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Category: Obstetrics & Gynecology--->Maternal-Fetal Physiology and Placentation
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Question 1# Print Question

A 29-year-old Caucasian primigravida is 20 weeks pregnant with twins. Today, on her routine ultrasound for fetal anatomy, she found out that she is carrying two boys.

In this patient’s case, which of the following statements correctly describes the zygosity of this pregnancy?

A. The twins must be monozygotic since they are both the same gender
B. If division of these twins occurred after formation of the embryonic disk, the twins will be conjoined
C. She has a higher incidence of having monozygotic twins because she is Caucasian
D. If the ultrasound showed two separate placentas, the twins must be dizygotic
E. If the ultrasound showed two separate placentas, the twins cannot be monozygotic


Question 2# Print Question

After delivery of a term newborn with Apgar scores of 2 at 1 minute and 7 at 5 minutes, you ask that blood from the umbilical arteries be collected for pH.

The umbilical arteries carry which of the following?

A. Oxygenated blood to the placenta
B. Oxygenated blood from the placenta
C. Deoxygenated blood to the placenta
D. Deoxygenated blood from the placenta
E. Mixed oxygenated blood from the placenta


Question 3# Print Question

A 25-year-old P0 presents for routine anatomy ultrasound at 20 weeks’ gestation. The only significant finding at the time of ultrasound is the presence of a single umbilical artery (SUA).

How should you counsel this patient about the finding of a SUA?

A. It is a very common finding and is insignificant
B. Fetal karyotype should be determined, because this finding is associated with an increased risk of aneuploidy
C. Careful anatomic survey should be performed, because it is an indicator of an increased incidence of congenital anomalies of the fetus
D. It is equally common in newborns of diabetic and nondiabetic mothers
E. Even if it is the only abnormality present, SUA is commonly associated with adverse pregnancy outcomes


Question 4# Print Question

A 25-year-old P0 presents for routine anatomy ultrasound at 20 weeks’ gestation. The only significant finding at the time of ultrasound is the presence of a single umbilical artery (SUA). Targeted ultrasound does not demonstrate any other abnormalities. The patient asks you if this SUA will impact how you manage the rest of her pregnancy.

What should you tell her?

A. Her pregnancy will not be managed any differently due to the isolated finding of SUA
B. The next step in her management should be genetic amniocentesis
C. She will require periodic assessments of fetal growth
D. She should be delivered by 39 weeks’ gestation at the latest
E. She will require delivery by cesarean


Question 5# Print Question

A 22-year-old G1P0 at 28 weeks’ gestation by LMP presents to labor and delivery complaining of decreased fetal movement. She has had no prenatal care. On the fetal monitor there are no contractions. The fetal heart rate is 150 beats per minute and reactive, with no decelerations in the fetal heart tracing. An ultrasound demonstrates a 28-week fetus with normal anatomy and size consistent with menstrual dates. The placenta is implanted on the posterior uterine wall and its margin is well away from the cervix. A succenturiate lobe of the placenta is seen implanted low on the anterior wall of the uterus. Doppler flow studies indicate a blood vessel is traversing the cervix connecting the two lobes.

This patient is most at risk for which of the following?

A. Premature rupture of the membranes
B. Fetal exsanguination after rupture of the membranes
C. Torsion of the umbilical cord caused by velamentous insertion of the umbilical cord
D. Amniotic fluid embolism
E. Placenta accreta




Category: Obstetrics & Gynecology--->Maternal-Fetal Physiology and Placentation
Page: 1 of 3