1) Down’s syndrome is associated with
A) Lower maternal serum free beta-HCG in the first trimester
B) Lower maternal serum pregnancy associated plasma protein A in the first trimester
C) Lower maternal serum AFP in the first trimester
D) Lower maternal serum unconjugated oestradiol in the first trimester
E) Higher maternal serum unconjugated oestradiol in the first trimester
2) In the second trimester
A) Serum AFP levels are lower in women with a fetus with Down’s syndrome
B) Serum unconjugated oestradiol levels are higher in women with a fetus with Down’s syndrome
C) Fetal serum AFP levels are lower in fetus with Down’s syndrome
D) Fetal serum AFP levels are higher in fetuses with Down’s syndrome
E) Serum unconjugated oestradiol levels are lower in women with a fetus with Down’s syndrome
3) Which one is used as part of second trimester biochemical screening for Down’s syndrome?
A) Maternal serum unconjugated oestradiol
B) Maternal serum unconjugated oestriol
C) Maternal serum oestradiol
D) Maternal serum conjugated oestriol
E) Maternal serum unconjugated oestrogen
4) Which one is used as part of first trimester screening for Down’s syndrome?
A) Maternal serum unconjugated oestriol
B) Maternal serum AFP
C) Maternal serum free beta-HCG
D) Maternal serum inhibin-A
E) Maternal serum placental growth factor
5) Which one is used as part of first trimester screening for Down’s syndrome?
A) Maternal serum unconjugated oestriol
B) Maternal serum AFP
C) Maternal serum inhibin-A
D) Maternal serum placental growth factor
E) Maternal serum pregnancy-associated plasma protein A
6) In normal pregnancies between 14 and 20 weeks gestation
A) Maternal serum AFP levels fall
B) Maternal serum unconjugated oestradiol levels fall
C) Maternal serum free beta-HCG levels fall
D) Maternal serum unconjugated oestradiol levels fall
E) Maternal serum oestrogen levels plateau
7) Which one is the most effective maternal serum marker for Down’s syndrome during the second trimester?
A) Unconjugated oestradiol
B) Unconjugated oestriol
C) Alpha-fetoprotein
D) Free beta-HCG
E) Inhibin-A
8) Between 11 – 14 weeks gestation
A) Maternal serum pregnancy associated plasma protein A levels are unchanged
B) Maternal serum pregnancy associated plasma protein A levels decrease
C) Maternal serum free beta-HCG levels are unchanged
D) Maternal serum free beta-HCG levels decrease
E) Fetal nuchal transluscency decreases
9) Maternal serum inhibin-A levels
A) Decrease with increasing gestation age after 17 weeks
B) Are higher in women with a fetus affected by Down’s syndrome
C) Increase with increasing gestation age between 11 – 14 weeks
D) Are unaffected by fetal Down’s syndrome
E) Plateau after 20 weeks gestation
10) Increasing maternal weight is associated with
A) An increase in maternal serum AFP levels in the second trimester
B) An increase in maternal serum unconjugated oestriol levels in the second trimester
C) A decrease in maternal serum free beta-HCG levels in the second trimester
D) No change in maternal serum AFP levels in the second trimester
E) No change in maternal serum free beta-HCG levels in the second trimester
11) Which one of the factors below is listed with the appropriate effect on maternal serum markers for Down’s syndrome?
A) Obesity – increased maternal serum AFP levels
B) Insulin-dependent diabetes mellitus – decreased maternal serum AFP levels
C) Smoking – decreased maternal serum inhibin-A levels
D) Smoking – increased maternal serum free beta-HCG levels
E) Parity – increased maternal serum AFP levels with increasing parity
12) Which one of the factors below is listed with the appropriate effect on maternal serum markers for Down’s syndrome?
A) Black ethnic origin – higher maternal serum AFP levels
B) Black ethnic origin – lower maternal serum free beta-HCG levels
C) Obesity – higher maternal serum free beta-HCG levels
D) IVF pregnancy – lower maternal serum free beta-HCG levels
E) IVF pregnancy – higher maternal serum unconjugated oestriol levels
13) Conception through IVF is associated with (TRUE / FALSE)
An increased risk of Down’s syndrome
Higher rate of false positive screening for Down’s syndrome
Higher maternal serum free beta-HCG levels in the second trimester
Lower maternal serum unconjugated oestriol levels in the second trimester
14) Which one is not used in the integrated screening test for Down’s syndrome
A) Nuchal transluscency
B) Pregnancy associated plasma protein A at 11-14 weeks
C) Free beta-HCG at 11-14 weeks
D) AFP at 14-20 weeks
E) Unconjugated oestriol at 14-20 weeks
15) The integrated test to screen for Down’s syndrome is undertaken at
A) 11 – 14 weeks gestation
B) 9 – 11 weeks gestation
C) 14 – 20 weeks gestation
D) 11 – 14 and 14 – 20 weeks gestation
E) 9 – 11 and 11 – 14 weeks gestation
16) Which one is not correct with reference to the Combined screening test for Down’s syndrome?
A) Measures nuchal transluscency
B) Measures free beta-HCG
C) Measures pregnancy-associated plasma protein A
D) Measures alpha feto-protein
E) Is undertaken at 11-14 weeks gestation
17) Which one of the statements regarding the Quadruple screening test for Down’s syndrome is not correct?
A) Undertaken at 11 – 14 weeks gestation
B) Measures maternal serum AFP
C) Measures maternal serum unconjugated oestriol
D) Measures maternal serum inhibin-A
E) Measures maternal serum free beta-HCG
18) The Triple test used to screen for Down’s syndrome
A) Should not be performed after 15 weeks gestation
B) Measures AFP, HCG and Inhibin-A
C) Measures AFP, HCG and oestrogen
D) Measures AFP, HCG and unconjugated oestriol
E) Measures AFP, HCG and PAPP-A
19) Which one of these conditions can be diagnosed using fluorescent in-situ hybridization?
A) Duchenne muscular dystrophy
B) Sickle cell disease
C) Patau’s syndrome
D) Cystic fibrosis
E) Tay-Sach’s disease
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