Relevant EMCQPC22-3 Flashcards by Voithos Gabela

Neural tube defects (NTDs) are primarily caused by:
a) Insufficient folate supplementation
b) Maternal fever during the second trimester
c) Chromosomal aberrations
d) Fetal exposure to amniotic band syndrome

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When do neural tube defects typically develop?
a) During the 1st week of pregnancy
b) Between the 3rd and 4th week of pregnancy
c) During the 2nd trimester
d) In the final weeks of pregnancy

Between the 3rd and 4th week of pregnancy

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Which end of the neural tube is more commonly affected by spina bifida?
a) Cranial end
b) Caudal end
c) Middle region
d) Both ends equally

b) Caudal end

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What is the term used to describe spina bifida without any apparent clinical features?
a) Myelomeningocele
b) Anencephaly
c) Spina bifida occulta
d) Cranial fissure malformation

c) Spina bifida occulta

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What is the most severe manifestation of cranial fissure malformations?
a) Myelomeningocele
b) Anencephaly
c) Spina bifida occulta
d) Chiari II malformation

b) Anencephaly

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How are neural tube defects often diagnosed during pregnancy?
a) Genetic testing
b) Maternal blood test for alpha-fetoprotein levels
c) Ultrasound examination
d) Fetal MRI

c) Ultrasound examination

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What is the primary symptom of myelomeningocele?
a) Bladder dysfunction
b) Cranial cleft formation
c) Cranial fissure malformation
d) Sensory and motor function loss

d) Sensory and motor function loss

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Which prenatal marker can be used to detect neural tube defects?
a) Elevated alpha-fetoprotein levels
b) Decreased alpha-fetoprotein levels
c) Elevated hCG levels
d) Decreased hCG levels

a) Elevated alpha-fetoprotein levels

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What is the recommended timing for initiating folate supplementation to prevent NTDs?
a) At the time of conception
b) 1 week after conception
c) 4 weeks prior to conception
d) During the 2nd trimester

c) 4 weeks prior to conception

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What is the treatment for neural tube defects?
a) Prophylactic administration of antibiotics
b) Fetal surgery during the 1st trimester
c) Administration of anticonvulsant drugs
d) Rapid surgical closure of the defect

d) Rapid surgical closure of the defect

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Which drug can interfere with folate metabolism and increase the risk of NTDs?
a) Methotrexate
b) Paracetamol (acetaminophen)
c) Ibuprofen
d) Aspirin

a) Methotrexate

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Which of the following is not a maternal risk factor for NTDs?
a) Folate deficiency
b) Pregestational diabetes mellitus
c) Obesity
d) Exposure to amniotic band syndrome

d) Exposure to amniotic band syndrome

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What is the most common type of NTD affecting the spine?
a) Myelomeningocele
b) Anencephaly
c) Spina bifida occulta
d) Cranial fissure malformation

d) Cranial fissure malformation

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Which genetic abnormality is associated with an increased risk of NTDs?
a) Trisomy 13
b) Trisomy 21
c) Trisomy 18
d) Turner syndrome

c) Trisomy 18

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What is the primary cause of NTDs in the fetus?
a) Maternal obesity
b) Maternal fever during the third trimester
c) Fetal exposure to amniotic band syndrome
d) Chromosomal aberrations and other genetic factors

d) Chromosomal aberrations and other genetic factors

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What type of neural tube defect is covered by skin and/or connective tissue?
a) Open NTD
b) Closed NTD
c) Myelomeningocele
d) Anencephaly

b) Closed NTD

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Which region of the spine is most commonly affected by spinal defects?
a) Cervical region
b) Thoracic region
c) Lumbar or sacral region
d) Coccygeal region

c) Lumbar or sacral region

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What is the term used to describe defects at the cranial end of the neural tube?
a) Spina bifida occulta
b) Myelomeningocele
c) Cranial fissure malformation
d) Anencephaly

d) Anencephaly

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What is the purpose of prophylactic administration of antibiotics in the treatment of NTDs?
a) Prevent CNS infections
b) Promote fetal brain development
c) Reduce maternal fever
d) Stimulate folate metabolism

a) Prevent CNS infections

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Besides folate deficiency, which maternal condition is associated with an increased risk of NTDs?
a) Hypothyroidism
b) Gestational diabetes mellitus
c) Rheumatoid arthritis
d) Hyperthyroidism

b) Gestational diabetes mellitus

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Which type of neural tube defect is characterized by a vertebral bone defect without herniation?
a) Lipomyelomeningocele
b) Myeloschisis
c) Myelocele
d) Meningocele

d) Meningocele

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What is the most common closed neural tube defect?
a) SPina bifida occulta
b) Lipomyelomeningocele
c) Myelomeningocele
d) Myelocele

a) SPina bifida occulta

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Which type of neural tube defect is characterized by a subcutaneous mass in the lumbar or sacral region and contains fat tissue covered by skin?
a) Lipomyelomeningocele
b) Myeloschisis
c) Lipomeningocele
d) Meningocele

c) Lipomeningocele

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What is the characteristic feature of Chiari II malformation?
a) Motor loss and flaccid paralysis
b) Hydrocephalus
c) Maternal diabetes and folate deficiency
d) Myelomeningocele

b) Hydrocephalus
why not d??
Myelomeningocele is a type of neural tube defect characterized by the herniation of meninges and parts of the spinal cord through a vertebral bone defect. It is often associated with Chiari II malformation, which involves displacement of the cerebellum and brainstem downward through the foramen magnum. This displacement can obstruct the flow of cerebrospinal fluid (CSF) and lead to hydrocephalus, which is the abnormal accumulation of fluid in the brain.

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Which type of neural tube defect is associated with a collection of fat, patch of hair, and normal levels of AFP? a) Spina bifida occulta b) Lipomyelomeningocele c) Myeloschisis d) Meningocele

a) Spina bifida occulta

What type of neural tube defect is characterized by a subcutaneous mass in the lumbar or sacral region, contains fat tissue covered by skin, and has normal levels of AFP? a) Lipomyelomeningocele b) Lipomeningocele c) Myelocele d) Meningocele

b) Lipomeningocele Just confirm with your lectures.

Which neural tube defect is associated with bladder and bowel dysfunction, developmental delays, and cognitive impairment? a) Pina bifida occulta b) Myelomeningocele c) Myeloschisis d) Myelocele

b) Myelomeningocele

Which neural tube defect is the most severe subtype and is characterized by bare, exposed neural tissue without coverage of meninges, bones, or skin? a) Pina bifida occulta b) Lipomyelomeningocele c) Myeloschisis d) Myelocele

c) Myeloschisis confirm this answer with your lectures.

Which neural tube defect is associated with a vertebral bone defect and parts of the spinal cord herniating without meningeal coverage? a) Pina bifida occulta b) Lipomyelomeningocele c) Myeloschisis d) Myelocele

d) Myelocele

True or False: Myelomeningocele is associated with maternal diabetes and folate deficiency.

True

True or False: Meningocele is associated with motor loss and flaccid paralysis.

False

True or False: Lipomeningocele contains fat tissue and is covered by skin, but it does not have a subcutaneous mass.

False

Myelomeningocele is the characteristic feature of Chiari II malformation.

True

What is the main screening test used during the prenatal period? a) Amniocentesis b) Ultrasonography c) Maternal serum alpha-fetoprotein (MSAFP) test d) AChE test

c) Maternal serum alpha-fetoprotein (MSAFP) test

MSAFP is primarily elevated in which type of neural tube defects (NTDs)? a) Open NTDs b) Closed NTDs c) Spina bifida occulta d) Anencephaly

Which NTD is associated with a lack of cranial vault and brain tissue? a) Spina bifida occulta b) Anencephaly c) Meningocele d) Encephalocele

What are the characteristic findings in anencephaly on ultrasonography? a) Absence of cranial vault and brain tissue b) Presence of residual, disorganized cerebellar and/or brainstem tissue c) Bulging eyes and underdeveloped forehead d) All of the above

Which condition is often associated with polyhydramnios? a) Anencephaly b) Spina bifida occulta c) Meningocele d) Encephalocele

a) Anencephaly

What is the purpose of screening for malformations of other structures during ultrasonography? a) To identify potential chromosomal abnormalities b) To rule out other causes of elevated MSAFP c) To confirm the presence of open NTDs d) To detect abdominal wall defects

d) To detect abdominal wall defects

When should amniocentesis be performed in relation to other screening tests? a) Prior to ultrasonography b) After elevated MSAFP but inconclusive ultrasound findings c) As the initial screening test d) Only if AChE is elevated in amniotic fluid

b) After elevated MSAFP but inconclusive ultrasound findings

What does an increase in both AFP and AChE in amniotic fluid indicate? a) Closed NTDs b) Trisomy 13 c) Open NTDs d) Trisomy 18

In addition to NTDs, what can amniocentesis be used to test for? a) Gestational age miscalculation b) Multiple gestations c) Fetal death d) Chromosomal abnormalities

: d) Chromosomal abnormalities

True or False: AFP is only elevated in open NTDs.

True

Which screening test is NOT used to detect open NTDs? a) Amniocentesis b) MSAFP test c) Ultrasonography d) AChE test

d) AChE test

At what stage of gestation is ultrasonography typically performed for screening? a) 10-12 weeks b) 16-18 weeks c) 20-22 weeks d) 24-26 weeks

c) 20-22 weeks

Which structure is absent in anencephaly? a) Cranial vault b) Brain tissue c) Cerebellum d) Brainstem

a) Cranial vault

True or False: Elevated MSAFP is observed in spina bifida occulta.

False

What is the purpose of the quad screen test? a) To identify open NTDs b) To detect chromosomal abnormalities c) To confirm ultrasound findings d) To assess fetal death

b) To detect chromosomal abnormalities

Which condition may present with bulging eyes and an underdeveloped forehead? a) Meningocele b) Encephalocele c) Spina bifida occulta d) Anencephaly

d) Anencephaly

True or False: An elevated MSAFP may be caused by miscalculated gestational age.

True

What is the purpose of using amniocentesis as a confirmation test? a) To identify multiple gestations b) To detect fetal death c) To confirm open NTDs when ultrasound findings are inconclusive d) To assess AFP levels in amniotic fluid

c) To confirm open NTDs when ultrasound findings are inconclusive

Besides open NTDs, which chromosomal abnormality can be tested using amniocentesis? a) Trisomy 13 b) Trisomy 18 c) Trisomy 21 d) Turner syndrome

a) Trisomy 13 and b) Trisomy 18

What is the significance of an increase in both AFP and AChE in amniotic fluid? a) Closed NTDs are likely b) Chromosomal abnormalities are present c) Open NTDs are highly probable d) Miscalculated gestational age is likely

c) Open NTDs are highly probable

What is the recommended daily folate supplementation for women planning or capable of pregnancy? a) 200-400 μg/day b) 400-800 μg/day c) 800-1200 μg/day d) 1200-1600 μg/day

b) 400-800 μg/day

After counseling, patients with prenatal concerns should be referred to specialized clinics for which of the following options? a) Neonatal ICU admission b) Pediatric neurosurgery c) Continuation or termination of the pregnancy d) Fetal surgery

c) Continuation or termination of the pregnancy

In cases of myelomeningocele, when is fetal surgery typically indicated? a) Only if maternal risk factors are present b) Only if fetal risk factors are present c) Depending on both fetal and maternal risk factors d) Fetal surgery is not indicated in myelomeningocele cases

c) Depending on both fetal and maternal risk factors

In which type of center should deliveries of babies with myelomeningocele take place? a) Any general hospital with obstetric services b) Specialized centers providing neonatal ICU and pediatric neurosurgery c) Birthing centers with midwife-led care d) Home births with a qualified midwife

b) Specialized centers providing neonatal ICU and pediatric neurosurgery

What is the recommended birth mode for babies with myelomeningocele? a) Vaginal delivery b) Emergency cesarean delivery c) Prelabor cesarean delivery d) Induced labor with assisted vaginal delivery

c) Prelabor cesarean delivery

How should the defect in open neural tube defects (NTDs) be managed immediately after delivery? a) Cover with sterile, wet compresses b) Apply direct pressure on the defect c) Clean with antiseptic solution and leave open to air d) Apply a tight bandage over the defect

What is the recommended timeframe for performing surgery in cases of open NTDs? a) Within 24 hours after delivery b) Within 48 hours after delivery c) Within 72 hours after delivery d) After 1 week of delivery

How should closed NTDs be managed initially? a) Immediate surgery is necessary b) Close monitoring and possible elective surgery c) Administration of broad-spectrum antibiotics d) Application of a ventriculoperitoneal shunt

b) Close monitoring and possible elective surgery

Which intervention should be considered for the management of hydrocephalus in babies with NTDs? a) Administration of broad-spectrum antibiotics b) Placement of a ventriculoperitoneal shunt c) Immediate surgical closure of the defect d) Prophylactic administration of folic acid

b) Placement of a ventriculoperitoneal shunt

What are some long-term care options for babies with myelomeningocele? a) Administration of antiepileptic drugs b) Surgical closure of the defect after 1 year of age c) Physical therapy and rehabilitation programs d) Prophylactic administration of corticosteroids

c) Physical therapy and rehabilitation programs

When should folate supplementation be initiated for women planning a pregnancy? a) At least 2 weeks prior to conception b) At least 4 weeks prior to conception c) At least 6 weeks prior to conception d) At least 8 weeks prior to conception

b) At least 4 weeks prior to conception

What is the recommended daily folate supplementation for women with planned pregnancies? a) 200-400 μg/day b) 400-800 μg/day c) 800-1200 μg/day d) 1200-1600 μg/day

d) 1200-1600 μg/day 😳😳why? Pls confirm

How long should folate supplementation be continued during pregnancy? a) Throughout the entire pregnancy b) Until the end of the second trimester c) Until the end of the first trimester d) Until the beginning of the third trimester

c) Until the end of the first trimester

What is the purpose of prophylactic administration of broad-spectrum antibiotics in postnatal management? a) To prevent neurogenic bladder dysfunction b) To reduce the risk of CNS infection c) To promote wound healing d) To prevent hydrocephalus

b) To reduce the risk of CNS infection

What is the recommended daily folate supplementation for women with no planned pregnancies? a) 200-400 μg/day b) 400-800 μg/day c) 800-1200 μg/day d) 1200-1600 μg/day

a) 200-400 μg/day No planned 🤔

What is the primary goal of surgical treatment for open NTDs? a) To restore neurological function b) To prevent hydrocephalus c) To reduce the risk of infection d) To improve bladder control

c) To reduce the risk of infection

What is the recommended daily folate supplementation for women with no planned pregnancies and a previous history of NTD? a) 200-400 μg/day b) 400-800 μg/day c) 800-1200 μg/day d) 4 mg/day

d) 4 mg/day High risk

What is the primary purpose of myelomeningocele fetal surgery? a) To improve bladder control b) To prevent hydrocephalus c) To repair the neural tube defect before birth d) To reduce the risk of infection after delivery

c) To repair the neural tube defect before birth How 😳

What is the recommended daily folate supplementation for all women planning or capable of pregnancy? a) 200-400 μg/day b) 400-800 μg/day c) 800-1200 μg/day d) 1200-1600 μg/day

b) 400-800 μg/day