and Janesh Gupta2
(1)
Fetal Medicine, Rainbow Hospitals, Hyderabad, Telangana, India
(2)
University of Birmingham Birmingham Women’s Hospital, Birmingham, UK
FM1
Approximately what percentage of pregnant women are offered a choice of invasive prenatal testing?
A.
0.2 %
B.
2 %
C.
5 %
D.
10 %
E.
15 %
FM2
Third-trimester amniocentesis is associated with all of the following except:
A.
Blood-stained amniotic fluid.
B.
Need for multiple attempts.
C.
Higher rates of culture failure for karyotyping.
D.
Serious complications are rare.
E.
Significant risk of emergency delivery.
FM3
Which of the following statements about prenatal invasive testing is true?
A.
Decontamination of ultrasound probes can be potentially damaging.
B.
In Rhesus-negative women, additional anti-D after prenatal invasive testing is not recommended if she has been on RAADP.
C.
Invasive prenatal testing cannot be carried out on women infected with HIV.
D.
Severe sepsis, including maternal death, can be a complication.
E.
Sterilisation of ultrasound gel is an unnecessary practice and hence not recommended.
FM4
All of the following ultrasound features suggest that the twins are dichorionic except:
A.
Bicornuate uterus
B.
Discordant gender
C.
The ‘lambda’ sign
D.
Twin-peak sign
E.
Two separate placental masses
FM5
Chorionicity in multifetal pregnancy is best assessed at what gestation:
A.
5–6 weeks
B.
11–14 weeks
C.
16–18 weeks
D.
20–24 weeks
E.
30–34 weeks
FM6
All of the following are ultrasound criteria to diagnose twin to twin transfusion syndrome except:
A.
Discordant bladder appearances
B.
Discordant fluid volumes—polyhydramnios/oligoamnios
C.
Discordant gender
D.
Haemodynamic and cardiac compromise
E.
Presence of a single placental mass
FM7
Which of the following statements regarding twin to twin transfusion syndrome (TTTS) is true?
A.
Screening for TTTS should start after 24 weeks of gestation.
B.
Screening for TTTS should start in the first trimester of pregnancy.
C.
Severe twin–twin transfusion syndrome presenting before 26 weeks of gestation should be treated by laser ablation rather than by amnioreduction or septostomy.
D.
TTTS complicates about 50 % of monochorionic twin pregnancies.
E.
TTTS may sometimes complicate dichorionic pregnancies.
FM8
Possible sources of error in noninvasive prenatal testing for fetal aneuploidies include:
A.
Late gestational age
B.
Low maternal BMI
C.
Maternal heart disease
D.
Maternal malignancies
E.
Placenta previa
FM9
Which of the following twin pregnancies is not possible physiologically?
A.
Dichorionic monoamniotic
B.
Dichorionic quadriamniotic
C.
Dichorionic triamniotic
D.
Monochorionic diamniotic
E.
Monochorionic monoamniotic
FM10
Which of the following statements about standard Pedigree drawing is false?
A.
Circles represent females.
B.
Consanguineous mating is represented by a single horizontal line.
C.
Diamonds represent unspecified gender.
D.
Square represents males.
E.
Usually three generations are drawn.
FM11
When using two measurements of AC or EFW to estimate growth velocity, to minimise false-positive rates for diagnosing FGR, the measurements should be:
A.
1 week apart
B.
2 weeks apart
C.
3 weeks apart
D.
4 weeks apart
E.
6 weeks apart
FM12
The following conditions have a 25 % recurrence risk except:
A.
Achondroplasia
B.
Beta-thalassemia
C.
Cystic fibrosis
D.
Propionic academia
E.
Spinal muscular atrophy
FM13
All of the following ultrasound signs help in the diagnosis of chorionicity in twin pregnancies except
A.
Concordant fetal sex
B.
Lambda sign
C.
Presence of separate placental masses
D.
‘T’ sign
E.
Thickness of the intertwin membrane
FM14
In a couple with a previous child with congenital adrenal hyperplasia, the risk of having a subsequent virilised female is:
A.
1:2
B.
1:4
C.
1:8
D.
1:16
E.
1:32
FM15
All of the following statements are true about the management of a woman with a previous child with congenital adrenal hyperplasia except:
A.
Dexamethasone should be started prior to 7 weeks’ gestation.
B.
Dexamethasone regimen reduces the need for corrective surgery for virilisation.
C.
Dexamethasone is successful in preventing virilisation in all cases of affected female fetuses.
D.
Dexamethasone should be stopped if the fetus is male or an unaffected female.
E.
Dexamethasone has significant maternal side effects.
FM16
The commonest enzyme deficiency seen in congenital adrenal hyperplasia
A.
11 β-hydroxylase
B.
17 α-hydroxylase
C.
17 hydroxysteroid dehydrogenase
D.
18 hydroxylase
E.
21 hydroxylase
FM17
Incidence of chromosomal abnormalities in sporadic first trimester miscarriage is:
A.
10–22 %
B.
20–30 %
C.
40–50 %
D.
50–60 %
E.
70 %
FM18
A 40-year-old woman is 12 weeks pregnant. She is attending hospital antenatal clinic for her dating scan. She is concerned about her risk of having a child affected by Down syndrome. Which SINGLE action is the most appropriate management action given her anxiety and consistent with current routine antenatal screening advice for the UK?
A.
Measure nuchal translucency and check for presence/absence of fetal nasal bone at 12 weeks.
B.
Measure nuchal translucency and maternal serum PAPP-A and HCG at 12 weeks.
C.
Offer amniocentesis at 15 weeks.
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