Question 1

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?

Accepted Answer

Elevated alpha-Fetoprotein levels are associated with the neural tube defects (NTDs) such as myeloschisis or meningomyelocele. Club foot, chondrodysplasia, cleft palate, and atrial septal defect are not associated with elevated alpha-Fetoprotein levels.

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?

Accepted Answer

C

Question 3

A baby is born to an HIV-positive mother.What statement regarding treatment options is true?

Accepted Answer

Treatment with antiretrovirus drugs should begin immediately and continue postnatally to decrease the risk of transmission and improve the infant's health outcome. HIV can be transmitted through breast milk, so breastfeeding should be avoided in this case. Blood transfusion is not necessary unless the infant develops anemia or other complications. Options A and B are incorrect because HIV can be transmitted from mother to child during pregnancy, labor, delivery, and breastfeeding.

Question 4

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?

Accepted Answer

The quadruple test differs from the triple test by including the measurement of Inhibin-A, in addition to the other markers measured by the triple test (AFP, hCG, and estriol).

Question 5

A developing fetus is diagnosed with congenital adrenal hyperplasia.What treatment would be appropriate for this condition?

Accepted Answer

Administering dexamethasone to the mother can help reduce the excess adrenal androgens in the developing fetus and prevent further abnormalities. This is the current standard of care for treating congenital adrenal hyperplasia in the fetus.

Question 6

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?

Accepted Answer

Doppler ultrasonography is the most appropriate technique for measuring fetal blood flow. Ultrasonography alone can give information about fetal anatomy, but Doppler is needed to assess blood flow. The other techniques listed do not directly measure blood flow.

Question 7

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?

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 8

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?

Accepted Answer

The critical sensitive period differs for the two organs. This means that the anencephaly defect occurs when the drug is given during a specific period of gestation, while cleft palate occurs during a different period. This indicates that there are different critical periods for the development of these two organs, and the drug is affecting them at different times.

Question 9

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?

Accepted Answer

The presence of separate amnions, chorions, umbilical cords, and placentae strongly suggests that the twins are dizygotic, or fraternal twins. In dizygotic twins, each twin develops their own amnion, chorion, and placenta, which are separate from their sibling's. This is in contrast to monozygotic twins, who develop from a single fertilized egg and may share a placenta, amnion, or chorion.

Question 10

An Rh− 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?

Accepted Answer

The best choice is to administer anti-Rh antibodies (RhoGAM) to the mother. This is because during delivery, there is a chance of fetal blood mixing with maternal blood, which can sensitize the mother to the Rh antigen. Administration of anti-Rh antibodies to the mother after delivery prevents her from becoming sensitized to the Rh antigen, which can cause problems in future pregnancies. Giving the newborn child a transfusion of Rh− blood or giving the mother a transfusion of Rh+ blood would not address the issue of sensitization to the Rh antigen. Doing nothing or not taking any action could lead to problems in future pregnancies.

Quiz 7: Fetal Development and the Fetus As a Patient