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Adobe Scan 27 Oct 2023
Adobe Scan 27 Oct 2023
Adobe Scan 27 Oct 2023
25 ed
and
4. Referencing the graphic below, what can be said about dating
ultrasonography in obstetrics?
a. Postterm birthweights were relatively lower using menstrual
dating.
b. Best obstetric estimates were mainly based on menstrual dating.
the use of best obstetric
C. Preterm birthweights were overestimated prior to
estimates.
d. All of the above
differentiated?
5. How is symmetrical versus asymmetrical growth restriction
small.
a. Symmnetrically growth restricted fetuses were proportionately
ratio is used to differentiate
b. The abdominal circumference to head circumference
between the two.
lagging head
c. Asymmetrically growth restricted fetuses had a disproportionately
compared with abdominal growth.
d. All of the above
sparing and growth
6. Which of the following statements is true regarding brain
restriction?
restricted fetuses.
a. Brain sparing is restricted to symmetrically growth
b. With limited nutrients, there is preferential shunting of oxygen and nutrients
to the brain.
growth restricted infant, brain sparing is
C. During the last 12 weeks of growth in the ofthe normal 2:1.
demonstrated by a brain-to-liver weight ratio of 3:1instead
laag Pa
d. Allofthe above
7 Growing evidence suggests that fetal growth restriction
especially which of the following?
affects organ development,
a. Brain
b. Heart
c. Kidney
d Thyroid
8 Risk factors for impaired fetal growth are divided into mother, fetus,
and placenta.
Which of the following is a common risk factor to allthree sources?
a. Infection
b. Drugs and teratogens
c. Genetic abnormalities
d. Maternal medical conditions
9. What risk factors are associated with fetal growth restriction in women with
pre
gestational diabetes?
a. Maternal vascular disease
b. Congenital malformations
c. Worsening White classification
d. All of the above
10. Compared to women who do not undergo psychosocial risk factor screening during
pregnancy, those that do have which of the following?
a. Lower preterm birth rates
b. More appropriate interventions
c. Lower rates of low-birthweight newborns
d. Allof the above
15. Which of the following antiphospholipid antibodies are associated with fetal growth
restriction?
a. G20210A mutation
b. Lupus anticoagulant
C. Anti-ß2 glycoprotein antibodies
d. Allof the above
20 Your patient arrives late in her care. She brought a copy of her
ultrasound from 12wecks' gestation which matched her dates of
32 weeks. Ultrasound performed in your office reveals an
estimated fetal weight <3rd percentile for gestational age.
Doppler velocimetry of the umbilical artery reveals the waveform 150, minimal
below. Continuous fetal monitor detects a fetal baseline heart rate of
action?
variability. and repetitive late decelerations. What is your next course of
a. Proceed with primary cesarean delivery
b. Give betamethasone, wait 48 hours, and deliver
c. Admit to the floor for daily fetal surveillance
d. Any of the above would be reasonable
virtually always present?
21. In which chromosomal aneuploidy is fetal-growth restriction
a. 45, X
b. Trisomy 13
C. Trisomy 18
d Trisomy 21
growth?
22. Which of the following drugs and chemicals is capable of limiting fetal
a. Alcohol
b. Cocaine
c. Cigarettes
d. All of the above
23. Which ofthe following practices may prevent or limit fetal growth restriction?
a. Smoking cessation
b. Increase caloric requirements for women with a growth restricted infant.
c. Even with normal fundal height and presumed growth, it is reasonable to perform
Doppler velocimetry and fetal surveillance on the current pregnancy if the woman had
an infant with growth restriction previously.
d. All of the above
24. Ms. Smith is a 37-year-old multigravida who presents to your oftice at 32 weeks'
gestation as calculated by her last menstrual period. Her hematocrit is 29%, and she has
sickle-cll rait During sonographic evaluation, the letus has biometric values that
correlate with a 28-wek fetus. What is the most likely explanation?
a Ancuploidy
b. Chronic bypoxia
c. Poor pregnancy dating
d First-trimester
cytomegalovirus infection
25. For the patient in Question above, when willyou
a. Iweek reevaluate fetal growth?
b. 2 weeks
C. 3weeks
d. 6weeks
26. Elevated C-peptide levels are associated with which of the following?
a. Hyperinsulinemia
b. Hypercholesterolemia
c. Fetal-growth restriction
d. All of the above
27. Amino acids undergo which type of transport fromn maternal to fetal circulation?
a. Active transport
b. Passive diffusion
c.Facilitated difusion
d. None of the above
28. This graph depicts the relationship between birthweight percentile -rar
32. Which of the following is true regarding women with pregravid weights less than 1001b
compared with normal~weight women?
a. They have a twofold risk of having growth~restricted fetuses.
b. They have a slightly incrcased risk of having a fetus with ancuploidy.
c. The risk of fetal-growth restriction may be modulated by appropriate maternal
gestational weight gain.
d. All of the above
37. Which of the following is the primary autoantibody that predicts obstetrical
antiphospholipid antibody syndrome?
a. Lupus anticoagulant
b. Anticardiolipin antibodies
c. Anti-beta-glycoprotein-l antibodies
d. Anti-double-stranded DNA antibodies
38. Fetal-growth restriction is associated with all EXCEPT which of the following?
a. Prior infertility
b. Placental chorangioma
c. Inherited thrombophilia
d. Velamentous cord insertion
39. The graph below suggests which of the following regarding fetal
growth restriction and multifetal pregnancy?
quadruplet
a. Most growth-restricted neonates result from
pregnancies.
gestation
b. Fetal-growth restriction can be detected at 20 weeks'
in quadruplets.
typically becomes apparent in
c. In multifetal gestations, fetal-growth restriction
the early third trimester.
d. All of the above
47. For the patient in Question 25, during the next week, umbilical artery Doppler
(REDF), and the amnionic fluid index
velocimetry indicates reversed end-diastolic flow
(AFI)is 4 cm. What is appropriate at this time?
a. Deliver the fetus
b. Plan delivery at 38 weeks after amniocentesis for pulmonary maturity
c. Continue serial umbilical artery Doppler
studies and AFI assessment
d. Allare reasonable
week approximates which of the
48. The average weight gain (grams per day)after 32
following?
a. 5-10 g/d
b. 20 g/d
c. 30 gld
d. 40 g/d
49. Which of the following cell growth phases occurs during the first 16 weeks of
gestation?
a. Cellular hyperplasia and hypertrophy
b.Cellular hyperplasia
c. Cellular hypertrophy
d. Apoptosis
50. Mostclinically
what percentile?meaningful adverse outcomes are in neonates bonweighing below
a. 20th
b. 10th
c. 5th
d. 3rd
53. Lack of maternal weight gain in which period especially correlates with decreased fetal
birthweight?
a. Preconception
b. First trimester
c. Second trimester
d. Third trimester
54. Placental mosaicism of which of the following trisomies may be responsible for
previously unexplained cases of fetal growth restriction?
a. Trisomy 13
b. Trisomy 16
c. Trisomy 18
d. Trisomy 21
55. Serial fundal height measurements detect what percentage of fetal growth restriction
cases?
a. 25
b. 40
c. 70
d. 85
s9. As shown in this figure, perinatal mortality rates are lowest with
which of the following largest-vertical-pocket measurements?
a. < 2cm
b. 2cm
C. 7 cm
d. > 8 cm
61. With fetal growth restriction near term (34 weeks) and oligohydramnios, which of the
following is the most appropriate management?
a. Fetal surveillance and delivery by 37 weeks
b.Cordocentesis and diagnostic karyotyping
c. Delivery
d. Bed rest and fetal surveillance