Where and when is alpha-fetoprotein produced by the fetus?

1.   ?    Yolk sac and Liver, 12th week
2.   ?    Yolk sac and Liver, 4th week
3.   ?    Yolk sac, 4th week, Liver 4th month

How does alpha-fetoprotein get into the amniotic fluid?

1.   ?    excreted in the fetal urine
2.   ?    excreted in the fetal stool
3.   ?    diffuses through chorionic membrane
4.   ?    active secretion by allantois

When during pregnancy is alpha-fetoprotein screening done for the mothers?

1.   ?    16 to 18 weeks gestation
2.   ?    4th week of gestation
3.   ?    last trimester
4.   ?    after 30 weeks gestation

When does maternal AFP reach its peak?

1.   ?    12 weeks
2.   ?    20 weeks
3.   ?    24 weeks
4.   ?    32 weeks

AFP in maternal serum samples greater than 2 or 3 times normal could be due to all of the following EXCEPT?

1.   ?    Turners syndrome
2.   ?    SC teratoma
3.   ?    Fetal renal defect
4.   ?    Anencephaly

Which of the following is NOT indicated in the evaluation of elevated maternal AFP?

1.   ?    fetal ultrasound
2.   ?    CVS chorionic villus sampling
3.   ?    amniocentesis

Which of the following would NOT account for an abnormally low alpha-fetoprotein level?

1.   ?    anencephaly
2.   ?    trisomy 18 or 21
3.   ?    IUGR
4.   ?    older mother with trisomy 21 in fetus

Elevated maternal blood levels of what hormone are sometimes seen with Down's syndrome?

1.   ?    Prolactin
2.   ?    AFP
3.   ?    HCG
4.   ?    ACTH

When is an amniocentesis usually done and what is the risk of miscarriage with the procedure?

1.   ?    12 to 18 weeks, fetal loss is about 0.5 to 1 percent
2.   ?    after 20 weeks, fetal loss is about 0.5 to 1 percent
3.   ?    after 20 weeks, fetal loss about 5 percent

A maternal triple screen for increased fetal risk includes all EXCEPT?

1.   ?    Hexosaminidase A
2.   ?    Estriol
3.   ?    HCG
4.   ?    AFP

What might a decreased maternal serum hexosaminidase A indicate?

1.   ?    Downs syndrome
2.   ?    Tay-Sachs disease
3.   ?    Trisomy 18

A 50-year-old mother versus a 20-year-old mother has a 150-fold greater chance of having a baby with Down's syndrome: T or F?

1.   ?    True
2.   ?    False

When is chorionic villus sampling done?

1.   ?    third trimester
2.   ?    second trimester
3.   ?    first trimester

What is the risk of miscarriage with the CVS (Chorionic villus sampling?

1.   ?    3 percent
2.   ?    5 percent
3.   ?    1 percent
4.   ?    10 percent

Which condition would chorionic villus sampling NOT be done for?

1.   ?     Duchenne's muscular dystrophy
2.   ?    Sickle cell anemia
3.   ?    Cystic fibrosis
4.   ?    Neurofibromatosis

T or F: There is a significant incidence of limb reduction defects after CVS (Chorionic villus sampling)?

1.   ?    True
2.   ?    False

What percent of pregnancies have a fetal abnormality detected?

1.   ?    5 percent
2.   ?    1 3 percent
3.   ?    Less than 1 percent

Which procedure has the highest risk of fetal loss?

1.   ?    PUBS
2.   ?    Fetoscopy
3.   ?    CVS
4.   ?    Amniocentesis

Which is the most frequent type of congenital anomaly?

1.   ?    CV
2.   ?    GU
3.   ?    CNS
4.   ?    GI

At what stage of gestation does the fetus began excreting amniotic fluid back into the amniotic pool?

1.   ?    4th week
2.   ?    4th 5th month
3.   ?    last trimester
4.   ?    2nd week

Which is NOT a cause of anhydramnios?

1.   ?    ureteral obstruction
2.   ?    bilateral renal agenesis
3.   ?    urethral obstruction
4.   ?    bilateral multicystic kidneys

Which is NOT a cause of polyhydramnios?

1.   ?    duodenal atresia
2.   ?    esophageal compression from thoracic mass
3.   ?    multicystic kidney
4.   ?    anencephaly

At what gestational age can the fetal kidney be seen on ultrasound?

1.   ?    4 -6 weeks
2.   ?    10 -12 weeks
3.   ?    after 20 weeks
4.   ?    16 18 weeks

At what gestational age can the fetal heart be seen on ultrasound?

1.   ?    4 -6 weeks
2.   ?    10 -12 weeks
3.   ?    after 20 weeks
4.   ?    16 18 weeks

What is the expected mortality rate for fetuses with oligohydramnios early in the second trimester?

1.   ?    About 50 percent
2.   ?    More than 90 percent
3.   ?    Less than 10 percent

Which is NOT a criteria for fetal intervention for oligohydramnios?

1.   ?    Fetal urine NA greater than 100
2.   ?    Fetal CL less than 90
3.   ?    Fetal urine osmolarity less than 210
4.   ?    Fetal lung immaturity

Open fetal bladder decompression (marsupialization) requires a gestational age of at least 28 weeks?

1.   ?    True
2.   ?    False

The peak phase of nephrogenesis is BLANK weeks of gestational age?

1.   ?    After 30th week
2.   ?    10th 20th week
3.   ?    20th 30th week

What percent of infants born with a diaphragmatic hernia have pulmonary insufficiency?

1.   ?    25 percent
2.   ?    50 percent
3.   ?    75 percent
4.   ?    90 percent

Which is NOT an indicator of a poor outcome in babies with a congenital diaphragmatic hernia?

1.   ?    Stomach in the chest with gastric dilation
2.   ?    Respiratory distress at birth
3.   ?    Maternal oligohydramnios

Which factors in neonatal or fetal chylothorax are NOT associated with a bad outcome?

1.   ?    Fetal diagnosis
2.   ?    Hydrops
3.   ?     Diagnosis before 32 weeks EGA

In a fetal diagnosis of sacrococcygeal teratoma, the prognosis is better if the infant is older than how many weeks gestational age?

1.   ?    34 weeks
2.   ?    30 weeks
3.   ?    24 weeks

Fetal SC teratoma larger than 5 cm should be delivered via cesarean section: T or F?

1.   ?    True
2.   ?    False

For fetal surgery, what maternal inhalational anesthetic is usually preferred?

1.   ?    Nitrous Oxide
2.   ?    Isoflurane
3.   ?    Halothane
4.   ?    Enflurane

If fetal surgery has been previously performed, future deliveries can be via cesarean section or vaginal?

1.   ?    True
2.   ?    False

For fetal surgery, what agent is NOT used for maternal tocolysis?

1.   ?    magnesium sulfate
2.   ?    ritrodrine
3.   ?    indocin
4.   ?    PGE 2