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During the later stages of pregnancy, maternal blood is separated from fetal blood by
A.
Syncytiotrophoblast only
B.
Cytotrophoblast only
C.
Syncytiotrophoblast and cytotrophoblast
D.
Syncytiotrophoblast and fetal endothelium
E.
Cytotrophoblast and fetal endothelium
Correct Answer
D. SyncytiotropHoblast and fetal endothelium
Explanation During the later stages of pregnancy, the placental membrane becomes very thin and consists of two layers, the syncytiotrophoblast and fetal endothelium.
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2.
The maternal and fetal components of the placenta are
A.
Decidua basalis and secondary chorionic villi
B.
Decidua capsularis and secondary chorionic villi
C.
Decidua parietalis and tertiary chorionic villi
D.
Decidua capsularis and villous chorion
E.
Decidua basalis and villous chorion
Correct Answer
E. Decidua basalis and villous chorion
Explanation The placenta is a unique organ in that it is a composite of tissue from two different sources,
the mother and the fetus. The maternal component is the decidua basalis, and the fetal component is the villous chorion
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3.
The intervillous space of the placenta contains
A.
Maternal blood
B.
Fetal blood
C.
Maternal and fetal blood
D.
Amniotic fluid
E.
Maternal blood and amniotic fluid
Correct Answer
A. Maternal blood
Explanation The intervillous space contains only maternal blood as the spiral arteries of the
endometrium penetrate the outer cytotrophoblast shell.
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4.
A young insulin-dependent diabetic woman in her first pregnancy is concerned that her
daily injection of insulin will cause a congenital malformation in her baby. What should the
physician tell her?
A.
Insulin is highly teratogenic; discontinue treatment
B.
Insulin does not cross the placental membrane
C.
Insulin crosses the placental membrane but is degraded rapidly
D.
Insulin will benefit her baby by increasing glucose metabolism
E.
Insulin crosses the placental membrane but is not teratogenic
Correct Answer
B. Insulin does not cross the placental membrane
Explanation Insulin, like all protein hormones, does not cross the placental membrane in significant
amounts.
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5.
What is a normal amount of amniotic fluid at term?
A.
50 mL
B.
500 mL
C.
1000 mL
D.
1500 mL
E.
2000 mL
Correct Answer
C. 1000 mL
Explanation The normal amount of amniotic fluid at term is 1000 mL. However, the amount of amniotic
fluid at various stages of pregnancy can be indicative of congenital malformations.
Oligohydramnios (400 mL in late pregnancy) may be indicative of renal agenesis.
Polyhydramnios (2000 mL in late pregnancy) may be indicative of either anencephaly or
esophageal atresia.
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6.
Which of the following does not pass through the primitive umbilical ring?
A.
Allantois
B.
Amnion
C.
Yolk sac
D.
Connecting stalk
E.
Space connecting the intraembryonic and extraembryonic coeloms
Correct Answer
B. Amnion
Explanation The amnion does not pass through the primitive umbilical ring. As craniocaudal folding
occurs, the amnion becomes the outer covering of the umbilical cord.
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7.
Which of the following best describes the placental components of dizygotic twins?
A.
One placenta, two amniotic sacs, one chorion
B.
One placenta, two amniotic sacs, two chorions
C.
Two placentas, two amniotic sacs, one chorion
D.
Two placentas, two amniotic sacs, two chorions
E.
One placenta, two amniotic sacs, two chorions
Correct Answer
D. Two placentas, two amniotic sacs, two chorions
Explanation Dizygotic twins and 35% of monozygotic twins have two placentas, two amniotic sacs, and
two chorions (i.e., 222).
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8.
A 26-year-old pregnant woman experiences repeated episodes of bright red vaginal bleeding at week 28, week 32, and week 34 of pregnancy. The bleeding spontaneously subsided each time. Using ultrasound, the placenta is located in the lower right portion of the uterus over the internal os. What is the diagnosis?
A.
Hydatidiform mole
B.
Vasa previa
C.
Placenta previa
D.
Placental abruption
E.
Premature rupture of the amniochorionic membrane
Correct Answer
C. Placenta previa
Explanation A placenta implanted in the lower part of the uterus near the internal os is called placenta
previa. The repeated episodes of bright red vaginal bleeding are caused by the gradual dilation of
the uterus in the later stages of pregnancy. As the uterus dilates, spiral arteries and veins supplying the placenta are ruptured. The mother may bleed to death, and the fetus is placed in jeopardy because of the compromised maternal blood flow.
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9.
A 19-year-old woman in week 32 of a complication-free pregnancy is rushed to the emergency department because of profuse vaginal bleeding. The bleeding subsides, but afterwards no fetal heart sounds can be heard, indicating intrauterine fetal death. The woman goes into labor and delivers a stillborn infant. On examination of the afterbirth, a velamentous placenta is detected. Although not much can be done at this point, what is the diagnosis?
A.
Placenta previa
B.
Vasa previa
C.
Hydatidiform mole
D.
Premature rupture of the amniochorionic membrane
E.
Amniotic band syndrome
Correct Answer
B. Vasa previa
Explanation A velamentous placenta occurs when umbilical blood vessels abnormally travel through the
amniochorionic membrane before reaching the placenta proper. If the vessels cross the internal
os, a serious condition called vasa previa exists. As the fetus grows during pregnancy and the
amniochorionic membrane stretches, the umbilical vessels may rupture. When that happens, the
fetus will bleed to death. The mother is in no danger of bleeding to death in vasa previa because
only the umbilical vessels rupture.
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10.
Human chorionic gonadotropin (hCG) is produced by which of the following?
A.
Ectoderm
B.
Cytotrophoblast
C.
Decidua basalis
D.
Syncytiotrophoblast
E.
Mesoderm
Correct Answer
D. SyncytiotropHoblast
Explanation The syncytiotrophoblast produces hCG.
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11.
A reliable index of fetal-placenta function is maternal urinary levels of
A.
Estrone
B.
Human placental lactogen (hPL)
C.
Prolactin (PRL)
D.
Progesterone
E.
Estriol
Correct Answer
E. Estriol
Explanation Maternal urinary levels of estriol have long been recognized as a reliable index of fetalplacental function because estriol production is dependent on a normal-functioning fetal adrenal cortex, fetal liver, and placenta.
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12.
The Doppler fetal heart rate is first audible in which of the following trimesters?
A.
First trimester
B.
Second trimester
C.
Third trimester
Correct Answer
A. First trimester
Explanation The fetal heart rate is first audible in the first trimester at around week 12.
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13.
The lungs become capable of respiration in which of the following trimesters?
A.
First trimester
B.
Second trimester
C.
Third trimester
Correct Answer
B. Second trimester
Explanation The lungs become capable of respiration at weeks 25-27 in the second trimester
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14.
Leber hereditary optic neuropathy demonstrates which of the following inheritance patterns?
Duchenne muscular dystrophy demonstrates which of the following inheritance patterns?
A.
Mitochondrial inheritance
B.
X-linked recessive
C.
Autosomal dominant
D.
Autosomal recessive
Correct Answer
B. X-linked recessive
Explanation Duchenne muscular dystrophy demonstrates an X-linked recessive inheritance pattern
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16.
Huntington disease demonstrates which of the following inheritance patterns?
A.
Mitochondrial inheritance
B.
X-linked recessive
C.
Autosomal dominant
D.
Autosomal recessive
Correct Answer
C. Autosomal dominant
Explanation Huntington disease demonstrates an autosomal dominant inheritance pattern.
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17.
Which of the following is inherited entirely through maternal transmission?
A.
Huntington disease
B.
Cystic fibrosis
C.
Duchenne muscular dystrophy
D.
Leber hereditary optic neuropathy
Correct Answer
D. Leber hereditary optic neuropathy
Explanation Leber hereditary optic neuropathy involves a mutation in the ND4 gene located on mitochondrial DNA. All mitochondrial DNA is inherited only from the mother because sperm (male) mitochondria do not pass into the ovum at fertilization
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18.
Which of the following genetic diseases involves a mutation in a Cl- channel?
A.
Huntington disease
B.
Cystic fibrosis
C.
Duchenne muscular dystrophy
D.
Leber hereditary optic neuropathy
Correct Answer
B. Cystic fibrosis
Explanation Cystic fibrosis is an autosomal recessive disease that involves a mutation in the CF gene that encodes for a Cl- channel.
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