End of Chapter Questions: Amniotic Fluid

Question 1

Which of the following is not a function of Amniotic Fluid?
A. Allows movement of the fetus
B. Allows carbon dioxide and oxygen exchange
C. Protects fetus from extreme temperature changes
D. Acts as a protective cushion for the fetus

Answer 1

B. Allows carbon Dioxide and Oxygen exchange

Question 2

What is the primary cause of the normal increase in amniotic fluid as pregnancy progresses?
A. Fetal cell metabolism
B. Fetal swallowing
C. Fetal urine
D. Transfer of water across the placenta

Answer 2

C. Fetal urine

Question 3

Which of the following is not a reason for decreased amounts of amniotic fluid?
A. Fetal failure to begin swallowing
B. Increased fetal swallowing
C. Membrane leakage
D. Urinary tract defects

Answer 3

A. Fetal failure to begin swallowing

Question 4

Why might a creatinine level be requested on an amniotic fluid?
A. Detect oligohydramnios
B. Detect polyhydramnios
C. Differentiate amniotic fluid from maternal urine
D. Evaluate lung maturity

Answer 4

C. Differentiate amniotic fluid from maternal urine

Question 5

Amniotic fluid specimens are placed in amber-colored tubes prior to sending them to the laboratory to prevent the destruction of:
A. Alpha-fetoprotein
B. Bilirubin
C. Cells for cytogenetics
D. Lecithin

Answer 5

B. Bilirubin

Question 6

How are specimens for FLM testing delivered to and stored in the laboratory?
A. Delivered on ice and refrigerated 
B. Immediately centrifuged
C. Kept at room temperature
D. Delivered in a vacuum tube

Answer 6

A. Delivered on ice and refrigerated

Question 7

Why are amniotic fluid specimens for cytogenetic analysis incubated at 37C prior to analysis?
A. To detect the presence of meconium
B. To differentiate amniotic fluid from urine
C. To prevent photo-oxidation of bilirubin to biliverdin
D. To prolong fetal cell viability and integrity

Answer 7

D. To prolong fetal cell viability and integrity

Question 8

A significant rise in the OD of amniotic fluid at 450nm indicates the presence of what analyze?
A. Bilirubin
B. Lecithin
C. Oxyhemoglobin
D. Sphingomyelin

Answer 8

A. Bilirubin

Question 9

Plotting the amniotic fluid OD on a Liley graph represents the severity of hemolytic disease of the newborn. A value that is plotted in zone II indicates what condition of the fetus?
A. No hemolysis
B. Mildly affected fetus
C. Moderately affected fetus that requires close monitoring
D. Severely affected fetus that requires intervention

Answer 9

C. Moderately affected fetus that requires close monitoring

Question 10

The presence of a fetal neural tube disorder may be detected by:
A. Increased amniotic fluid bilirubin
B. Increased maternal serum alpha-fetoprotein
C. Decreased amniotic fluid phosphatidyl glycerol
D. Decreased maternal serum acetylcholinesterase

Answer 10

B. Increased maternal serum alpha-fetoprotein

Question 11

T/F: An AFP MoM greater than 2x the median value is considered an indication of a neural tube disorder.

Answer 11

True

Question 12

When severe HDN is present, which of the following tests on the amniotic fluid would the physician not order to determine whether the fetal lungs are mature enough to withstand a premature delivery?
A. AFP levels
B. Foam stability index
C. Lecithin/sphingomyelin ratio
D. Phosphatidyl glycerol detection

Answer 12

A. AFP levels

Question 13

T/F: Prior to 35 weeks gestation, the normal L/S ratio is less than 1.6

Answer 13

True

Question 14

When preforming an L/S by thin-layer chromotography, a mature fetal lung will show:
A. Sphingomyelin twice as concentrated as lecithin
B. No sphingomyelin
C. Lecithin twice as concentrated as sphingomyelin
D. Equal concentrations of lecithin and sphingomyelin

Answer 14

C. Lecithin twice as concentrated as Sphingomyelin

Question 15

T/F: Phosphatidyl glycerol is present with an L/S ratio of 1:1

Answer 15

True

Question 16

A rapid immunologic test for FLM that does not require performance of thin-layer chromotography is:
A. AFP levels
B. Amniotic acetylcholinesterase
C. Aminostat-FLM
D. Bilirubin scan

Answer 16

C. Amniostat-FLM

Question 17

Does the failure to produce bubbles in the Foam Stability Index indicate increased or decreased lecithin?
A. Increased
B. Decreased

Answer 17

B. Decreased

Question 18

The presence of phosphatidyl glycerol in amniotic fluid fetal lung maturity tests must be confirmed when:
A. Hemolytic disease of the newborn is present
B. The mother has maternal diabetes
C. Amniotic fluid is contaminated by hemoglobin
D. Neural tube disorder is suspected

Answer 18

B. The mother has maternal diabetes

Question 19

A lamellar body count of 50,000 correlates with:
A. Absent phosphatidyl glycerol and L/S ratio of 1.0
B. L/S ratio of 1.5 and absent phosphatidyl glycerol
C. OD at 650 nm of 1.010 and an L/S ratio of 1.1
D. OD at 650 nm of 0.150 and an L/S ratio of 2.0

Answer 19

D. OD at 650nm of 0.150 and an L/S ratio of 2.0