Screening
Guidelines
FNP practice
Ethical Considerations
Grab bag
100
What is a first semester screening that assess the fluid filled space behind the fetal neck between 11 and 14 weeks of gestation.
Nuchal Translucency
100
Who does ACOG recommend screening?
Everyone !!!
100
Name one factor that influences reproductive decisions?
pregnancy history, anxiety about fetus, support, access to services...... many influences
100
Define directive counseling
defined as patient counseling in which the provider plays an active role in the patients decision making by offering advice, guidance, and reccomendations
100
What is the difference between genetic screening and diagnostic testing?
screening is designed to assess if patient is at increased risk of genetic disorder diagnostic testing is intended to diagnose, with as much certainty as possible whether a specific genetic disorder or condition is present in the fetus
200
If the PAPP-A is low and the free beta Hcg is 2x as high as normal what genetic abnormality does this suggest?
Down syndrome
200
Who does ACOG recommend that invasive testing be offered to?
Over 35 or anyone with a positive screen
200
You are a PCP caring for a women who is 15 weeks pregnant. What are her options available for appropriate genetic counseling would you offer her?
Quad screen, serum markers or Non invasive prenatal testing
200
What is the practice of compelling someone to do something by using personal opinion, or force
Coercion
200
Name a second trimester screening
Quad and NIPT
300
Name one of the genetic abnormalities that the Quad screen looks for.
Down syndrome, trisomy 18 and neural tube defects
300
What is the reason that Noninvasive prenatal testing is reserved for high risk women?
$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ (high cost)
300
A 39 year old pregnant women comes into your office for her initial OB visit. Which screenings would be most appropriate based on her age?
Non invasive (due to age), Serum markers and NT
300
What is a potential harm of prenatal screening?
false reassurance, decision stress, anxiety as a result of a false positive
300
What are the two most common diagnostic tests?
CVS and amniocentesis
400
What is trimester is the Quad screen performed?
Second trimester
400
In addition to further genetic testing, what should be offered with patients with an increased nuchal fold?
Targeted ultrasound or fetal eccho
400
Your patients genetic testing report came back and have the following results: low PAPP-A, elevated HCG (2x higher then normal), and an abnormal NT (>3.5mm). What do these results indicate and what are the appropriate next steps for your patient and what are the appropriate next steps for your patient?
Down syndrome, refer for diagnostics
400
True or false parents religion should play a role in decision making
True
400
Which test must be performed between 11-14 weeks?
Nuchal translucency
500
What is the biochemical measurement that is used for the non invasive prenatal testing
Fetal cell free DNA
500
At what week gestation can amniocentesis be performed?
15
500
Name one of the advantages of discussing genetic testing in primary care?
Established relationship Family centered approach
500
At what gestational age is it suggested that a fetus can feel pain?
24 weeks
500
Name one of the components of the maternal fetal quad screen
HCG, AFP, estriol, inhibin A
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