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Old 04-15-2012
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ObGyn Elevated Maternal Serum Alpha-Fetoprotein Level

Concept taken from Kaplan qbank

16 weeks pregnant lady undergoes screening for maternal serum alpha-fetoprotein levels. It turnes out to be 4.5 multiples of the appropriate gestational median. Assuming her pregnancy is correctly dated for gestational age, what should she be tested for?

a Trisomy 21
b Trisomy 13
c Open spina bifida
d Multiple fetuses
e Fetal demise
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Old 04-15-2012
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Spina bifida. AFP is elevated in neural tube defects and decreased in chromosomal abnormalities.
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Quote:
Originally Posted by shan564 View Post
Spina bifida. AFP is elevated in neural tube defects and decreased in chromosomal abnormalities.
I know that Spina Bifida is the correcr answer, but for the sake of discussion- isn't AFP used in screening for Down's Syndrome?
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Old 04-15-2012
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My bad. AFP is reduced in Down's.

Fetuses with d\Down's will have higher levels of hCG and inhibin A in the Screening test, and will also have lower levels of AFP and uE3.
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Old 04-15-2012
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Yes, sorry I wasn't clear... AFP is reduced in chromosomal abnormalities, which includes trisomies (i.e. Down syndrome, Edwards syndrome, Patau syndrome).
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Old 04-16-2012
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the answer is d Multiple fetuses
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Old 04-16-2012
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isnt beta-hCg the one that is increased in multiple fetuses?
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Old 04-16-2012
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Quote:
Originally Posted by DocSikorski View Post
the answer is d Multiple fetuses
Wouldn't a previous ultrasound have already told us that there are 2 embryos inside the uterus???

Just asking... thanks for the question...
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Guys, I think this question is either too effed up or at least extremely unfair... I chose spina bifida too.
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Old 04-16-2012
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Default how much inc

Quote:
Originally Posted by DocSikorski View Post
Guys, I think this question is either too effed up or at least extremely unfair... I choosed spina bifida too.
is there any relation to how much inc ?

probably 4.5 too high
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Old 04-16-2012
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Quote:
Originally Posted by DocSikorski View Post
Guys, I think this question is either too effed up or at least extremely unfair... I choosed spina bifida too.
Diagnostic: WTF question

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Old 04-17-2012
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Quote:
Originally Posted by DocSikorski View Post
Guys, I think this question is either too effed up or at least extremely unfair... I choosed spina bifida too.
Damn! I just read all the options. The first time, I just stopped at spina bifida. I agree- the question is unfair.
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Old 04-17-2012
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this question is very unfair for a step-1 aspirant.at 16 week, everyone would know that it was a multi pregnancy even before AFP levels getting checked
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Old 03-22-2014
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hi, i have a question. i reading FA 2014 written there AFP level is normal for meningocele. while when i read kaplan it says increase in AFP level.
May i know which is true?
thank you so much
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Old 03-23-2014
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Quote:
Originally Posted by kdm0101 View Post
this question is very unfair for a step-1 aspirant.at 16 week, everyone would know that it was a multi pregnancy even before AFP levels getting checked

How would you know that at 16 weeks it was multiple pregnancy...even before knowing about the AFP levels?

It is obvious that elevated levels of AFP either occurring through wrong dating, multiple pregnancies or spina bifida, but just by reading "16 weeks" how would you know that they are looking for multiple pregnancies (without knowing AFP)?
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Old 03-23-2014
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Quote:
Originally Posted by williamyap_100 View Post
hi, i have a question. i reading FA 2014 written there AFP level is normal for meningocele. while when i read kaplan it says increase in AFP level.
May i know which is true?
thank you so much
you're right. I saw the FA 2014,but I saw in Goljan pathology and kaplan book that meningocele AFP is elevated.good luck
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Embryology-, Endocrine-, Pathology-, Reproductive-, Step-1-Questions

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