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Test 6: Neural tube defects

  1. What is a neural tube defect?
    • An abnormality of the peripheral nerves.
    • A malformation of the neural tube.
    • A narrowing or absence of the neural tube.
    • A form of nerve deafness.
  2. Which of the following is an example of a neural tube defect?
    • Meningomyelocoele.
    • Omphalocoele.
    • Microcephaly.
    • All of the above.
  3. With anencephaly:
    • The spine is open in the lumbar and sacral region of the back.
    • Only the membranes bulge out of a defect in the vertebral column.
    • Both the membranes and spinal cord bulge out of the defect in the vertebral column.
    • The top of the skull is open and the malformed brain is exposed.
  4. Infants with anencephaly usually:
    • Die soon after birth.
    • Are operated on after delivery.
    • Are only referred for surgery when they are able to walk.
    • Survive with blindness and deafness.
  5. Which of the following is an open spinal defect?
    • Spina bifida occulta.
    • Encephalocoele.
    • Meningomyelocoele.
    • Hydrocephalus.
  6. The birth prevalence of neural tube defects in South Africa is:
    • 10–40/1000.
    • 1–4/1000.
    • 1/ 10 000.
    • 4/ 100 000.
  7. In South Africa, neural tube defects are commoner in:
    • Urban areas.
    • Rural areas.
    • Older mothers.
    • Teenage mothers.
  8. Most neural tube defects are due to:
    • Autosomal dominant inheritance.
    • Autosomal recessive inheritance.
    • X-linked recessive inheritance.
    • Multifactorial inheritance.
  9. Neural tube defects may occasionally be caused by:
    • High doses of folic acid.
    • Smoking cigarettes.
    • Some anticonvulsants.
    • Taking iron supplements during pregnancy.
  10. Common complications of encephalocoele include:
    • Intellectual disability.
    • Paralysed legs and bladder incontinence.
    • Meningitis.
    • Kyphosis or scoliosis.
  11. Meningomyelocoele commonly results in:
    • Deafness.
    • Club feet.
    • Anencephaly.
    • Blindness.
  12. Meningocoele usually presents with:
    • Paralysed legs.
    • A bulge over the midline of the spine.
    • Incontinence of bladder and bowel.
    • Bed sores.
  13. A spina bifida occulta may be recognised by:
    • A bulge over the lower spine.
    • A large head at birth.
    • A patch of hair in the midline of the lower back.
    • Club feet.
  14. Meningocoele can be corrected with:
    • Surgery.
    • Antibiotics.
    • Neurodevelopmental therapy.
    • Anticonvulsants.
  15. To reduce the risk of neural tube defects, supplementation should be given:
    • Three months before and three months after conception.
    • As soon as pregnancy is diagnosed.
    • Only after the first trimester.
    • Throughout the second half of pregnancy.
  16. What dietary fortification can reduce the risk of neural tube defects?
    • Vitamin A.
    • Vitamin C.
    • Folic acid.
    • Zinc.
  17. What are the risks of a mother having a second child with a neural tube defect?
    • 1%.
    • 5%.
    • 25%.
    • 50%.
  18. Which maternal serum screening test helps to identify pregnant women at increased risk of having a child with neural tube defects?
    • Alkaline phosphatase.
    • Glucose 6 phosphate dehydrogenase (G6PD).
    • Alpha-fetoprotein.
    • Ferritin.
  19. Ultrasound screening for neural tube defects is best done at:
    • 10 weeks.
    • 18 weeks.
    • 26 weeks.
    • 36 weeks.
  20. What is the management of a woman who has a fetus with a neural tube defect?
    • Nothing can be done.
    • Amniocentesis.
    • Induction of labour at 36 weeks for early surgery.
    • Genetic counselling.