ABGC Boards Prenatal Study Set Questions and Answers 100% Pass

ABGC Boards Prenatal Study Set Questions and Answers 100% Pass T21 Risk by Maternal Age - ANSWER -Age-------------------------------Risk 30 --------------------------------1/952 (.1%) 35 --------------------------------1/385 (.3%) 37 --------------------------------1/227 (.4%) 40 --------------------------------1/106 (.9%) 43 --------------------------------1/50 (3.1%) Risk of Any Chrom Abnl by Maternal Age - ANSWER -Age--------------------------------Risk 30---------------------------------1/384 (0.3%) 35---------------------------------1/202 (0.5%) 37---------------------------------1/129 (0.8%) 40---------------------------------1/65 (1.6%) 43---------------------------------1/32 (3.1%) Maternal Serum Quad Screen - ANSWER -Measurement of biochemical analytes in maternal serum to provide adjusted risk for certain conditions. Performed during second trimester typically 14-21 weeks 2 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. SLO vs XL ichthyosis, SLO has pre and postnatal growth restrictions - ANSWER -Differentials for extremely low uE3 on QUAD screen and how can you differentiate Non-disjunction in Meiosis I - ANSWER -What is the most common cause of aneuploidy Quad screen conditions - ANSWER --Open Neural tube defects - Down Syndrome - Trisomy 18 Quad screen analytes - ANSWER --AFP (alpha-fetoprotein) -hCG (human chorionic gonadotrophin): -uE3 (unconjugated estriol): - Inhibin Factors to take into account for Quad Screen - ANSWER -Gestational Age: As this changes so does expected values of each analyte Weight: as maternal weight increases so does blood volume. Dilutes analytes 3 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. Race: Different ethnic backgrounds can affected expected levels - i.e. African American ancestry tend to have higher AFP levels -Diabetic status: insulin dependent diabetics tend to have lower AFP Effects of inaccurate dating for Quad Screen - ANSWER --Overestimate (believe pregnancy is further along) can lead to false positive for Down syndrome. (Overestimate brings you down) - Underestimate (reported to be earlier than it is) leads to false positive for NTD. London (The under is the tubes) - Generally use first trimester ultrasound for dating rather than LMP IgM (Most recent) IgG (It is gone) - ANSWER -You see IgM but not IgG is this more concerning for recent infections due to maternal infection. Memory device Estriol and hCG low but AFP high early All low: Late - ANSWER -Patterns for recent and older fetal demise 4 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. Trends of Analytes in Second Trimester - ANSWER -Analyte Trend hCG Decreases as GA increases Inhibin Remains Stable uE3 Increases with GA AFP increases with GA Positive Quad screen pattern Increased risk for Down Syndrome - ANSWER -HI (Increased) LO (Decreased) H: hCG I: Inhibin L: estriol O: AFP Quad screen positive T18 increased risk - ANSWER -AFP: Low hCG: Low uE3: Low DIA: N/A Pattern of Quad screen with abnormal placental functioning - ANSWER -AFP: HI hCG: High 5 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. uE3: Low Inhibin: High First Trimester Screening - ANSWER -Maternal serum analytes and ultrasound are used to adjust a woman's a priori risk for aneuploidy. Performed in 1st trimester usually between 11-13 weeks First Trimester Screening Analytes - ANSWER -Free Beta-hCG PAPP-A AFP Analytes are measures and then adjusted for gestational age, maternal weight and race Measured in MoM- multiples of median First Trimester Screen Ultrasound Components - ANSWER -Crown to Rump length measurement Nuchal translucency Nasal Bone Advantages of First Tri Screening over Quad - ANSWER -Increased sensitivity for T21 and T18 Includes T13 Risk assessment earlier 6 | P a g e Created by Grace Amelia © 2025, All Rights Reserved. Eliminates incorrect dating issue Nuchal translucency - ANSWER -a collection of fluid that extends behind the fetal neck and along the spine in the first trimester Increased NT - ANSWER -Greater than 95th percentile in size Increased NT associated with what genetic conditions? - ANSWER -- Down syndrome - Trisomy 18 - Trisomy 13 - Turner Syndrome - Noonan Syndrome What is the most common reason for a mildly increased NT? - ANSWER -Normal Variation and a healthy baby What is a cystic hygroma? - ANSWER -Extremely increased NT often have tissue septations within space Estimated to increase risk for aneuploidy by 50-60%