Quiz
Amniotic Fluid
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1What is the normal gestation period?
- A38-42 weeks
- B30-35 weeks
- C45-50 weeks
- D20-35 weeks
2Which of the following is a function of amniotic fluid?
- ACushions the fetus while in utero and allows for movement
- BStabilizes fetal temperature
- CPlays a role in fetal lung development
- DAllows exchange of water and substances between the fluid, the fetus and the maternal
circulation. - EAll of the above
3Initially, amniotic fluid is produced by the [blank_start]amnion and the placenta[blank_end].
- Aamnion and the placenta
4Production of amniotic fluid in the first trimester is supplied by [blank_start]maternal circulation[blank_end], approximately [blank_start]35mL[blank_end].
- Amaternal circulation
- B35mL
5Amniotic fluid in the first trimester is similar to the composition of the mother's plasma (plus some sloughed off cells from the fetus).
- ARichtig
- BFalsch
6In the 2nd trimester, [blank_start]fetal urine[blank_end] is the main contributor.
- Afetal urine
7In 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].- Afetal lung fluid
8Surfactants secreted by the fetus include
- AAlpha fetoprotein and AChE
- BAChE and Lecithin
- CSphingomyelin and AChE
- DLecithin and sphingomyelin
9The 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.
- A3rd trimester
- Bdecreasing
10_______ is an excess accumulation of amniotic fluid due to failure of the fetus to
start swallowing the fluid.- AOligohydramnios
- BPolyhydramnios
11Polyhydramnios is associated with _____ while oligohydramnios is associated with ______.
- ACongenital fetal deformations; Congenital deformations or amniotic membrane rupture
- BCongenital deformations or amniotic membrane rupture; Congenital fetal deformations
12Check the answers that are associated with polyhydramnios.
- AFetal distress
- BFailure of the fetus to start swallowing amniotic fluid
- CIncreased fetal swallowing
- DUrinary tract deformities
- EFetal structure anomalies
- FNeural tube disorders
- GAmniotic membrane leakage
- HCongenital infections
- ICardiac arrhythmias
- JChromosomal abnormalities
13Check the answers associated with Oligohydramnios.
- AAccumulation of amniotic fluid
- BDecreased amniotic fluid
- CCardiac arrhythmias
- DFailure of the fetus to start swallowing the fluid.
- EUrinary tract deformities
- FIncreased fetal swallowing
- GAmniotic membrane leakage
- HUmbilical cord compression
14As 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.
- ADecrease in creatinine
- BIncrease in creatinine
- CIncrease in urea
- DIncrease in uric acid
- EIncrease in protein
- FDecrease in protein
- GIncrease in glucose
- HDecrease in glucose
- IDecrease in urea
- JDecrease in uric acid
15Amniotic 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].
- A1.5-2.0
- B> 2.0 mg/dL
16Generally, amniocentesis can be performed anytime after 8 weeks gestation, but the purpose for
the procedure dictates when it is actually performed.- ARichtig
- BFalsch
17Amniocentesis when used to screen for birth defects is performed between [blank_start]15-18[blank_end] weeks.
- A15-18
18Amniocentesis, when performed to monitor fetal distress is performed between [blank_start]20-42[blank_end] weeks.
- A20-42
19Check the appropriate boxes associated with amniotic fluid collection.
- AKeep at room temperature.
- BKeep on ice.
- CSeparate from cells asap.
20[blank_start]Filtration[blank_end] is recommended for FLM (fetal lung maturity studies) to prevent loss of phospholipids (lung surfactants)
- AFiltration
21Surfactants are unstable at room temperature but stable if refrigerated for up to 72 hours
- ARichtig
- BFalsch
22Centrifugation 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).- ARichtig
- BFalsch
23The mother's triple screen serum test includes [blank_start]AFP[blank_end], [blank_start]hCG[blank_end], and [blank_start]UE3[blank_end].
- AAFP
- BhCG
- CUE3
24Produced 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.
- AEstriol
- BBilirubin
- CAFP
- DhCG
25Low levels are a concern for maintaining the pregnancy. High levels are associated with down syndrome.
- AhCG
- BEstriol
- CBilirubin
- DAFP
26High "unconjugated estriol" indicates a problem with the fetus development.
- ARichtig
- BFalsch
27Erroneous results can be obtained for ____ due to preeclampsia, anemia, and kidney disease.
- AEstriol
- BAFP
- CBilirubin
- DhCG
28DHEA, a precursor hormone, is produced by the fetal adrenal glands and converted to estriol in the placenta.
- ARichtig
- BFalsch
29What is included in a Quad Screen?
- ACholesterol
- BDHEA
- CInhibin-A
- DGlucose
30Inhibin-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.
- ARichtig
- BFalsch
31The 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.
- ARichtig
- BFalsch
32All amniotic fluid is turbid to some degree
- ARichtig
- BFalsch
33 A protein produced by the fetal liver during the 1st trimester and present in both fetal serum and fetal CSF
- AAFP
- BAChE
- CBilirubin
- DAlbumin
34These are tests that measure the various lung surfactants - lecithin, sphingomyelin, and [blank_start]phosphatidyl glycerol[blank_end].
- Aphosphatidyl glycerol
35The 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.- Aphospholipids
36AFP 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.
- ARichtig
- BFalsch
37Check the tests associated with assessing AFP levels.
- ACytogenetics
- BFlow Cytometry
- CEIA
- DRIA
38AChE 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.- ARichtig
- BFalsch
39Amniotic fluid - Bilirubin and the Liley Graph - Zone 1
- Aindicates a normal to mildly affected fetus
- Bquires careful monitoring of the pregnancy as it suggests HDFN may be
occurring - Cindicates a severely affected fetus and a need for intervention.
40Amniotic fluid - Bilirubin and the Liley Graph - Zone 3
- Aindicates a normal to mildly affected fetus
- Brequires careful monitoring of the pregnancy as it suggests HDFN may be
occurring - Cindicates a severely affected fetus and a need for intervention
41FML 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- A32
42When 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.- Alung surfactants
43The most common complication of early delivery and is the leading cause of death in premature infants.
- ADown Syndrome
- BAnencephaly
- CRDS
- DAIDS
44The function of the surfactant is to keep the [blank_start]alveoli open[blank_end].
- Aalveoli open
45The primary lung surfactant is
- ALecithin
- BSphingomyelin
- CPhosphatidyl Glycerol
46[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.- ALecithin
- Blecithin
47[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.- ASphingomyelin
- Bsphingomyelin
48Prior 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.- A1.6
- B2.0
49Lecithin and sphingomyelin are measured by
- ATLC
- BRIA
- CEIA
50[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.
- APhosphatidyl Glycerol
51It 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.- ARichtig
- BFalsch
52[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- AAmniostat FLM
53Phosphatidyl glycerol (PGL) is measured by (check all associated with it).
- ATLC
- BAmniostat FLM
- CEIA
- DRIA
54Rapid tests for determining FLM (Check all that apply).
- AEIA
- BRIA
- CFSI
- DLamellar body counts
- ETLC
55The FSI is based on the fact that [blank_start]ethanol[blank_end] destroys [blank_start]phospholipids[blank_end]; it is an antifoaming agent.
- Aethanol
- Bphospholipids
56Amniotic Fluid - FSI
- AWhen mixed with amniotic fluid and shaken, the amount of foam is proportional to the
amount of surfactant present. - BWhen mixed with amniotic fluid and shaken, the amount of foam is inversely proportional to the amount of surfactant present.
- AWhen mixed with amniotic fluid and shaken, the amount of foam is proportional to the
57Foam 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.- ARichtig
- BFalsch
58FSI: The ones with less ethanol should have less bubbles because ethanol is an antifoaming agent.
- ARichtig
- BFalsch
59The first tube that shows foaming gives us the FSI.
- ARichtig
- BFalsch
60FSI: 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.
- ARichtig
- BFalsch
61The storage form of lung surfactants
- ALamellar bodies
- BSphingomyelin
- CLecithin
- DPhosphatidyl glycerol
62As the lungs mature the increased lamellar body production reflects a decrease in phospholipids and L/S ratio.
- ARichtig
- BFalsch
63[blank_start]Lamellar bodies[blank_end] will increase the optical density of amniotic fluid.
- ALamellar bodies
64When measured at 650 nm, [blank_start]meconium[blank_end] falsely increases the optical density, but [blank_start]hemoglobin[blank_end] does not.
- Ameconium
- Bhemoglobin
65An OD reading of 0.150 correlates well with an L/S ratio ≥ 2.0 and the presence of phosphatidyl glycerol.
- ARichtig
- BFalsch
66In 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.
- Ablood
- Bplatelets
67[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.
- AFetal Fibronectin
68During 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- Afetal fibronectin
69Fetal fibronectin Test is performed on
- AA cervical/vaginal swab
- BAmniotic fluid
- CUrine
- DSerum
70Fetal Fibronectin tests include
- AELISA
- BRapid Lateral flow immunosorbent assay
- CRIA
- DFlow cytometry
71At 22-35 weeks gestation, fFN levels are normally below [blank_start]50[blank_end] ng/dL.
- A50
Informationen
- Beschreibung
- From the amniotic fluid lecture
- Autor
- Samantha Hale
- Sprache
- English
- Aufrufe
- 119
- Schlagwörter
- Bewertung
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