Clinical Chemistry Test Bank Chapter 44 (Pregnancy and Prenatal Testing)

1- Which one of the following statements concerning maternal endocrine changes during the first 12 weeks (first trimester) of pregnancy is correct??

A) Cortisol gradually decreases

B) Free thyroxine values remain unchanged

C) TSH remains unchanged

D) 1,25-Dihydroxyvitamin D decreases

... Answer is C)

2- The placental peptide hormone that has exceptional homology with growth hormone and that has aldosterone-stimulating effects is:?

A) estriol

B) Chorionic gonadotropin

C) Progesterone

D) estrone

... Answer is B)

3- In a preterm infant, the lack of pulmonary surfactant in immature lungs will produce which of the following symptoms??

A) Red blood cell hemolysis

B) Unconjugated hyperbilirubinemia

C) Respiratory distress

D) Metabolic acidosis

... Answer is C)

4- The presence of bilirubin in amniotic fluid is an indicator of:?

A) Fetal erythroblastosis.

B) Respiratory distress.

C) Down syndrome

D) Eclampsia

... Answer is A)

5- When the gradual replacement of hemoglobin F by hemoglobin A does not occur normally, what is the result??

A) Increased oxygen affinity to hemoglobin F

B) Hyperbilirubinemia and a jaundiced baby

C) Overactive embryonic hemoglobin and fetal death

D) A lack of surfactant and respiratory distress

... Answer is A)

6- Fetal lung maturity:?

A) Is complete at 20 weeks gestation

B) Can be accelerated by administration of corticosteroids before birth.

C) Is indicated by an L/S ratio less than 2.0.

D) Can be assessed by measuring maternal inhibin A serum concentration.

... Answer is B)

7- The primary function of amniotic fluid is to:?

A) Provide nourishment to the fetus

B) Facilitate oxygen and carbon dioxide exchange in fetal lungs

C) Synthesize hormones before the brain develops.

D) Provide protection, constant temperature, and moisture for the fetus.

... Answer is D)

8- The trophoblast cells that surround the developing blastocyst:?

A) Form the amnion and amniotic fluid.

B) Synthesize glucose for the fetus

C) Are the major blood-forming organs in early fetal life.

D) Invade the endometrium and form the placenta.

... Answer is D)

9- The cells that form surfactant in fetal lungs are the?

A) Type II pneumocytes.

B) Placental trophoblasts

C) Fetal hepatocytes

D) Maternal lung cells

... Answer is A)

10- A pregnant woman, who has been previously diagnosed with preeclampsia, develops edema, headaches, and nausea over several weeks. She complains about a band of pain around the upper part of her abdomen. Her eyes and skin are yellow. Her obstetrician orders a full blood workup, including coagulation studies, CBC, liver enzyme profile, and electrolyte panel. Her serum appears hemolyzed. If this woman was diagnosed with preeclampsia originally, what might these laboratory results reveal??

A) Elevated liver enzymes, abnormal coagulation results, low platelet count, elevated sodium

B) Normal liver enzymes, elevated red blood cell count, elevated white blood cell count, normal coagulation studies, hypoproteinemia

C) Decreased liver enzymes, decreased albumin, decreased bilirubin, normal electrolytes, abnormal coagulation times

D) These symptoms are normal in a pregnant woman, so all lab results would be within healthy reference intervals.

... Answer is A)

11- In the second trimester of pregnancy, maternal serum inhibin A concentration is:?

A) Very high in a normal pregnancy

B) Very low in the presence of twins

C) High in the presence of Down syndrome and low in trisomy 18

D) Undetectable in disorders related to any trisomy.

... Answer is C)

12- The maternal screening tests that are considered to be part of the "quadruple test" for estimating Down syndrome risk include:?

A) Alpha-fetoprotein, alpha1-antitrypsin, bilirubin, and chorionic gonadotropin.

B) Unconjugated estriol, chorionic gonadotropin, inhibin A, and inhibin B

C) Alpha-fetoprotein, amniotic bilirubin, inhibin A, and unconjugated estriol

D) Alpha-fetoprotein, unconjugated estriol, chorionic gonadotropin, and inhibin A.

... Answer is D)

13- A pregnant woman was tested for fetal fibronectin (fFN) using vaginal secretions as the specimen. The fFN result indicated a concentration of 55 ng/mL. What information does this analyte's value provide??

A) It indicates that the risk of preterm delivery is two to four times greater than normal.

B) It indicates that the fetal Down syndrome risk is 10 times higher than in a normal pregnancy.

C) It indicates a deficiency of placental sulfatase and likely delayed labor and delivery.

D) This value is within the reference interval and indicates that the gestational age of the pregnancy is 24 weeks.

... Answer is A)

14- Early in gestation, amniotic fluid has a composition similar to:?

A) Intracellular fluid

B) Extracellular fluid

C) Urine

D) Water

... Answer is B)

15- A pregnant woman in her second trimester visits her obstetrician with elevated blood pressure. A urine sample reveals normal glucose, elevated protein, and a small number of red and white blood cells. The woman is recommended for bed rest for the remaining term of her pregnancy. This condition is known as:?

A) Eclampsia

B) Preeclampsia

C) hydramnios

D) Oligohydramnios

... Answer is B)

16- During embryonic development of the brain and spinal cord, failure of the neural tube to close with resultant fetal protein leaking into the amniotic fluid is referred to as:?

A) Hydrops fetalis.

B) Down syndrome

C) Anencephaly

D) Trisomy 18

... Answer is C)

17- Concerning alpha-fetoprotein (AFP), which one of the following statements is correct??

A) A decrease in AFP in a pregnant woman's serum indicates the presence of possible spina bifida in the fetus.

B) An appropriate time to measure AFP in maternal serum is at 16 weeks gestation when it is approximately 3.5 µg/dL.

C) An increase in AFP in a pregnant woman's serum indicates the presence of Down syndrome in the fetus.

D) AFP in maternal serum rapidly decreases to a low point at 11 weeks and then increases to reach a second maximum at 13 weeks.

... Answer is B)

18- A hormone that is monitored to assess conditions associated with intrauterine (vs.ectopic) fetal growth is:?

A) Progesterone

B) Placental lactogen (PL).

C) Estrogen

D) Chorionic gonadotropin (CG).

... Answer is D)

19- In the second trimester, maternal age along with a screening serum analysis of alpha-fetoprotein, inhibin A, unconjugated estriol, chorionic gonadotropin, and which of the following are assessed as the "integrated test" testing panel for Down syndrome risk estimate??

A) Nuchal translucency (NT) and pregnancy-associated plasma protein A (PAPP-A)

B) Placental lactogen and NT

C) PAPP-A and placental lactogen

D) Estrone and PAPP-A

... Answer is A)

20- Greenish amniotic fluid indicates the presence of:?

A) Fetal meconium.

B) Hemolysis

C) Increased surfactant

D) Fetal death.

... Answer is A)

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