CHAPTER 7 Embryogenesis and Fetal Development.pptx

Embryogenesis and Fetal Development

1. CHAPTER 7 Embryogenesis and Fetal Development

2. 7–1. Which of the following is assumed when using the first day of the last menstrual period for dating? a. The patient has a 36-day cycle. b. The patient became pregnant on that day. c. The patient ovulated approximately two weeks later. d. The first day of the last menstrual period was implantation bleeding. 7–2. What is the accuracy of an ultrasound measurement shown below? a. ±2–3 days b. ±5–7 days c. ±8–10 days d. ±12–14 days 7–3. Approximately how long is each trimester of pregnancy? a. 12 weeks b. 13 weeks c. 14 weeks d. 15 weeks

3. 7–4. When is a conceptus termed an embryo? a. Third week from the last menstrual period b. Fifth week from the last menstrual period c. Sixth week from the last menstrual period d. Twelfth week from the last menstrual period 7–5. A 20-year-old primigravida presents to your office to start prenatal care. She reports having an ultrasound performed last week at another facility. She shows you an ultrasound image which is provided below. Interested in science, the patient would like to know what is happening to the fetus at this gestational age. Which of the following statements would be incorrect? a. The fetus has fingers and toes. b. Skins and nails are developing. The eyes are moving, and there is blinking. The fetus is beginning to make spontaneous movements 7–6. A 29-year-old multigravida presents at 15 weeks’ gestation to establish prenatal care. The patient’s first child had a neural-tube defect. The patient did not know she was pregnant until this week, so she asks you about starting folic acid as she was counseled in her last pregnancy that she needed a higher dose because of her first child’s condition. Which of the following statements should be covered in your counseling? a. Starting folic acid is just as beneficial now as ever, so she should start today but at a dose of 8 mg per day. b. The neural-tube does not close until 21 weeks’ gestation, so she should start folic acid 4 mg daily within the next 1–2 weeks. c. The neural-tube closes by 6 weeks’ gestation, so she would have needed to start the folic acid before then for it to be efficacious. d. Having a prior child with a neural-tube defect does not increase the risk of a neural-tube defect in this pregnancy, so she does not need to worry about that.

4. 7–7. The diencephalon, pictured below, gives rise to what part of the brain? a. Thalami b. Medulla c. Midbrain d. Cerebral hemispheres 7–8. How does the oxygen content of the blood coming to the heart from the inferior vena cava compare to the oxygen content of the blood leaving the placenta? a. Equal b. Lower c. Higher d. Varies depending on fetal activity 7–9. After birth, the intraabdominal remnants of the umbilical vein become which of the following? a. Ligamentum teres b. Umbilical ligaments c. Ligamentum venosum d. Ligamentum vascularum

5. 7–10. Which value defines anemia in the fetus? a. 20% b. 25% c. 30% d. 40% 7–11. Approximately what percentage of the total hemoglobin is hemoglobin F in a term fetus? a. 25% b. 40% 50% 75% 7–12. The last stage of fetal lung development starts late in the fetal period and continues into childhood. What is this stage called? a. Alveolar stage b. Canalicular stage c. Terminal sac stage d. Pseudoglandular stage

6. 7–13. Where does biosynthesis of surfactant take place? a. Type I pneumocytes b. Type II pneumocytes c. Type III pneumocytes d. Type IV pneumocytes 7–14. Starting at what gestational age does the fetus engage in respiratory movements that are intense enough to move amnionic fluid in and out of the respiratory tract? a. 4 months b. 5 months c. 6 months d. 7 months 7–15. The foregut gives rise to all except which of the following? a. Liver b. Stomach c. Pancreas d. Appendix

7. 7–16. At what gestational age does swallowing begin? a. 6–8 weeks’ gestation b. 10–12 weeks’ gestation c. 16–18 weeks’ gestation d. 20–22 weeks’ gestation 7–17. How much amnionic fluid do term fetuses swallow per day? a. 50–100 mL per day b. 100–200 mL per day c. 200–760 mL per day d. 1500–2000 mL per day 7–18. Which of the following gives meconium its greenish- black color? a. Vernix b. Biliverdin c. Scalp hair d. Hydrochloric acid

8. 7–19. At what gestational age do the fetal kidneys start producing urine? a. 6 weeks’ gestation b. 8 weeks’ gestation c. 12 weeks’ gestation d. 16 weeks’ gestation 7–20. How much urine does a fetus make at term? a. 10 mL per day b. 50 mL per day c. 200 mL per day d. 650 mL per day 7–21. Which of the following increases fetal urine formation? a. Urethral obstruction b. Fetal growth restriction Uteroplacental insufficiency Maternally administered furosemide

9. 7–22. Which of the following hormones is not produced by the anterior lobe of the fetal pituitary gland? a. Vasopressin b. Growth hormone c. Follicle-stimulating hormone d. Thyroid-stimulating hormone 7–23. Which of the following statements about the fetal thyroid gland is true? a. The fetal thyroid starts to make hormones starting at 36 weeks’ gestation. b. By 12 weeks’ gestation, the fetal thyroid is concentrating iodide more avidly than the maternal thyroid. c. With congenital fetal hypothyroidism, the fetus will develop a large goiter in addition to hepatosplenomegaly. d. After birth, cooling to room temperature causes a sudden and marked decrease in the secretion of thyroid-stimulating hormone, which results in less serum T4 with a nadir at 24–36 hours of life. 7–24. Where is fetal immunoglobulin M (IgM) produced? a. Fetus b. Mother c. Mother and fetus d. The fetus does not have IgM

10. 7–25. Which immunoglobulin in colostrum provides mucosal protection against enteric infections? a. IgA b. IgE c. IgG d. IgM 7–26. Which of the following statements about leptin is true? a. It is produced exclusively by the placenta. b. Concentrations peak in amnionic fluid at term. c. 95% of placental production enters the fetal circulation. d. Abnormal levels have been associated with fetal growth disorders, gestational diabetes, and preeclampsia. 7–27. Which of the following is found in greater con- centrations in maternal plasma compared to fetal plasma? a. Zinc b. Iodide c. Copper d. Vitamin A

11. 7–28. Which of the following does not affect immuno- globulin G (IgG) transfer across the placenta? a. Gestational age b. Placental integrity c. Maternal levels of IgG Maternal levels of IgM and IgA 7–29. What is uteroplacental blood flow at term? a. 200–400 mL/min b. 400–600 mL/min c. 700–900 mL/min d. 1200–1400 mL/min 7–30. How does immunoglobulin G (IgG) cross the placenta? a. Simple diffusion b. It does not cross the placenta c. Trophoblast receptor-mediated transfer d. Facilitated diffusion involving calcium-binding protein

12. 7–31. What is the average oxygen saturation of intervillous blood? a. 25–35% b. 45–55% c. 65–75% d. 85–95% 7–32. At term, what is the average PCO2 in the umbilical arteries? a. 30 mmHg b. 50 mmHg c. 60 mmHg d. 100 mmHg