regarding treatment options is true?&#10;A) HIV is spread only by sexual contact, so no treatment is required.&#10;B) HIV does not cross the placenta either before or during parturition, so no treatment is required.&#10;C) Treatment with antiretrovirus drugs should begin immediately and continue postnatally.&#10;D) HIV cannot be transmitted in breast milk, so no treatment is required with breastfeeding.&#10;E) The baby should receive a blood transfusion with non-HIV-positive blood.

Accepted Answer

Treatment with antiretroviral drugs should begin immediately and continue postnatally to prevent mother-to-child transmission of HIV. Breastfeeding should also be avoided if possible to further reduce transmission risk. Option A is incorrect because HIV can be spread through various modes of transmission, not just sexual contact. Option B is incorrect because HIV can cross the placenta and infect the fetus before or during delivery. Option D is incorrect because HIV can be transmitted through breast milk. Option E is not necessary as blood transfusions are not a standard treatment for preventing mother-to-child transmission of HIV.

Question 4

A developing fetus is diagnosed with congenital adrenal hyperplasia.What treatment would be appropriate for this condition?&#10;A) Administer folic acid to the mother.&#10;B) Administer propranolol to the mother.&#10;C) Administer cyanocobalamin to the mother.&#10;D) Do a fetal blood transfusion.&#10;E) Administer dexamethasone to the mother.

Accepted Answer

Administering dexamethasone to the mother is the appropriate treatment for congenital adrenal hyperplasia in a developing fetus. This medication can cross the placental barrier and reduce the overproduction of androgens by the fetal adrenal gland, preventing potentially harmful effects on the developing genitals. The other choices are not appropriate treatments for this condition.

Question 5

A small drug company is testing a new drug on pregnant mice.When the drug is given at 8 days of gestation,anencephaly occurs,but when given at 10 days,cleft palate occurs.What is the most likely explanation for this difference?

A) Critical sensitive period differs for the two organs.
B) Gene-environmental interactions differ for the two organs.
C) Critical dose differs for the two organs.
D) The genetic constitutions of the mice differ, accounting for different defects.
E) Too high a dose was administered.
F) Too low a dose was administered.

Accepted Answer

Anencephaly and cleft palate are two different types of birth defects that occur at different stages of embryonic development. The fact that the drug causes anencephaly when given at 8 days of gestation and cleft palate when given at 10 days suggests that there is a critical sensitive period for each organ. This means that there is a specific time frame during embryonic development when each organ is most susceptible to the effects of the drug.

Question 6

A pregnant woman is told that one of the tests she has taken shows severely elevated alpha-Fetoprotein.Which defect might be present in her fetus?&#10;A) Myeloschisis&#10;B) Club foot&#10;C) Chondrodysplasia&#10;D) Cleft palate&#10;E) Atrial septal defect

Accepted Answer

Severely elevated alpha-fetoprotein levels are associated with neural tube defects, such as myeloschisis. Club foot, chondrodysplasia, cleft palate, and atrial septal defect are not typically associated with elevated alpha-fetoprotein levels.

Question 7

A family is delighted to learn that the mother is expecting twins.At the birth of the twin girls,the placenta and extraembryonic membranes are carefully examined,and it is concluded that the twins are likely dizygotic.Which finding would support this conclusion?

A) Separate amnions, chorions, umbilical cords, and placentae are present.
B) Common amnion, chorion, umbilical cord, and placenta are present.
C) Common amnion, chorion, and placenta are present, along with separate umbilical cords.
D) Separate amnions and umbilical cords are present along with a common amnion, chorion, and placenta.
E) Separate amnions, chorions, and umbilical cords are present, along with a common placenta.

Accepted Answer

Presence of separate amnions, chorions, umbilical cords, and placentae indicates dizygotic twins. This means that each twin developed from a separate fertilized egg, and therefore, have their own set of extraembryonic membranes. Common membranes and placenta would suggest identical twins (monozygotic), where a single fertilized egg splits into two embryos. Option C is also possible in rare cases of monozygotic twins where the splitting of the fertilized egg occurs after day 4 of development, leading to the development of separate umbilical cords. However, option A is the most common scenario for dizygotic twins. Option D and E are not possible combinations.

Question 8

On a routine visit,your patient,who has just completed the fifth month (gestational age) of her pregnancy,asks: how big is my child? What is the correct answer to her question?&#10;A) About 5.5 cm or 2 inches crown-rump length&#10;B) About 12 cm or 4.5 inches crown-rump length&#10;C) About 30 cm or 12 inches crown-rump length&#10;D) About 42.5 cm or 16.5 inches crown-rump length&#10;E) About 51 cm or 20 inches crown-rump length

Accepted Answer

At the end of the fifth month of pregnancy, the fetus is typically about 30 cm or 12 inches in crown-rump length.

Question 9

A 40-year-old pregnant woman undergoes quadruple maternal serum screening to determine the likelihood that her unborn child has certain birth defects.How does the quadruple test differ from the triple test?

A) The quadruple test also measures hCG.
B) The quadruple test also measures Inhibin-A.
C) The quadruple test also measures estriol.
D) The quadruple test also measures testosterone.
E) The quadruple test also measures AFP.

Accepted Answer

The quadruple test differs from the triple test in that it also measures Inhibin-A, in addition to the three markers measured by the triple test (AFP, estriol, and hCG).

Question 10

An 8-month-old fetus is suspecting of having cardiovascular anomalies resulting in abnormal blood flow.What technique(s) could be used to measure fetal blood flow?&#10;A) Ultrasonography and nuchal translucency screening&#10;B) Ultrasonography and amniocentesis&#10;C) Ultrasonography and chorionic villus sampling&#10;D) Doppler ultrasonography&#10;E) Fetal MRI

Accepted Answer

Doppler ultrasonography is a non-invasive technique that is frequently used to measure fetal blood flow in suspected cases of cardiovascular anomalies. It uses sound waves to detect the movement of blood cells and can provide information about the direction and velocity of blood flow in different vessels. This allows for the early detection and monitoring of potential problems. The other options listed may also be used in prenatal diagnosis, but they are not specifically focused on measuring fetal blood flow.

Deck 7: Fetal Development and the Fetus As Patient