LEC 01 - AMNIOTIC FLUID

Question 1

The fluid that bathes the fetus throughout its gestation

Answer 1

AMNIOTIC FLUID

Question 2

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

Answer 2

Early pregnancy

Question 3

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

Answer 3

Water-solute

Question 4

UNDER COLLECTION

___ is preferred

Answer 4

Transabdominal amniocentesis

Question 5

THREE METHODS UNDER COLLECTION

Answer 5

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

Question 6

UNDER COLLECTION

High risk of infection and possible contamination of vaginal cells

Answer 6

Vaginal amniocentesis

Question 7

UNDER COLLECTION

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

Answer 7

2-3

Question 8

VOLUME
12 weeks gestation:

Answer 8

25-50 ml

Question 9

VOLUME
37 weeks gestation:

Answer 9

800-1200 ml

Question 10

Decreased fetal swallowing, congenital fetal malformations

Answer 10

Polyhydramnios

Question 11

VOLUME
__ : < 800 ml

Answer 11

Oligohydramnios

Question 12

Premature rupture of amniotic membrane

Answer 12

Oligohydramnios

Question 13

VOLUME
__ : > 1200 ml

Answer 13

Polyhydramnios

Question 14

no amniotic fluid

Answer 14

Anhydramnios

Question 15

PHYSICAL EXAMINATION
Color
* Normal:

Answer 15

colorless or pale yellow

Question 16

PHYSICAL EXAMINATION
Color
___ : yellow or amber

Answer 16

Presence of bilirubin

Question 17

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

Answer 17

Presence of meconium

Question 18

PHYSICAL EXAMINATION
Color
Fetal death:

Answer 18

dark red-brown

Question 19

PHYSICAL EXAMINATION
Color
Blood contamination:

Answer 19

pale pink to red

Question 20

T OR F

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

Answer 20

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

Question 21

Used to evaluate premature rupture of membranes

Answer 21

Fern test

Question 22

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

Answer 22

positive screen for AF

Question 23

Amniotic fluid has ___ and ___ levels equal to plasma

Answer 23

urea AND creatinine

Question 24

Creatinine comparison is challenging at ≥ __ weeks of gestation

Answer 24

37

Question 25

CHEMICAL EXAMINATION rarely performed test?

Answer 25

FETAL LUNG MATURITY TESTS

Question 25

TESTS FOR FETAL DISTRESS : GIVE ME THOSE 4 UNDER THIS

Answer 25

- 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)

Question 25

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

Answer 25

FETAL LUNG MATURITY TESTS

Question 26

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

Answer 26

Respiratory distress syndrome

Question 27

SURFACTANTS __ % phospholipids, __ % protein

Answer 27

90% phospholipids 10% protein

Question 28

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

Answer 28

lamellar bodies

Question 29

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

Answer 29

Surfactants

Question 30

FETAL LUNG MATURITY TESTS: GIVE ME THOSE 5 UNDER THIS

Answer 30

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

Question 31

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

Answer 31

Lecithin (major) and sphingomyelin

Question 32

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

Answer 32

F lecithin increases; sphingomyelin remains constant or decreases

Question 33

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

Answer 33

T

Question 34

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

Answer 34

TLC

Question 35

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

Answer 35

Phosphatidylglycerol

Question 36

Phosphatidylglycerol Not detectable until ___ weeks gestation

Answer 36

35

Question 37

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

Answer 37

Amniostat-FLM

Question 38

Also known as the ‘shake test’

Answer 38

Foam stability index

Question 39

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

Answer 39

95% ethanol

Question 40

Foam stability index Presence of foam means ?

Answer 40

sufficient amount of phospholipids

Question 41

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

Answer 41

Falsely mature results

Question 42

Storage of pulmonary surfactants

Answer 42

LAMELLAR BODY COUNT

Question 43

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

Answer 43

F phospholipids NOT LECITHIN

Question 44

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

Answer 44

Fetal lung maturity

Question 45

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

Answer 45

AMNIOTIC FLUID BILIRUBIN

Question 46

AMNIOTIC FLUID BILIRUBIN Measured using __

Answer 46

spectrophotometry

Question 47

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

Answer 47

350 nm AND 580 nm

Question 48

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

Answer 48

365 nm

Question 49

Detected by measuring maternal serum alpha-fetoprotein (AFP)

Answer 49

NEURAL TUBE DEFECT

Question 50

NEURAL TUBE DEFECT Reported in terms of ___

Answer 50

multiples of the median (MoM)

Question 51

NEURAL TUBE DEFECT Elevated results are followed by measurement of

Answer 51

amniotic acetylcholinesterase