EFA 12

Question 1

Answer 1

Question 2

Answer 2

Question 3

Answer 3

Question 4

Answer 4

Question 5

Answer 5

Question 6

Answer 6

Question 7

Answer 7

Question 8

Answer 8

Question 9

Answer 9

Question 10

Answer 10

Question 11

What name is given to the concept that challenges to the fetus in utero can impact long term health after birth? (1 mark)

Answer 11

Developmental origins of adult disease hypothesis (Dohad) (Barker hypothesis acceptable – but answer above is better).

Question 12

Give two examples of challenges the fetus may encounter in utero that may affect its long term health (2 marks)

Answer 12

Any two from: Infection Maternal nutrition Maternal illness Maternal medication Environmental factors (eg pesticides, hormonal disruptors, maternal stress)

Question 13

3. At the physiological level, what developmental changes are thought to occur to the fetus during its development in response to these challenges that may predispose to health issues in later life? Give two examples (2 marks)

Answer 13

Any two from:

• Altered fetal endocrinology/metabolism
• Changes in fetal bone or fat mass
• Altered fetal blood flow
• Altered fetal immune responses
• Epigenetic changes/changes to DNA methylation also acceptable

Question 14

Give one example of a screening test undertaken during pregnancy or shortly after birth as part of the NHS screening programme. Specify the condition being screened for and the approximate time during pregnancy or in the neonatal period that the screen is performed (2 marks)

Answer 14

Variety of options – 1 mark for the condition, 1 mark for the time period, includingf:

Trisomies 21, 13 and 18, blood test around 12 weeks

Detailed ultrasound for fetal structural anomalies 18-21 weeks

Newborn blood spot test (day 5 after birth) – phenylketonuria, sickle cell, cystic fibrosis and others