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aubf finals > LEC 01 - AMNIOTIC FLUID > Flashcards

LEC 01 - AMNIOTIC FLUID Flashcards

1
Q

The fluid that bathes the fetus throughout its gestation

A

AMNIOTIC FLUID

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2
Q

_____ : produced by the amnion and the placenta from maternal plasma

A

Early pregnancy

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3
Q

____ exchange between the fetus and the surrounding medium (product of fetal metabolism)

A

Water-solute

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4
Q

UNDER COLLECTION

___ is preferred

A

Transabdominal amniocentesis

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5
Q

THREE METHODS UNDER COLLECTION

A
  1. With ultrasonic examination
  2. Vaginal amniocentesis
  3. Aspirate 10-20 ml in several sterile syringes
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6
Q

UNDER COLLECTION

High risk of infection and possible contamination of vaginal cells

A

Vaginal amniocentesis

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7
Q

UNDER COLLECTION

Aspirate 10-20 ml in several sterile syringes
Discard the first ___ ml

A

2-3

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8
Q

VOLUME
12 weeks gestation:

A

25-50 ml

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9
Q

VOLUME
37 weeks gestation:

A

800-1200 ml

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10
Q

Decreased fetal swallowing, congenital fetal malformations

A

Polyhydramnios

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11
Q

VOLUME
__ : < 800 ml

A

Oligohydramnios

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12
Q

Premature rupture of amniotic membrane

A

Oligohydramnios

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13
Q

VOLUME
__ : > 1200 ml

A

Polyhydramnios

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14
Q

no amniotic fluid

A

Anhydramnios

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15
Q

PHYSICAL EXAMINATION
Color
* Normal:

A

colorless or pale yellow

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16
Q

PHYSICAL EXAMINATION
Color
___ : yellow or amber

A

Presence of bilirubin

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17
Q

PHYSICAL EXAMINATION
Color
___ : green (gelatinous material that forms in fetal intestine as a result of swallowed AF and fetal intestinal secretions)

A

Presence of meconium

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18
Q

PHYSICAL EXAMINATION
Color
Fetal death:

A

dark red-brown

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19
Q

PHYSICAL EXAMINATION
Color
Blood contamination:

A

pale pink to red

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20
Q

T OR F

PHYSICAL EXAMINATION
* Early pregnancy: turbid
* Later stages of pregnancy: not very turbid

A

F
* Early pregnancy: not very turbid
* Later stages of pregnancy: turbid

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21
Q

Used to evaluate premature rupture of membranes

A

Fern test

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22
Q

Presence of ‘fern-like’ crystals on a dried vaginal fluid:

A

positive screen for AF

23
Q

Amniotic fluid has ___ and ___ levels equal to plasma

A

urea AND creatinine

24
Q

Creatinine comparison is challenging at ≥ __ weeks of gestation

A

37

25
Q

CHEMICAL EXAMINATION
rarely performed test?

A

FETAL LUNG MATURITY TESTS

25
Q

TESTS FOR FETAL DISTRESS :
GIVE ME THOSE 4 UNDER THIS

A
  • HEMOLYTIC DISEASE OF THE NEWBORN/AMNIOTIC FLUID BILIRUBIN
  • NEURAL TUBE DEFECTS
  • GENETIC TESTING (e.g., trisomy 21, 18, 13; family history)
  • FETAL INFECTIONS (TORCH complex)
25
Q

To assess if the fetus can survive outside of the uterus in cases of anticipated premature delivery

A

FETAL LUNG MATURITY TESTS

26
Q

A common cause of death in newborns due to insufficient surfactant production at the alveolar surfaces

A

Respiratory distress syndrome

27
Q

SURFACTANTS
__ % phospholipids, __ % protein

A

90% phospholipids
10% protein

28
Q

SURFACTANTS

Packaged into storage granules called ___ , secreted by type 2 pneumocytes

A

lamellar bodies

29
Q

__ keep the alveoli from collapsing by reducing the surface tension during breathing

A

Surfactants

30
Q

FETAL LUNG MATURITY TESTS:
GIVE ME THOSE 5 UNDER THIS

A

-Lecithin/sphingomyelin ratio: reference method
-Phosphatidylglycerol
-Foam stability index
-Lamellar body count
-Fluorescence polarization assay: obsolete test

31
Q

THE VERY FIRST FETAL LUNG MATURITY TESTS
WHAT ARE THE pulmonary surfactants : REFERENCE METHOD

A

Lecithin (major) and sphingomyelin

32
Q

T OR F
Lecithin/sphingomyelin ratio:
34-36 weeks: lecithin decreases; sphingomyelin remains constant or increases (produced at about 26 weeks)

A

F
lecithin increases; sphingomyelin remains constant or decreases

33
Q

T OF F
Lecithin/sphingomyelin ratio:
< 2.0: immature lungs
> or equal to 2.0: fetal lung maturity

A

T

34
Q

Lecithin/sphingomyelin ratio:
Measured using ___ and there should be no blood or meconium contamination

A

TLC

35
Q

A phospholipid that enhances the spread of surfactants across the alveolar surface

A

Phosphatidylglycerol

36
Q

Phosphatidylglycerol
Not detectable until ___ weeks gestation

A

35

37
Q

Phosphatidylglycerol
Use TLC or agglutination slide test
___ : contains anti-PG antibodies
Reporting: negative, low positive, and high positive

A

Amniostat-FLM

38
Q

Also known as the ‘shake test’

A

Foam stability index

39
Q

Foam stability index
Amniotic fluid + ___ , then shake for 15 seconds= production of foam and bubbles that remain stable for 15 minutes after shaking

A

95% ethanol

40
Q

Foam stability index
Presence of foam means ?

A

sufficient amount of phospholipids

41
Q

Foam stability index
if the AF is contaminated with blood or meconium?

A

Falsely mature results

42
Q

Storage of pulmonary surfactants

A

LAMELLAR BODY COUNT

43
Q

T OR F
The number of lamellar bodies in AF correlates with the number of lecithin present in the lungs

A

F
phospholipids NOT LECITHIN

44
Q

LAMELLAR BODY COUNT
___ : > 50,000/microliter in an uncentrifuged sample

A

Fetal lung maturity

45
Q

Oldest routinely performed test on AF (for fetal anemia due to HDFN)

A

AMNIOTIC FLUID BILIRUBIN

46
Q

AMNIOTIC FLUID BILIRUBIN
Measured using __

A

spectrophotometry

47
Q

AMNIOTIC FLUID BILIRUBIN
The optical density of the fluid is measured in intervals between __ and __

A

350 nm AND 580 nm

48
Q

AMNIOTIC FLUID BILIRUBIN
Highest OD at ___ and decreases linearly to 550 nm: normal

A

365 nm

49
Q

Detected by measuring maternal serum alpha-fetoprotein (AFP)

A

NEURAL TUBE DEFECT

50
Q

NEURAL TUBE DEFECT
Reported in terms of ___

A

multiples of the median (MoM)

51
Q

NEURAL TUBE DEFECT
Elevated results are followed by measurement of

A

amniotic acetylcholinesterase

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