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Emrbyo 3

front 1

During implantation, which trophoblast layer remains mitotically active and supplies new cells?
A. Syncytiotrophoblast
B. Hypoblast
C. Cytotrophoblast
D. Epiblast

back 1

C. Cytotrophoblast

front 2

Which trophoblast layer is multinucleated, erosive, and responsible for invasion into endometrium?
A. Syncytiotrophoblast
B. Cytotrophoblast
C. Amnion
D. Decidual stroma

back 2

A. Syncytiotrophoblast

front 3

The embryoblast of the blastocyst is the:
A. Outer trophoblast shell
B. Lacunar network
C. Exocoelomic membrane
D. Inner cell mass

back 3

D. Inner cell mass

front 4

The bilaminar embryonic disc is composed of:
A. Amnion + chorion
B. Epiblast + hypoblast
C. Cytotrophoblast + syncytium
D. Somatic + splanchnic mesoderm

back 4

B. Epiblast + hypoblast

front 5

“Embryotroph” is best defined as:
A. Maternal nourishing fluid
B. Fetal capillary blood
C. Amniotic fluid only
D. Yolk-derived nutrients

back 5

A. Maternal nourishing fluid

front 6

Decidual cells near implantation are:
A. Multinucleated trophoblast masses, glycogen-lipid stores
B. Cuboidal hypoblast cells, glycogen-lipid stores
C. Polyhedral CT, glycogen-lipid stores
D. Smooth muscle myocytes, glycogen-lipid stores

back 6

C. Polyhedral CT, glycogen-lipid stores

front 7

hCG is a:
A. Steroid hormone
B. Glycoprotein hormone
C. Prostaglandin lipid
D. Catecholamine amine

back 7

B. Glycoprotein hormone

front 8

hCG reaches maternal blood for detection mainly through:
A. Spiral arteries directly
B. Maternal lymphatics
C. Endometrial glands
D. Syncytial lacunae to blood

back 8

D. Syncytial lacunae to blood

front 9

The corpus luteum is:
A. Exocrine mucus gland
B. Implantation enzyme layer
C. Endocrine estrogen-progesterone tissue
D. Fibrin coagulum plug

back 9

C. Endocrine estrogen-progesterone tissue

front 10

By the end of week 2, common pregnancy tests detect which syncytiotrophoblast product?
A. Human chorionic gonadotropin
B. Progesterone
C. Early pregnancy factor
D. Human placental lactogen

back 10

A. Human chorionic gonadotropin

front 11

The epiblast is primarily composed of:
A. Small cuboidal cells
B. Multinucleated invasive cells
C. Polyhedral decidual cells
D. High columnar cells

back 11

D. High columnar cells

front 12

The hypoblast is primarily composed of:
A. High columnar cells
B. Small cuboidal cells
C. Multinucleated syncytium
D. Mitotic cytotrophoblast

back 12

B. Small cuboidal cells

front 13

Primordial germ cells originate (per these notes) in the:
A. Primary umbilical vesicle
B. Chorion
C. Prechordal plate
D. Amniotic cavity

back 13

A. Primary umbilical vesicle

front 14

“Umbilical vesicle” is used instead of “yolk sac” because:
A. It forms placenta directly
B. It becomes umbilical cord
C. Humans lack yolk
D. It produces surfactant

back 14

C. Humans lack yolk

front 15

The amniotic cavity forms when:
A. Hypoblast cavitates
B. Cytotrophoblast hollows out
C. Lacunae coalesce
D. Amnioblasts split from epiblast

back 15

D. Amnioblasts split from epiblast

front 16

Extraembryonic mesoderm is the tissue that:
A. Lines only endometrium
B. Surrounds amnion and vesicle
C. Forms embryonic germ layers
D. Replaces zona pellucida

back 16

B. Surrounds amnion and vesicle

front 17

Oxygen is supplied and wastes removed by which vessels, respectively?
A. Spiral arteries; endometrial veins
B. Endometrial veins; spiral arteries
C. Umbilical arteries; umbilical vein
D. Chorionic villi; fetal veins

back 17

A. Spiral arteries; endometrial veins

front 18

What forms at the same time as the amniotic cavity?
A. Primary chorionic villi
B. Prechordal plate
C. Secondary umbilical vesicle
D. Bilaminar embryonic disc

back 18

D. Bilaminar embryonic disc

front 19

A “10-day conceptus” is:
A. Free in uterine cavity
B. Completely embedded endometrium
C. Primary villi already formed
D. Uteroplacental flow established

back 19

B. Completely embedded endometrium

front 20

Early implantation nutrition reaches the embryonic disc mainly via:
A. Umbilical blood flow
B. Chorionic villus capillaries
C. Embryotroph in syncytial lacunae
D. Amniotic fluid swallowing

back 20

C. Embryotroph in syncytial lacunae

front 21

The trophoblast is best defined as:
A. Outer blastocyst enzyme-secreting cells
B. Inner cell mass
C. Hypoblast cuboidal sheet
D. Amnioblast lining

back 21

A. Outer blastocyst enzyme-secreting cells

front 22

Compared with trophoblast expansion, bilaminar disc growth is:
A. Faster than trophoblast
B. Slower than trophoblast
C. Same rate
D. Stops after day 7

back 22

B. Slower than trophoblast

front 23

The “closing plug” sealing endometrial epithelium is a:
A. Chorionic villus cap
B. Mucus glycoprotein seal
C. Decidual cell cluster
D. Fibrin blood coagulum

back 23

A. Chorionic villus cap

front 24

Lacunar networks later become the primordia of:
A. Neural tube lumen
B. Amniotic cavity
C. Intervillous space primordia
D. Prechordal plate

back 24

C. Intervillous space primordia

front 25

Deficient implantation-site vascular development is associated with low:
A. hCG
B. Connexin 43
C. Progesterone receptor
D. Actin myosin

back 25

B. Connexin 43

front 26

The connecting stalk later becomes the:
A. Umbilical cord
B. Chorionic plate
C. Amniotic fold
D. Vitelline duct

back 26

A. Umbilical cord

front 27

The secondary umbilical vesicle forms when:
A. Cytotrophoblast invaginates
B. Epiblast undergoes apoptosis
C. Hypoblast endodermal migration
D. Lacunae fuse

back 27

C. Hypoblast endodermal migration

front 28

Compared with the primary umbilical vesicle, the secondary vesicle is:
A. Larger than primary vesicle
B. Filled with yolk stores
C. Immediately perfused by cord
D. Smaller than primary vesicle

back 28

D. Smaller than primary vesicle

front 29

The end of the second week is marked by appearance of:
A. Primary chorionic villi appear
B. Definitive germ layers appear
C. Neural folds appear
D. Secondary villi vascularize

back 29

A. Primary chorionic villi appear

front 30

The closing plug becomes covered around day 12 due to:
A. Estrogen and oxytocin
B. cAMP and progesterone
C. LH and FSH
D. Prolactin and hPL

back 30

B. cAMP and progesterone

front 31

The extraembryonic coelom splits into:
A. Epiblast and hypoblast
B. Ectoderm and endoderm
C. Somatic and splanchnic mesoderm
D. Amnion and chorion

back 31

C. Somatic and splanchnic mesoderm

front 32

Extraembryonic somatic mesoderm primarily:
A. Surrounds umbilical vesicle, covers amnion
B. Forms embryonic germ layers, covers amnion
C. Lines embryo proper, covers amnion
D. Lines trophoblast, covers amnion

back 32

D. Lines trophoblast, covers amnion

front 33

Extraembryonic splanchnic mesoderm primarily:
A. Surrounds umbilical vesicle
B. Covers amnion surface
C. Lines trophoblast
D. Forms neural plate

back 33

A. Surrounds umbilical vesicle

front 34

The chorion is the outermost membrane forming the fetal placenta part; it is formed by:
A. Splanchnic mesoderm + hypoblast
B. Somatic mesoderm + trophoblast layers
C. Epiblast + amnioblasts
D. Endometrium + decidua

back 34

B. Somatic mesoderm + trophoblast layers

front 35

Before 20 weeks, expulsion of fetus with retained placenta is:
A. Complete abortion
B. Missed abortion
C. Incomplete abortion
D. Threatened abortion

back 35

C. Incomplete abortion

front 36

Formation of the extraembryonic coelom occurs alongside formation of the:
A. Secondary umbilical vesicle
B. Prechordal plate
C. Neural tube
D. Primary chorionic villi

back 36

A. Secondary umbilical vesicle

front 37

Placenta partially/completely covering the internal os (with bleeding risk) is:
A. Abruptio placentae
B. Placenta accreta
C. Cervical ectopic pregnancy
D. Placenta previa

back 37

D. Placenta previa

front 38

The prechordal plate forms as:
A. Day 12, cytotrophoblast thickening
B. Day 13, syncytium thickening
C. Day 14, hypoblast thickening
D. Day 15, epiblast groove

back 38

C. Day 14, hypoblast thickening

front 39

The prechordal plate is clinically important because it marks the:
A. Future umbilical ring
B. Future mouth, head organizer
C. Intervillous space boundary
D. Neural crest migration

back 39

B. Future mouth, head organizer

front 40

Pelvic inflammatory disease (PID) is:
A. Pelvic organ infection/inflammation
B. Physiologic implantation pain
C. Endometrial decidualization only
D. Isolated ovarian torsion

back 40

A. Pelvic organ infection/inflammation

front 41

PID may include:
A. Orchitis, prostatitis, cystitis
B. Vaginitis, vulvitis, urethritis
C. Appendicitis, ileitis, peritonitis
D. Salpingitis, oophoritis, endometritis, endocervicitis

back 41

D. Salpingitis, oophoritis, endometritis, endocervicitis

front 42

Abdominal pregnancy (per these notes) begins with implantation in the:
A. Uterine fundus
B. Ampulla or fimbriae
C. Cervical canal
D. Ovary surface

back 42

B. Ampulla or fimbriae

front 43

After expulsion into the peritoneal cavity, implantation often occurs in the:
A. Rectouterine pouch
B. Vesicouterine pouch
C. Inguinal canal
D. Hepatorenal recess

back 43

A. Rectouterine pouch

front 44

Early pregnancy evaluation: endovaginal US measures which diameter to assess development/outcome?
A. Biparietal diameter
B. Femur length
C. Chorionic sac diameter
D. Nuchal translucency

back 44

C. Chorionic sac diameter

front 45

A medically performed termination before 20 weeks is:
A. Threatened abortion
B. Habitual abortion
C. Spontaneous abortion
D. Induced abortion

back 45

D. Induced abortion

front 46

A “stone fetus” (lithopedion) occurs when an:
A. Tubal conceptus ruptures
B. Abdominal conceptus dies unnoticed
C. Intrauterine fetus post-term calcifies
D. Cervical pregnancy resorbs

back 46

B. Abdominal conceptus dies unnoticed

front 47

Which embryonic tissue layers are formed from the hypoblast?
A. Ectoderm only
B. Endoderm only
C. None; all from epiblast
D. Mesoderm only

back 47

C. None; all from epiblast

front 48

In these notes, the hypoblast still contributes by forming:
A. Extraembryonic mesoderm
B. Cytotrophoblast
C. Neural tube
D. Syncytiotrophoblast

back 48

A. Extraembryonic mesoderm

front 49

Implantation chronology: day 5 is characterized by:
A. Lacunar networks form
B. Closing plug forms
C. Blastocyst adheres
D. Zona pellucida degenerates

back 49

D. Zona pellucida degenerates

front 50

Implantation chronology: day 6 is characterized by:
A. Trophoblast differentiates
B. Lacunae appear
C. Blastocyst adheres endometrium
D. Primary villi develop

back 50

C. Blastocyst adheres endometrium

front 51

Implantation chronology: day 7 is characterized by:
A. Syncytium erodes endometrium
B. Trophoblast splits two layers
C. Maternal vessels opened
D. Zona pellucida degenerates

back 51

B. Trophoblast splits two layers

front 52

Implantation chronology: day 8 is characterized by:
A. Syncytium erodes, embeds blastocyst
B. Blood-filled lacunae appear
C. Closing plug forms
D. Epithelium defect repaired

back 52

A. Syncytium erodes, embeds blastocyst

front 53

Implantation chronology: day 9 is characterized by:
A. Lacunar networks form
B. Primary villi form
C. Blood-filled lacunae appear
D. Prechordal plate forms

back 53

C. Blood-filled lacunae appear

front 54

Implantation chronology: day 10 is characterized by:
A. Epithelium defect repaired
B. Maternal vessels eroded
C. Primary villi develop
D. Closing plug forms

back 54

D. Closing plug forms

front 55

Implantation chronology: day 11 is characterized by:
A. Blood-filled lacunae appear
B. Lacunar networks form
C. Zona pellucida degenerates
D. Prechordal plate forms

back 55

B. Lacunar networks form

front 56

Implantation chronology: day 12 establishes uteroplacental circulation when:
A. Maternal blood enters lacunae
B. Bilaminar disc forms
C. Primary villi develop
D. Closing plug covered

back 56

A. Maternal blood enters lacunae

front 57

Implantation chronology: day 13 is characterized by:
A. Primary villi form
B. Lacunar networks form
C. Uteroplacental flow begins
D. Endometrial defect repaired

back 57

D. Endometrial defect repaired

front 58

Implantation chronology: day 14 is characterized by:
A. Secondary villi vascularize
B. Prechordal plate forms
C. Primary chorionic villi develop
D. Zona reaction occurs

back 58

C. Primary chorionic villi develop

front 59

Main cause of maternal death in first trimester (per these notes) is:
A. Placenta previa
B. Tubal ectopic pregnancy
C. Preeclampsia
D. Amniotic embolism

back 59

B. Tubal ectopic pregnancy

front 60

Missed period + abdominal pain + bleeding + peritoneal irritation most suggests:
A. Tubal ectopic pregnancy
B. Complete abortion
C. Placenta previa
D. PID flare

back 60

A. Tubal ectopic pregnancy

front 61

Right-sided tubal ectopic pain may be confused with:
A. Ovarian torsion
B. Renal colic
C. Appendicitis
D. Cholecystitis

back 61

C. Appendicitis

front 62

Compared with intrauterine pregnancy, ectopic β-hCG rises at a:
A. Faster rate
B. Same rate
C. Pulsatile rate
D. Slower rate

back 62

D. Slower rate

front 63

Slower β-hCG rise in ectopic pregnancy can cause:
A. False-negative test
B. False-positive ultrasound
C. Higher progesterone
D. Immediate fetal viability

back 63

A. False-negative test

front 64

“Abortion” is best defined as:
A. Delivery after 28 weeks
B. Pre-viability conceptus expulsion
C. Failure of fertilization
D. Implantation outside uterus

back 64

B. Pre-viability conceptus expulsion

front 65

Threatened abortion is:
A. Retained products after expulsion
B. Dead fetus retained
C. Three consecutive losses
D. Bleeding with miscarriage threat

back 65

D. Bleeding with miscarriage threat

front 66

Spontaneous abortion is best defined (per these notes) as:
A. Loss before 20 weeks
B. Loss after 28 weeks
C. Medically induced loss
D. Placenta covering internal os

back 66

A. Loss before 20 weeks

front 67

Habitual abortion is:
A. Two consecutive losses
B. Three consecutive losses
C. Any bleeding episode
D. Loss after viability

back 67

B. Three consecutive losses

front 68

Complete abortion is:
A. Fetus expelled, placenta retained
B. Dead fetus retained
C. All products expelled
D. Medically induced termination

back 68

C. All products expelled

front 69

Missed abortion is:
A. Bleeding with viable fetus
B. All products expelled
C. Fetus expelled, placenta retained
D. Dead fetus retained

back 69

D. Dead fetus retained

front 70

The morning-after pill prevents pregnancy mainly by:
A. Blocking fertilization
B. Preventing implantation
C. Killing sperm directly
D. Inducing ovulation

back 70

B. Preventing implantation