27857420
Descripción
Test por Samantha Hale, actualizado hace más de 1 año
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Creado por Samantha Hale
hace casi 4 años
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Pregunta 1
Pregunta
What is the normal gestation period?
Respuesta
-
38-42 weeks
-
30-35 weeks
-
45-50 weeks
-
20-35 weeks
Pregunta 2
Pregunta
Which of the following is a function of amniotic fluid?
Respuesta
-
Cushions the fetus while in utero and allows for movement
-
Stabilizes fetal temperature
-
Plays a role in fetal lung development
-
Allows exchange of water and substances between the fluid, the fetus and the maternal circulation.
-
All of the above
Pregunta 3
Pregunta
Initially, amniotic fluid is produced by the [blank_start]amnion and the placenta[blank_end].
Respuesta
-
amnion and the placenta
Pregunta 4
Pregunta
Production of amniotic fluid in the first trimester is supplied by [blank_start]maternal circulation[blank_end], approximately [blank_start]35mL[blank_end].
Respuesta
-
maternal circulation
-
35mL
Pregunta 5
Pregunta
Amniotic fluid in the first trimester is similar to the composition of the mother's plasma (plus some sloughed off cells from the fetus).
Respuesta
- True
- False
Pregunta 6
Pregunta
In the 2nd trimester, [blank_start]fetal urine[blank_end] is the main contributor.
Respuesta
-
fetal urine
Pregunta 7
Pregunta
In the last half (to 1/3) of the pregnancy, regulation of the volume of amniotic fluid is
further influenced by the production of [blank_start]fetal lung fluid[blank_end].
Respuesta
-
fetal lung fluid
Pregunta 8
Pregunta
Surfactants secreted by the fetus include
Respuesta
-
Alpha fetoprotein and AChE
-
AChE and Lecithin
-
Sphingomyelin and AChE
-
Lecithin and sphingomyelin
Pregunta 9
Pregunta
The volume of amniotic fluid increases throughout the pregnancy and peaks during the [blank_start]3rdtrimester[blank_end] (around 36 weeks gestation) before gradually [blank_start]decreasing[blank_end] prior to delivery.
Respuesta
-
3rd trimester
-
decreasing
Pregunta 10
Pregunta
_______ is an excess accumulation of amniotic fluid due to failure of the fetus to
start swallowing the fluid.
Respuesta
-
Oligohydramnios
-
Polyhydramnios
Pregunta 11
Pregunta
Polyhydramnios is associated with _____ while oligohydramnios is associated with ______.
Respuesta
-
Congenital fetal deformations; Congenital deformations or amniotic membrane rupture
-
Congenital deformations or amniotic membrane rupture; Congenital fetal deformations
Pregunta 12
Pregunta
Check the answers that are associated with polyhydramnios.
Respuesta
-
Fetal distress
-
Failure of the fetus to start swallowing amniotic fluid
-
Increased fetal swallowing
-
Urinary tract deformities
-
Fetal structure anomalies
-
Neural tube disorders
-
Amniotic membrane leakage
-
Congenital infections
-
Cardiac arrhythmias
-
Chromosomal abnormalities
Pregunta 13
Pregunta
Check the answers associated with Oligohydramnios.
Respuesta
-
Accumulation of amniotic fluid
-
Decreased amniotic fluid
-
Cardiac arrhythmias
-
Failure of the fetus to start swallowing the fluid.
-
Urinary tract deformities
-
Increased fetal swallowing
-
Amniotic membrane leakage
-
Umbilical cord compression
Pregunta 14
Pregunta
As the pregnancy continues, the composition of amniotic fluid changes to reflect contributions from the fetus. Check the answers to the changes that we would see in this case.
Respuesta
-
Decrease in creatinine
-
Increase in creatinine
-
Increase in urea
-
Increase in uric acid
-
Increase in protein
-
Decrease in protein
-
Increase in glucose
-
Decrease in glucose
-
Decrease in urea
-
Decrease in uric acid
Pregunta 15
Pregunta
Amniotic fluid creatinine levels may be used to assess fetal age. At less than 36 weeks old, that should be [blank_start]1.5-2.0[blank_end] mg/dL. At greater than 36 weeks old, that should be [blank_start]> 2.0 mg/dL[blank_end].
Respuesta
-
1.5-2.0
-
> 2.0 mg/dL
Pregunta 16
Pregunta
Generally, amniocentesis can be performed anytime after 8 weeks gestation, but the purpose for
the procedure dictates when it is actually performed.
Respuesta
- True
- False
Pregunta 17
Pregunta
Amniocentesis when used to screen for birth defects is performed between [blank_start]15-18[blank_end] weeks.
Respuesta
-
15-18
Pregunta 18
Pregunta
Amniocentesis, when performed to monitor fetal distress is performed between [blank_start]20-42[blank_end] weeks.
Respuesta
-
20-42
Pregunta 19
Pregunta
Check the appropriate boxes associated with amniotic fluid collection.
Respuesta
-
Keep at room temperature.
-
Keep on ice.
-
Separate from cells asap.
Pregunta 20
Pregunta
[blank_start]Filtration[blank_end] is recommended for FLM (fetal lung maturity studies) to prevent loss of phospholipids (lung surfactants)
Respuesta
-
Filtration
Pregunta 21
Pregunta
Surfactants are unstable at room temperature but stable if refrigerated for up to 72 hours
Respuesta
- True
- False
Pregunta 22
Pregunta
Centrifugation must be done much slower than for other specimen types. 140g are used to recover
fetal cells, 500g is used to separate supernatant containing phospholipids for FLM analysis. Higher
centrifugation forces will result in loss of phospholipids into the pellet with erroneous L/S ratio
(later). Other assays can be done in clear supernatant after centrifugation at 1500g (5 to 15
minutes).
Respuesta
- True
- False
Pregunta 23
Pregunta
The mother's triple screen serum test includes [blank_start]AFP[blank_end], [blank_start]hCG[blank_end], and [blank_start]UE3[blank_end].
Respuesta
-
AFP
-
hCG
-
UE3
Pregunta 24
Pregunta
Produced by the fetal liver during 1st trimester; elevated with open neural tube defects (such as spina bifida – neural tissue is exposed, not covered with skin) – elevated in amniotic fluid and also in the mother’s circulation. Low levels are associated with Down Syndrome.
Respuesta
-
Estriol
-
Bilirubin
-
AFP
-
hCG
Pregunta 25
Pregunta
Low levels are a concern for maintaining the pregnancy. High levels are associated with down syndrome.
Respuesta
-
hCG
-
Estriol
-
Bilirubin
-
AFP
Pregunta 26
Pregunta
High "unconjugated estriol" indicates a problem with the fetus development.
Respuesta
- True
- False
Pregunta 27
Pregunta
Erroneous results can be obtained for ____ due to preeclampsia, anemia, and kidney disease.
Respuesta
-
Estriol
-
AFP
-
Bilirubin
-
hCG
Pregunta 28
Pregunta
DHEA, a precursor hormone, is produced by the fetal adrenal glands and converted to estriol in the placenta.
Respuesta
- True
- False
Pregunta 29
Pregunta
What is included in a Quad Screen?
Respuesta
-
Cholesterol
-
DHEA
-
Inhibin-A
-
Glucose
Pregunta 30
Pregunta
Inhibin-A is a protein produced by the fetus and ovaries. Elevated values, together with increased hCG, decreased AFP and estriol, are a better indication of Down syndrome.
Respuesta
- True
- False
Pregunta 31
Pregunta
The fern test helps determined if there is premature rupture of the amniotic sac. Vaginal fluid is smeared on a glass slide and allowed to dry. If amniotic fluid is present, it will crystalize in a characteristic fern-like formation.
Respuesta
- True
- False
Pregunta 32
Pregunta
All amniotic fluid is turbid to some degree
Respuesta
- True
- False
Pregunta 33
Pregunta
A protein produced by the fetal liver during the 1st trimester and present in both fetal serum and fetal CSF
Respuesta
-
AFP
-
AChE
-
Bilirubin
-
Albumin
Pregunta 34
Pregunta
These are tests that measure the various lung surfactants - lecithin, sphingomyelin, and [blank_start]phosphatidyl glycerol[blank_end].
Respuesta
-
phosphatidyl glycerol
Pregunta 35
Pregunta
The Foam Stability Index (FSI) is a test that measures the relative amounts of [blank_start]phospholipids[blank_end]; it
correlates well with results of the L/S ratio and phosphatidyl glycerol assays.
Respuesta
-
phospholipids
Pregunta 36
Pregunta
AFP Levels peak at 16 weeks (500µg/L) then slowly decrease. Only a small (<1%) amount is filtered by the kidney and excreted in fetal urine. As a result, small amounts of AFP are normally present (< 10 µg/L) in amniotic fluid.
Respuesta
- True
- False
Pregunta 37
Pregunta
Check the tests associated with assessing AFP levels.
Respuesta
-
Cytogenetics
-
Flow Cytometry
-
EIA
-
RIA
Pregunta 38
Pregunta
AChE acetylcholinesterase is normally present in amniotic fluid (called pseudoacetylcholinesterase) and it will
migrate slow in electrophoresis. With open NTDs, another form specific to neural tissue will be present that
migrates much faster.
Respuesta
- True
- False
Pregunta 39
Pregunta
Amniotic fluid - Bilirubin and the Liley Graph - Zone 1
Respuesta
-
indicates a normal to mildly affected fetus
-
quires careful monitoring of the pregnancy as it suggests HDFN may be occurring
-
indicates a severely affected fetus and a need for intervention.
Pregunta 40
Pregunta
Amniotic fluid - Bilirubin and the Liley Graph - Zone 3
Respuesta
-
indicates a normal to mildly affected fetus
-
requires careful monitoring of the pregnancy as it suggests HDFN may be occurring
-
indicates a severely affected fetus and a need for intervention
Pregunta 41
Pregunta
FML maturity - baby is mature enough to avoid respiratory distress syndrome and
delivery will be induced. After how many weeks is this usually? Answer: After [blank_start]32[blank_end] weeks
Respuesta
-
32
Pregunta 42
Pregunta
When results of the Liley graph point to very early induction, fetal lung maturity must first
be assessed. This is done by testing the level of [blank_start]lung surfactants[blank_end] present in the amniotic
fluid.
Respuesta
-
lung surfactants
Pregunta 43
Pregunta
The most common complication of early delivery and is the leading cause of death in premature infants.
Respuesta
-
Down Syndrome
-
Anencephaly
-
RDS
-
AIDS
Pregunta 44
Pregunta
The function of the surfactant is to keep the [blank_start]alveoli open[blank_end].
Respuesta
-
alveoli open
Pregunta 45
Pregunta
The primary lung surfactant is
Respuesta
-
Lecithin
-
Sphingomyelin
-
Phosphatidyl Glycerol
Pregunta 46
Pregunta
[blank_start]Lecithin[blank_end] production increases toward the end of the pregnancy; by 34-36 weeks the
amount of [blank_start]lecithin[blank_end] is present in sufficient amounts to prevent alveolar collapse.
Respuesta
-
Lecithin
-
lecithin
Pregunta 47
Pregunta
[blank_start]Sphingomyelin[blank_end] is a lipid that is produced at a constant steady rate after 26 weeks. The
exact role of [blank_start]sphingomyelin[blank_end] has not yet been determined but is used as a reference for
lecithin.
Respuesta
-
Sphingomyelin
-
sphingomyelin
Pregunta 48
Pregunta
Prior to 35 weeks L/S is usually <[blank_start]1.6[blank_end], but as lecithin increases (and sphingomyelin
remains constant) the ratio increases. When it reaches [blank_start]2.0[blank_end] it is considered safe to
deliver the baby.
Respuesta
-
1.6
-
2.0
Pregunta 49
Pregunta
Lecithin and sphingomyelin are measured by
Respuesta
-
TLC
-
RIA
-
EIA
Pregunta 50
Pregunta
[blank_start]Phosphatidyl Glycerol[blank_end] parallels the production of lecithin except in cases of maternal diabetes where production is delayed. In this case RDS can occur with an L/S of 2.0.
Respuesta
-
Phosphatidyl Glycerol
Pregunta 51
Pregunta
It is best to have an L/S ratio > 2.0 and detectable PGL to ensure FLM, however it’s only necessary
in women with gestational diabetes to measure all three.
Respuesta
- True
- False
Pregunta 52
Pregunta
[blank_start]Amniostat FLM[blank_end] uses antisera specific for phosphatidyl glycerol; this is a semi-quantitative
agglutination slide test that is faster to perform than TLC. There is no interference by blood
or meconium but it has higher incidence of false negatives
Respuesta
-
Amniostat FLM
Pregunta 53
Pregunta
Phosphatidyl glycerol (PGL) is measured by (check all associated with it).
Respuesta
-
TLC
-
Amniostat FLM
-
EIA
-
RIA
Pregunta 54
Pregunta
Rapid tests for determining FLM (Check all that apply).
Respuesta
-
EIA
-
RIA
-
FSI
-
Lamellar body counts
-
TLC
Pregunta 55
Pregunta
The FSI is based on the fact that [blank_start]ethanol[blank_end] destroys [blank_start]phospholipids[blank_end]; it is an antifoaming agent.
Respuesta
-
ethanol
-
phospholipids
Pregunta 56
Pregunta
Amniotic Fluid - FSI
Respuesta
-
When mixed with amniotic fluid and shaken, the amount of foam is proportional to the amount of surfactant present.
-
When mixed with amniotic fluid and shaken, the amount of foam is inversely proportional to the amount of surfactant present.
Pregunta 57
Pregunta
Foam Stability Test - The presence of bubbles around the outside edge of the
liquid surface is a sign that a sufficient amount of these phospholipids are present to
support lung function. This test may be performed at the bedside by the physician.
Respuesta
- True
- False
Pregunta 58
Pregunta
FSI: The ones with less ethanol should have less bubbles because ethanol is an antifoaming agent.
Respuesta
- True
- False
Pregunta 59
Pregunta
The first tube that shows foaming gives us the FSI.
Respuesta
- True
- False
Pregunta 60
Pregunta
FSI: If it corresponds to 47 or higher (0.47 mL ethanol or greater) that means there are enough phospholipids to over come the antifoaming action of the ethanol even at that higher amount and thus the lungs are mature enough.
Respuesta
- True
- False
Pregunta 61
Pregunta
The storage form of lung surfactants
Respuesta
-
Lamellar bodies
-
Sphingomyelin
-
Lecithin
-
Phosphatidyl glycerol
Pregunta 62
Pregunta
As the lungs mature the increased lamellar body production reflects a decrease in phospholipids and L/S ratio.
Respuesta
- True
- False
Pregunta 63
Pregunta
[blank_start]Lamellar bodies[blank_end] will increase the optical density of amniotic fluid.
Respuesta
-
Lamellar bodies
Pregunta 64
Pregunta
When measured at 650 nm, [blank_start]meconium[blank_end] falsely increases the optical density, but [blank_start]hemoglobin[blank_end] does not.
Respuesta
-
meconium
-
hemoglobin
Pregunta 65
Pregunta
An OD reading of 0.150 correlates well with an L/S ratio ≥ 2.0 and the presence of phosphatidyl glycerol.
Respuesta
- True
- False
Pregunta 66
Pregunta
In a lamellar body count, contamination from [blank_start]blood[blank_end] will falsely increase the counts since [blank_start]platelets[blank_end] will be present.
Respuesta
-
blood
-
platelets
Pregunta 67
Pregunta
[blank_start]Fetal Fibronectin[blank_end] is a glycoprotein secreted during pregnancy by cells of the fetal membranes (amnion and chorion) that make the amniotic sac and the fetal side of the placenta. It acts as a glue that binds the placenta to the uterus.
Respuesta
-
Fetal Fibronectin
Pregunta 68
Pregunta
During weeks 22 to 35, the presence of [blank_start]fetal fibronectin[blank_end] may be used as a predictor for preterm delivery.
If detected, it might be necessary for the mother to be on bed rest for the remainder of the pregnancy. A negative test is a predictor that delivery over the next two weeks is unlikely
Respuesta
-
fetal fibronectin
Pregunta 69
Pregunta
Fetal fibronectin Test is performed on
Respuesta
-
A cervical/vaginal swab
-
Amniotic fluid
-
Urine
-
Serum
Pregunta 70
Pregunta
Fetal Fibronectin tests include
Respuesta
-
ELISA
-
Rapid Lateral flow immunosorbent assay
-
RIA
-
Flow cytometry
Pregunta 71
Pregunta
At 22-35 weeks gestation, fFN levels are normally below [blank_start]50[blank_end] ng/dL.
Respuesta
-
50
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