front 1 At 2 weeks post-implantation, which structure develops fastest
relative to the fetus? | back 1 B. Placenta and membranes |
front 2 During the first 2–3 weeks after blastocyst implantation, the fetus
is best described as: | back 2 D. Almost microscopic |
front 3 After the early microscopic period, fetal length increases
almost: | back 3 A. Proportionally with age |
front 4 A 12-week fetus most likely measures about: | back 4 C. About 10 cm |
front 5 A 20-week fetus most likely measures about: | back 5 A. About 25 cm |
front 6 At term, the fetus most likely measures about: | back 6 B. About 53 cm |
front 7 An ultrasound at ~32 weeks estimates fetal weight. Average weight is
closest to: | back 7 D. 3.0 lb |
front 8 A fetus at ~36 weeks typically weighs closest to: | back 8 C. 4.5 lb |
front 9 Which statement best matches typical birth weight patterns at
term? | back 9 B. Avg 7 lb; 4.5–11 |
front 10 Beyond which point are fetal organs grossly similar to a
neonate’s? | back 10 A. After month 4 |
front 11 Earliest expected onset of human cardiac contractions occurs
around: | back 11 D. Week 4 |
front 12 When the fetal heart first begins beating, the rate is closest
to: | back 12 C. 65 beats/min |
front 13 Immediately before birth, typical fetal heart rate is closest
to: | back 13 A. 140 beats/min |
front 14 Earliest nucleated red blood cells begin forming primarily
at: | back 14 D. Week 3 yolk sac placenta |
front 15 Initial production of non-nucleated RBCs begins around: | back 15 B. Weeks 4–5 mesenchyme endothelium |
front 16 The fetal liver begins forming blood cells at about: | back 16 C. Week 6 |
front 17 The spleen and other lymphoid tissues begin hematopoiesis
around: | back 17 C. Third month |
front 18 From the third month onward, the principal source of RBCs
becomes: | back 18 B. Bone marrow |
front 19 Even after bone marrow predominates, continued RBC production in
lymphoid tissue especially includes: | back 19 A. Lymphocytes and plasma cells |
front 20 Why can respiration not occur during fetal life? | back 20 D. No air in amniotic cavity |
front 21 A late-gestation mechanism inhibits fetal “breathing” movements
mainly to: | back 21 B. Prevent meconium debris lung filling |
front 22 Up to the moment of birth, the fetal lungs are maintained
with: | back 22 C. Small amounts of clean fluid |
front 23 Most spinal cord and brainstem reflexes are present by: | back 23 D. Third–fourth months |
front 24 By midpregnancy, the fetus typically begins to: | back 24 A. Ingest and absorb amniotic fluid |
front 25 During the last 2–3 months, which function approaches that of a
normal neonate? | back 25 C. Gastrointestinal function |
front 26 Meconium is best described as: | back 26 A. Mucus epithelial cells swallowed residue |
front 27 Second-trimester fetal urine contributes approximately what fraction
of amniotic fluid? | back 27 D. 70–80% |
front 28 Severe fetal kidney dysfunction most directly increases risk
of: | back 28 B. Oligohydramnios and fetal death |
front 29 Fetal renal regulation of ECF volume, electrolytes, and acid-base
is: | back 29 C. Nearly absent until late fetal life |
front 30 The fetus primarily uses which fuel for energy? | back 30 A. Glucose |
front 31 Fetal calcium + phosphate needs are about what fraction of maternal
bone stores? | back 31 C. About 2% |
front 32 Which nutrient accumulates faster than calcium/phosphate in the
fetus? | back 32 A. Iron |
front 33 Early embryonic iron uptake occurs primarily via: | back 33 D. Trophoblastic cells |
front 34
Hemolysis in erythroblastosis fetalis severe
cases can cause fetal death mainly from: | back 34 D. Lack of adequate RBCs |
front 35 Term fetal liver iron is most important after birth for: | back 35 A. Hemoglobin synthesis months |
front 36 Which combination is required for RBCs and nervous tissue
growth? | back 36 C. Vitamin B12 and folate |
front 37 A deficiency impairing connective tissue matrix suggests low: | back 37 D. Vitamin C |
front 38 Maternal vitamin most critical for GI calcium absorption is: | back 38 B. Vitamin D |
front 39 Fetal vitamin K is used to form which coagulation factor? | back 39 A. Factor VII |
front 40 Maternal vitamin K insufficiency most directly causes deficiency
of: | back 40 D. Factor VII and prothrombin |
front 41 Most vitamin K is normally produced by bacteria in the: | back 41 C. Mother’s colon |
front 42 Newborn vitamin K deficiency risk is highest initially
because: | back 42 B. No colonic flora |
front 43 After an undepressed delivery, breathing begins: | back 43 D. Within seconds |
front 44 Normal respiratory rhythm usually occurs within: | back 44 A. Less than 1 minute |
front 45 Maternal general anesthesia most commonly causes neonatal respiration
to be: | back 45 B. Delayed several minutes |
front 46 Head trauma during delivery can impair breathing via: | back 46 C. Depressed respiratory center |
front 47 Prolonged fetal hypoxia during delivery can cause: | back 47 A. Respiratory center depression |
front 48 Which delivery complication commonly causes fetal hypoxia? | back 48 D. Umbilical cord compression |
front 49 A sudden loss of placental exchange during labor suggests: | back 49 B. Placental premature separation |
front 50 Classic erythroblastosis fetalis risk pairing is: | back 50 B. Fetus Rh+, mother Rh− |
front 51 Excessive maternal anesthesia can worsen fetal hypoxia by: | back 51 A. Depresses maternal oxygenation |
front 52 Some neonates may survive without breathing for up to: | back 52 B. Ten minutes |
front 53 At birth, alveoli are initially collapsed mainly because of: | back 53 C. Surface tension of fluid |
front 54 First opening of alveoli usually requires more than: | back 54 D. Greater than 25 mmHg |
front 55 Breathing becomes completely normal approximately: | back 55 A. About 40 minutes |
front 56 Severe neonatal respiratory distress is most associated with: | back 56 D. Prematurity or maternal diabetes |
front 57 A hallmark of respiratory distress syndrome is failure to
secrete: | back 57 B. Inadequate surfactant |
front 58 Surfactant primarily helps alveoli by: | back 58 C. Decreases alveolar surface tension |
front 59 Surfactant is produced by which cells? | back 59 A. Type II pneumocytes |
front 60 Meaningful surfactant secretion begins mainly during the
last: | back 60 B. Last 1 to 3 months |
front 61 During fetal life, minimal cardiac output is directed through which
organs? | back 61 C. Lungs and liver |
front 62 The fetal heart must pump large quantities of blood through
the: | back 62 A. Placenta |
front 63 Placental blood in the umbilical vein mainly bypasses the liver via
the: | back 63 D. Ductus venosus |
front 64 Well-oxygenated placental blood enters mainly the ______ side of the
heart. | back 64 B. Left |
front 65 The left ventricle preferentially supplies the: | back 65 A. Head and forelimbs |
front 66 Blood from the SVC is directed through which valve into the right
ventricle? | back 66 D. Tricuspid valve |
front 67 Most right-ventricular output reaches the descending aorta via
the: | back 67 C. Ductus arteriosus |
front 68 Deoxygenated fetal blood returns to the placenta primarily via
the: | back 68 B. Umbilical arteries |
front 69 Approximately what fraction of fetal blood flow goes through the
lungs? | back 69 A. About 12% |
front 70 At birth, loss of placental flow causes systemic vascular resistance
to: | back 70 B. Approximately double |
front 71 After birth, pulmonary vascular resistance primarily: | back 71 C. Decreases greatly |
front 72 A fivefold fall in lung resistance most directly lowers: | back 72 A. Pulmonary arterial pressure |
front 73 Immediately after birth, which atrial pressure pattern promotes
foramen ovale closure? | back 73 D. Low RA, high LA |
front 74 The flap valve over the foramen ovale closes because blood now
attempts to flow: | back 74 B. LA → RA |
front 75 Failure of permanent foramen ovale closure is called: | back 75 C. Patent foramen ovale |
front 76 In a patent foramen ovale, the valve stays shut mainly
because: | back 76 D. LA exceeds RA by 2–4 |
front 77 After birth, blood begins to flow through the ductus arteriosus
primarily: | back 77 A. Aorta → pulmonary artery |
front 78 “Functional closure” of the ductus arteriosus usually occurs
within: | back 78 C. 1 to 8 days |
front 79 Within hours after birth, the ductus arteriosus first: | back 79 B. Constricts markedly |
front 80 Ductus arteriosus closure is promoted by: | back 80 A. ↑O2, ↓PGE2 effects |
front 81 A medication often used to close a PDA is: | back 81 D. Indomethacin |
front 82 The ductus venosus typically closes within: | back 82 B. 1 to 3 hours |
front 83 After ductus venosus closure, portal venous pressure rises to
about: | back 83 C. 6 to 10 mm Hg |
front 84 The rise in portal pressure after birth mainly forces blood to flow
through: | back 84 D. Liver sinuses |
front 85 del | back 85 del |
front 86 Typical neonatal weight change in the first 2–3 days is: | back 86 A. 5 to 10% loss |
front 87 Normal neonatal respiratory rate is closest to: | back 87 D. 40 breaths/min |
front 88 If ~55% of blood goes through placenta, about how much goes through
fetal tissues? | back 88 C. About 45% |
front 89 Average neonatal cardiac output is closest to: | back 89 A. 500 mL/min |
front 90 Relative to body weight, neonatal output is: | back 90 D. Twice adult per kg |
front 91 First-day neonatal arterial pressure averages: | back 91 B. 70/50 mm Hg |
front 92 Immediately after birth, neonatal WBC count is about: | back 92 D. 45,000 per mm³ |
front 93 Physiologic anemia of infancy is typical at: | back 93 A. 6 to 12 weeks |
front 94 Physiologic hyperbilirubinemia is most typical during: | back 94 C. First 2 weeks |
front 95 The neonate rids bilirubin primarily through the: | back 95 B. Neonate’s liver |
front 96 Early neonatal bilirubin excretion is limited by poor: | back 96 D. Glucuronic acid conjugation |
front 97 Mild jaundice from physiologic hyperbilirubinemia lasts: | back 97 D. 1 to 2 weeks |
front 98 Most important abnormal cause of severe neonatal jaundice: | back 98 B. Erythroblastosis fetalis |
front 99 del | back 99 del |
front 100 In erythroblastosis fetalis, the mother becomes: | back 100 C. Unable to make antibodies |
front 101 del | back 101 del |
front 102 Hemolysis in erythroblastosis fetalis releases excess: | back 102 B. Bilirubin |
front 103 Severe cases can cause fetal death mainly from: | back 103 D. Lack of adequate RBCs |
front 104 Bilirubin is conjugated in the liver with: | back 104 C. Glucuronic acid |
front 105 Neonatal hepatic production of coagulation factors is: | back 105 B. Too little |
front 106 A neonate struggles with starch digestion due to low: | back 106 D. Pancreatic amylase |
front 107 Compared with older children, neonatal fat absorption is: | back 107 B. Somewhat less |
front 108 Early neonatal liver function makes ____ unstable and low: | back 108 C. Glucose |
front 109 Neonates lose heat readily mainly because of: | back 109 D. Large surface area ratio |
front 110 Rapid bone ossification increases need for: | back 110 B. Calcium |
front 111 Breast milk vitamin supply is adequate unless mother has
severe: | back 111 C. Vitamin C deficiency |
front 112 Maternal antibodies reach the fetus mainly via the: | back 112 A. Placenta |
front 113 The neonate forms antibodies to a significant extent: | back 113 D. Not significantly early on |
front 114 Maternal antibodies protect the infant for about: | back 114 C. 6 months |
front 115 Inherited antibodies are typically insufficient against: | back 115 A. Whooping cough |
front 116 For full safety, pertussis immunization is needed within: | back 116 B. First month |
front 117 Excess fetal androgen exposure in a female fetus can cause: | back 117 D. Androgen insensitivity |
front 118 Maternal antibodies protect against major infections
including: | back 118 B. Diphtheria measles polio |
front 119 A 2-day-old has breast enlargement with milky discharge; a small
subset develop inflammatory mastitis. Most likely cause of the milk
secretion is: | back 119 B. Placental maternal sex hormones |
front 120 A newborn of an untreated diabetic mother is at highest risk for
which change? | back 120 D. Islet hypertrophy hyperfunction |
front 121 In this infant (untreated diabetic mother), blood glucose can fall
shortly after birth to: | back 121 A. Below 20 mg/dL |
front 122 The most common maternal diabetes type associated with “large babies”
is: | back 122 B. Maternal type 2 diabetes |
front 123 The key maternal metabolic feature driving this macrosomia
is: | back 123 D. Insulin resistance hyperinsulinemia |
front 124 Which best explains how type 2 diabetes increases fetal
growth? | back 124 A. Fetal hyperinsulinemia plus nutrients |
front 125 Uncontrolled maternal type 1 diabetes most likely leads to: | back 125 C. Stunted growth impaired maturity mortality |
front 126 A neonate is born with hypofunctional adrenal cortices. A likely
cause is: | back 126 D. Agenesis or exhaustion atrophy |
front 127 Maternal hyperthyroidism or excess thyroid hormone therapy most
likely causes the infant’s thyroid to be: | back 127 A. Temporary thyroid hyposecretion |
front 128 A mother had her thyroid removed before pregnancy; very high
gestational thyrotropin occurs. The infant may be born with: | back 128 B. Temporary neonatal hyperthyroidism |
front 129 An infant is >2 months premature. Diet should be: | back 129 A. Low fat diet |
front 130 In premature infants, immature liver function commonly leads to low
plasma proteins causing: | back 130 D. Hypoproteinemic edema |
front 131 A very premature infant receives high supplemental oxygen and later
develops blindness (retrolental fibroplasia). The mechanism
is: | back 131 C. Retinal vessel growth stops |
front 132 Brain mass growth is best described by which pairing (with near-adult
size by end year 2)? | back 132 D. 26% birth 55% one-year |
front 133 True respiration cannot occur in fetal life (no air), but respiratory
attempts begin around: | back 133 D. End first trimester |
front 134 Most reflexes involving spinal cord and brainstem are present by the
3rd–4th month; meanwhile the: | back 134 B. Brainstem reflexes; cortex immature |
front 135 Myelination of major tracts becomes complete at about: | back 135 C. About one year |
front 136 Meconium late in pregnancy is best described as: | back 136 D. Residue mucus; excreted amniotic |
front 137 Fetal kidneys begin urine excretion when, and urine makes what
fraction of amniotic fluid? | back 137 C. Second trimester; 70–80% |
front 138 Abnormal fetal kidney development reducing amniotic fluid (and
risking fetal death) is called: | back 138 B. Oligohydramnios |
front 139 Half of the 22.5 g fetal calcium accumulation occurs mainly during
the: | back 139 A. Last four weeks |
front 140 Which vitamin mapping is correct for fetal needs? | back 140 D. B12, folate, RBC nerves; D bones |
front 141 The “slightly asphyxiated” state of birth primarily stimulates
breathing via: | back 141 D. Hypoxia and hypercapnia |
front 142 The key sensory trigger that supports breathing onset
is: | back 142 A. Sudden cooling of skin |
front 143 During delivery, which event can directly cause fetal
hypoxia? | back 143 C. Umbilical cord compression |
front 144 Another intrapartum cause of fetal hypoxia is: | back 144 A. Premature placental separation |
front 145 Which pair contains only causes of fetal hypoxia during
delivery? | back 145 D. Uterine contracture, maternal anesthesia |
front 146 Adults often survive ~4 minutes apneic; neonates may survive apneic
for about: | back 146 B. 10 minutes |
front 147 Fluid-filled, collapsed alveoli usually require more than what
negative pressure to open initially? | back 147 C. 25 mmHg |
front 148 The first breath is typically strongest, reaching
approximately: | back 148 D. −60 mmHg |
front 149 After the initial breaths (with the second breath easier), breathing
becomes completely normal by about: | back 149 A. 40 minutes |
front 150 A neonate develops respiratory distress syndrome (RDS). Highest-risk
groups include premature infants and infants of: | back 150 B. Diabetic mothers |
front 151 Premature infants tend toward which acid–base status, given high
metabolism and kidney immaturity? | back 151 A. Acidotic tendency |
front 152 In neonatal RDS, alveoli may fill with proteinaceous fluid and
desquamated cells, termed: | back 152 D. Hyaline membrane disease |
front 153 Meaningful surfactant secretion begins mainly during the
last: | back 153 D. 1 to 3 months |
front 154 A key consequence of inadequate surfactant is: | back 154 A. Alveolar collapse, pulmonary edema |
front 155 Oxygenated blood entering the right atrium from the IVC is directed
mainly through the: | back 155 C. Foramen ovale |
front 156 Deoxygenated SVC blood reaches the descending aorta mainly through
the: | back 156 A. Ductus arteriosus |
front 157 In fetal life, pulmonary vessels are relatively constricted mainly
because: | back 157 B. Hypoxia induces vasoconstriction |
front 158 After birth, lung aeration/expansion causes pulmonary vessels
to: | back 158 D. Vasodilate |
front 159 A large fall in pulmonary resistance after birth most directly
lowers: | back 159 A. Pulmonary arterial, RV, RA pressures |
front 160 A patent foramen ovale is often clinically minor because: | back 160 B. LA pressure keeps it closed |
front 161 A premature infant receives high oxygen and later develops blindness
from abnormal retinal vessel changes. This condition is
called: | back 161 C. Retrolental fibroplasia |