AUBF - Chapter 7.4 Flashcards

1
Q

Which of the following statements about amniotic fluid bilirubin measured by scanning spectrophotometry is true?
A. 410-nm peak is caused by hemoglobin and 450-nm peak is caused by bilirubin
B. Baseline correction is not required because a diode array detector is used
C. Chloroform extraction is necessary only when meconium is present
D. In normal amniotic fluid, bilirubin increases with gestational age

A

A. 410-nm peak is caused by hemoglobin and 450-nm peak is caused by bilirubin

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2
Q

Which test best correlates with the severity of hemolytic disease of the fetus and newborn (HDFN)?
A. Rh antibody titer of the mother
B. Lecithin/sphingomyelin (L/S) ratio
C. Amniotic fluid bilirubin
D. Urinary estradiol

A

C. Amniotic fluid bilirubin

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3
Q

Which is the reference method for determining fetal lung maturity (FLM)?
A. Human placental lactogen
B. L/S ratio
C. Amniotic fluid bilirubin
D. Urinary estriol

A

B. L/S ratio

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4
Q

Which of the following statements regarding the L/S ratio is true?
A. A ratio of 2:1 or greater usually indicates adequate pulmonary surfactant to prevent RDS
B. A ratio of 1.5:1 indicates fetal lung maturity in pregnancies associated with diabetes mellitus
C. Sphingomyelin levels increase during the third trimester, causing the L/S ratio to fall slightly during the last 2 weeks of gestation
D. A phosphatidylglycerol (PG) spot indicates the presence of meconium in the amniotic fluid

A

A. A ratio of 2:1 or greater usually indicates adequate pulmonary surfactant to prevent RDS

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5
Q

Which of the following conditions is most likely to cause a falsely low L/S ratio?
A. The presence of PG in amniotic fluid
B. Freezing the specimen for one month at –20°C
C. Centrifugation at 1,000 × g for 10 minutes
D. Maternal diabetes mellitus

A

C. Centrifugation at 1,000 × g for 10 minutes

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6
Q

Which of the following statements accurately describes human chorionic gonadotropin (hCG) levels in pregnancy?
A. Levels of hCG rise throughout pregnancy
B. In ectopic pregnancy, serum hCG doubling time is below expected levels
C. Molar pregnancies are associated with lower levels than expected for the time of gestation
D. hCG returns to nonpregnant levels within 2 days following delivery, stillbirth, or abortion

A

B. In ectopic pregnancy, serum hCG doubling time is below expected levels

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7
Q

Which of the ff. statements regarding pregnancy testing is true?
A. β-Subunits of hCG, thyroid-stimulating hormone (TSH), and follicle-stimulating hormone (FSH) are identical
B. Antibodies against the β-subunit of hCG cross-react with luteinizing hormone (LH)
C. A false-positive result may occur in patients with heterophile antibodies
D. Serum should not be used for pregnancy tests because proteins interfere

A

C. A false-positive result may occur in patients with heterophile antibodies

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8
Q

SITUATION: A pregnant woman was seen by her physician, who suspected a molar pregnancy. An hCG test was ordered, and hCG levels were found to be low. The sample was diluted 10-fold and the assay was repeated. The level was found to be grossly elevated. What best explains this situation?
A. The wrong specimen was diluted
B. A pipeting error was made in the first analysis
C. Antigen excess caused a falsely low result in the undiluted sample
D. An inhibitor of the Ag–Ab reaction was present in the sample

A

C. Antigen excess caused a falsely low result in the undiluted sample

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9
Q

Which assay result is often approximately 25% below the expected level in pregnancies associated with Down syndrome?
A. Serum unconjugated estriol
B. L/S ratio
C. Amniotic fluid bilirubin
D. Urinary chorionic gonadotropin

A

A. Serum unconjugated estriol

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10
Q

Which of the following statements about alpha fetoprotein (AFP) is correct?
A. Maternal serum may be used to screen for open neural tube defects
B. Levels above 4 ng/mL are considered positive
C. Elevated levels in amniotic fluid are specific for spina bifida
D. AFP levels increase in pregnancies associated with Down syndrome

A

A. Maternal serum may be used to screen for open neural tube defects

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11
Q

First-trimester screening for Down syndrome can be performed using which markers?
A. AFP and unconjugated estriol
B. Free β hCG and pregnancy-associated plasma protein A
C. Intact hCG and dimeric inhibin A
D. Dimeric inhibin B and AFP

A

B. Free β hCG and pregnancy-associated plasma protein A

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12
Q

When performing marker screening tests for Down syndrome, why are results expressed in multiples of the median (MoM), rather than in concentration?
A. Concentration is not normally distributed
B. MoM normalizes for gestational age
C. Some tests cannot be reported in mass units
D. Mean cannot be determined accurately for these analytes

A

B. MoM normalizes for gestational age

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13
Q

Which test for 21 trisomy is not recommended for women who are carrying twins?
A. First trimester triple marker screening
B. Maternal plasma cell free fetal DNA
C. Chorionic villus sampling
D. Second trimester quad marker screening

A

B. Maternal plasma cell free fetal DNA

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14
Q

Which statement regarding the fetal fibronectin test is true?
A. A positive test is correlated with a low probability of delivery within 14 days
B. The test should not be performed before week 24 or after the end of week 34
C. The test is performed on amniotic fluid
D. The test is used to identify amniotic fluid after rupture of the fetal membranes

A

B. The test should not be performed before week 24 or after the end of week 34

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15
Q

What is the term for spermatozoa in which the anterior portion of the headpiece is smaller than normal?
A. Azoospermia
B. Microcephaly
C. Acrosomal deficiency
D. Necrozoospermia

A

C. Acrosomal deficiency

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16
Q

What is the most common cause of male infertility?
A. Mumps
B. Klinefelter syndrome
C. Varicocele
D. Malignancy

A

C. Varicocele

17
Q

Which of the following values is the lower limit of normal for sperm concentration?
A. 15 million per milliliter
B. 40 million per milliliter
C. 60 million per milliliter
D. 100 million per milliliter

A

A. 15 million per milliliter

18
Q

Which morphological abnormality of sperm is most often associated with varicocele?
A. Tapering of the head
B. Cytoplasmic droplet below the neckpiece
C. Lengthened neckpiece
D. Acrosomal deficiency

A

A. Tapering of the head

19
Q

Which of the following stains is used to determine sperm viability?
A. Eosin Y
B. Hematoxylin
C. Papanicolaou
D. Methylene blue

A

A. Eosin Y

20
Q

Which of the following semen analysis results is abnormal?
A. Volume 1.0 mL
B. Liquefaction 40 minutes at room temperature
C. pH 7.6
D. Motility 50% progressive movement

A

A. Volume 1.0 mL

21
Q

Which of the following sample collection and processing conditions will lead to inaccurate seminal fluid analysis results?
A. Sample stored at room temperature for 1 hour before testing
B. Sample collected following coitus
C. Sample collected without an anticoagulant
D. Sample collected without use of a condom

A

B. Sample collected following coitus

22
Q

When performing a seminal fluid analysis, what is the upper limit of normal for WBCs?
A. 1 × 10^6/mL
B. 5 × 10^6/mL
C. 10 × 10^6/mL
D. 20 × 10^6/mL

A

A. 1 × 10^6/mL

23
Q

Which carbohydrate measurement is clinically useful when performing a seminal fluid analysis?
A. Glucose
B. Galactose
C. Fructose
D. Maltose

A

C. Fructose

24
Q

Which condition is most often associated with gastric ulcers?
A. Cancer of the stomach
B. Helicobacter pylori infection
C. Zollinger-Ellison (Z-E) syndrome
D. Pernicious anemia

A

B. Helicobacter pylori infection

25
Q

In which condition is the highest level of serum gastrin usually seen?
A. Atrophic gastritis
B. Pernicious anemia
C. Z-E syndrome
D. Cancer of the stomach

A

C. Z-E syndrome

26
Q

In determining free HCl, the gastric fluid is titrated to pH ______.
A. 6.5
B. 4.5
C. 3.5
D. 2.0

A

C. 3.5

27
Q

Which test can identify persons with gastrin-secreting tumors that do not demonstrate a definitively increased plasma gastrin concentration?
A. Secretin stimulation
B. Pentagastrin
C. Cholecystokinin–pancreozymin
D. Trypsinogen

A

A. Secretin stimulation

28
Q

Which of the following tests would be normal in pancreatic insufficiency?
A. Secretin stimulation
B. D-Xylose absorption
C. Twenty-four-hour fecal fat
D. β-Carotene absorption

A

B. D-Xylose absorption

29
Q

Which of the ff. is commonly associated with occult blood?
A. Colon cancer
B. Atrophic gastritis
C. Pernicious anemia
D. Pancreatitis

A

A. Colon cancer

30
Q

Which test is most sensitive in detecting persons with chronic pancreatitis?
A. Fecal trypsin
B. Fecal chymotrypsin
C. Fecal elastin-1
D. Plasma lipase

A

C. Fecal elastin-1