45

CHAPTER 7

Embryogenesis and Fetal Development

7–1. Which of the following is assumed when using the
first day of the last menstrual period for dating?
a. The patient has a 36-day cycle.
b. The patient became pregnant on that day.
c. The patient ovulated approximately two weeks later.
d. The first day of the last menstrual period was
implantation bleeding.
7–2. What is the accuracy of an ultrasound measurement
shown below?
7–4. When is a conceptus termed an embryo?
a. Third week from the last menstrual period
b. Fifth week from the last menstrual period
c. Sixth week from the last menstrual period
d. Twelfth week from the last menstrual period
7–5. A 20-year-old primigravida presents to your office to
start prenatal care. She reports having an ultrasound
performed last week at another facility. She shows
you an ultrasound image which is provided below.
Interested in science, the patient would like to know
what is happening to the fetus at this gestational
age. Which of the following statements would be
incorrect?

a. ±2–3 days
b. ±5–7 days
c. ±8–10 days
d. ±12–14 days a. The fetus has fingers and toes.
b. Skins and nails are developing.
7–3. Approximately how long is each trimester of
pregnancy? c. The eyes are moving, and there is blinking.
a. 12 weeks d. The fetus is beginning to make spontaneous
movements.
b. 13 weeks
c. 14 weeks
d. 15 weeks
 46 Placentation, Embryogenesis, and Fetal Development

7–6. A 29-year-old multigravida presents at 15 weeks’
gestation to establish prenatal care. The patient’s first
child had a neural-tube defect. The patient did not
know she was pregnant until this week, so she asks
SECTION 3
7–9. After birth, the intraabdominal remnants of the
umbilical vein become which of the following?
a. Ligamentum teres

b. Umbilical ligaments
you about starting folic acid as she was counseled
in her last pregnancy that she needed a higher dose c. Ligamentum venosum
because of her first child’s condition. Which of the d. Ligamentum vascularum
following statements should be covered in your
counseling? 7–10. Which value defines anemia in the fetus?
a. Starting folic acid is just as beneficial now as ever, a. 20%
so she should start today but at a dose of 8 mg b. 25%
per day. c. 30%
b. The neural-tube does not close until 21 weeks’ d. 40%
gestation, so she should start folic acid 4 mg daily
within the next 1–2 weeks. 7–11. Approximately what percentage of the total
c. The neural-tube closes by 6 weeks’ gestation, hemoglobin is hemoglobin F in a term fetus?
so she would have needed to start the folic acid a. 25%
before then for it to be efficacious.
b. 40%
d. Having a prior child with a neural-tube defect
does not increase the risk of a neural-tube defect c. 50%
in this pregnancy, so she does not need to worry d. 75%
about that.
7–12. The last stage of fetal lung development starts late in
7–7. The diencephalon, pictured below, gives rise to what the fetal period and continues into childhood. What
part of the brain? is this stage called?
a. Alveolar stage
b. Canalicular stage
c. Terminal sac stage
d. Pseudoglandular stage

7–13. Where does biosynthesis of surfactant take place?

a. Type I pneumocytes
b. Type II pneumocytes
c. Type III pneumocytes
d. Type IV pneumocytes

7–14. Starting at what gestational age does the fetus engage

in respiratory movements that are intense enough to
move amnionic fluid in and out of the respiratory
tract?
a. Thalami a. 4 months
b. Medulla b. 5 months
c. Midbrain c. 6 months
d. Cerebral hemispheres d. 7 months

7–8. How does the oxygen content of the blood coming 7–15. The foregut gives rise to all except which of the
to the heart from the inferior vena cava compare following?
to the oxygen content of the blood leaving the a. Liver
placenta?
b. Stomach
a. Equal
c. Pancreas
b. Lower
d. Appendix
c. Higher
d. Varies depending on fetal activity
 Embryogenesis and Fetal Development 47

7–16. At what gestational age does swallowing begin? 7–23. Which of the following statements about the fetal
a. 6–8 weeks’ gestation thyroid gland is true?
b. 10–12 weeks’ gestation a. The fetal thyroid starts to make hormones

CHAPTER 7
starting at 36 weeks’ gestation.
c. 16–18 weeks’ gestation
b. By 12 weeks’ gestation, the fetal thyroid is
d. 20–22 weeks’ gestation
concentrating iodide more avidly than the
maternal thyroid.
7–17. How much amnionic fluid do term fetuses swallow
per day? c. With congenital fetal hypothyroidism, the
fetus will develop a large goiter in addition to
a. 50–100 mL per day
hepatosplenomegaly.
b. 100–200 mL per day
d. After birth, cooling to room temperature causes
c. 200–760 mL per day a sudden and marked decrease in the secretion of
d. 1500–2000 mL per day thyroid-stimulating hormone, which results in less
serum T4 with a nadir at 24–36 hours of life.
7–18. Which of the following gives meconium its greenish-
black color? 7–24. Where is fetal immunoglobulin M (IgM) produced?
a. Vernix a. Fetus
b. Biliverdin b. Mother
c. Scalp hair c. Mother and fetus
d. Hydrochloric acid d. The fetus does not have IgM

7–19. At what gestational age do the fetal kidneys start 7–25. Which immunoglobulin in colostrum provides
producing urine? mucosal protection against enteric infections?
a. 6 weeks’ gestation a. IgA
b. 8 weeks’ gestation b. IgE
c. 12 weeks’ gestation c. IgG
d. 16 weeks’ gestation d. IgM

7–20. How much urine does a fetus make at term?
a. 10 mL per day
b. 50 mL per day
c. 200 mL per day
d. 650 mL per day
7–21. Which of the following increases fetal urine
formation?
a. Urethral obstruction
b. Fetal growth restriction
c. Uteroplacental insufficiency
d. Maternally administered furosemide
7–22. Which of the following hormones is not produced
by the anterior lobe of the fetal pituitary gland?
a. Vasopressin
b. Growth hormone
c. Follicle-stimulating hormone
d. Thyroid-stimulating hormone
7–26. Which of the following statements about leptin is true?
a. It is produced exclusively by the placenta.
b. Concentrations peak in amnionic fluid at term.
c. 95% of placental production enters the fetal
circulation.
d. Abnormal levels have been associated with fetal
growth disorders, gestational diabetes, and
preeclampsia.
7–27. Which of the following is found in greater con-
centrations in maternal plasma compared to fetal
plasma?
a. Zinc
b. Iodide
c. Copper
d. Vitamin A
7–28. Which of the following does not affect immuno-
globulin G (IgG) transfer across the placenta?
a. Gestational age
b. Placental integrity
c. Maternal levels of IgG
d. Maternal levels of IgM and IgA
 48 Placentation, Embryogenesis, and Fetal Development

7–29. What is uteroplacental blood flow at term? 7–31. What is the average oxygen saturation of intervillous
a. 200–400 mL/min blood?
b. 400–600 mL/min a. 25–35%
SECTION 3

c. 700–900 mL/min b. 45–55%

d. 1200–1400 mL/min c. 65–75%
d. 85–95%
7–30. How does immunoglobulin G (IgG) cross the
placenta? 7–32. At term, what is the average PCO2 in the umbilical
a. Simple diffusion arteries?
b. It does not cross the placenta a. 30 mmHg
c. Trophoblast receptor-mediated transfer b. 50 mmHg
d. Facilitated diffusion involving calcium-binding c. 60 mmHg
protein d. 100 mmHg