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Old 10-17-2012
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Arrow Billy Step 1 Questions # 33

A 19-year-old woman, G2, P1, has a screening ultrasound at 20 weeks’ gestation that shows no abnormalities.
Premature labor leads to an emergent vaginal delivery at 31 weeks, however. Soon after birth, the neonate develops
respiratory distress requiring intubation with positive-pressure ventilation. Which of the following prenatal diagnostic tests
could have best predicted this neonate's respiratory distress?


□ (A) Maternal serum α-fetoprotein determination
□ (B) Phospholipid analysis of amniotic fluid
□ (C) Chromosomal analysis
□ (D) Coombs test on cord blood
□ (E) Genetic analysis for cystic fibrosis gene
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Old 10-17-2012
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My answer B) Phospholipid analysis of amniotic fluid
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Old 10-17-2012
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agree with teona...B----lecithin/sphingomyelin(phospholipids) ratio
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Old 10-17-2012
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□ (B) Phospholipid analysis of amniotic fluid easy q
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Old 10-17-2012
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□ (B) Phospholipid analysis of amniotic fluid
May be L/S ratio measurement. but L/S ratio become 2:1 by 35 wks. So i think it will be still decreased in this patient.
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Old 10-18-2012
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Yup its lecithin:sphingomyelin ratio....
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Old 10-18-2012
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Correct Answer B is correct

The neonate most likely has hyaline membrane disease from fetal lung immaturity and lack of surfactant.
Surfactant consists predominantly of dipalmitoyl phosphatidylcholine. The adequacy of surfactant production can be
gauged by the phospholipid content of amniotic fluid because fetal lung secretions are discharged into the amniotic fluid.
The maternal serum α-fetoprotein level is useful to predict fetal neural tube defects and chromosomal abnormalities.
Chromosomal analysis may help to predict problems after birth or the possibility of fetal loss. The Coombs test may help to
determine the presence of erythroblastosis fetalis. Cystic fibrosis does not cause respiratory problems at birth
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