😀 EASY

 Did you know that placenta means flat cake?  Yeah, its one of those useless facts.  But unlike that statement, the placenta itself is so important – and so often misunderstood.  Please watch the video, or if you’re feeling confident in your embryology, have a crack at this longer-than-usual quiz! 

Awaiting review

  • The development of the placenta from the morula phase 
  • The structure of the placenta 
  • The changes in fetal demand for energy 
  • An appreciation of the main types of placental disorder: placenta accreta, placental percreta, placental abruption and pre-eclampsia. 

placenta

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Question 1
Which of the following organs are least involved in the physiology of placentation?
A
Hypothalamus
Hint:
P
B
Pituitary
C
Ovary
D
Uterus
E
Adrenal gland
Question 1 Explanation: 
Whilst it is true that the adrenal glands are vital for later development, they play a minimal role in healthy placentation.
Question 2
Select all the below options that are not the remit of the female gonad
A
Secretion of oestrogen
B
Synthesis of progesterone
C
Secretion of beta-hCG
D
Oogenesis
E
Fertilisation
Question 2 Explanation: 
Fertilisation occurs in the ampulla. The corpus luteum of the ruptured Graafian follicle is maintained by hCG from an extra-ovarian source.
Question 3
What is stimulated by GnRH?
A
Hypothalamus
B
Anterior pituitary gland
C
Posterior pituitary gland
D
Endometrium
E
Myometrium
Question 3 Explanation: 
The anterior pituitary gland, specifically gonadotrophin cells, secrete LH and FSH in response to GnRH from the hypothalamus.
Question 4
What is a direct role of FSH?  Select all that may apply. 
A
Vital for folliculogenesis
B
Vital for deciidualisation
C
Causes the ovarian surge
D
Causes ovulation
E
Permits menses
Question 5
What triggers of FSH release from the anterior pituitary gland?
A
GnRH
B
FSH
C
LH
D
Oestrogen
E
Progesteorne
Question 5 Explanation: 
Low oestrogen levels cause FSH increase. This stimulates the gonadal follicles to produce oestrogen, creating a negative feedback loop. At a point, serum oestrogen is so high that LH becomes the predominant and decidualisation can occur alongside ovulation.
Question 6
Which region of the body is vital to maintain the first 2 weeks of pregnancy?
A
Graafian follicle
B
Primary follicle
C
Primordial follicle
D
Corpus luteum
E
Corpus albicans
Question 7
What is contained in the connecting stalk? Select all that may apply. 
A
Ectodermal cells
B
Endodermal cells
C
Embryonic mesoderm
D
Extra-embryonic mesoderm
E
Wharton's jelly
Question 8
At what day from fertilisation do the lacunae of the syncytiotrophoblast emerge?
A
D7
B
D8
C
D9
D
D10
E
D11
Question 9
The smooth chorion (chorionic laeve) is in apposition to
A
Decidua basalis
B
Decidua capsularis
C
Decidua parietalis
D
Decidua temporalis
E
Decidua occipitalis
Question 10
The chorionic frondosum is comprised of which cell types?  Select all which may apply. 
A
Cytotrophoblast
B
Syncytiotrophoblast
C
Extraembryonic mesoderm
D
Epiblast cells
E
Ectodermal cells
Question 11
How is glucose transported across the placenta?
A
GLUT1
B
GLUT2
C
GLUT3
D
GLUT4
E
GLUT5
Question 11 Explanation: 
Warwick Medical School have their likes. Weirdly, they seem to love GLUT. In this case, the answer is GLUT3. GLUT1 forms the basis of transport in red blood cells and the blood brain barrier. GLUT2 is the beta-cell (and liver) one. GLUT3 is in the placenta and neurons. GLUT4 is for most adipocytes. GLUT5 is for enterocyte uptake from gut lumen.
Question 12
Which of the following statements are false?
A
Oestrogen stimulates uterine vascularisation
B
Oestrogen stimulates FSH levels
C
Oestrogen surge triggers ovulation
D
Progesteone causes changes to the decidua functionalis
E
Progesterone causes the laxity of the pubic symphysis
Question 13
Which cell type anchors the placenta to the basal plate?
A
Extraembryonic mesoderm
B
Amniotic epiblast cells
C
Splanchonopleuric extraembryonic mesoderm
D
Somatopleuric extraembryonic mesoderm
E
Cytotrophoblast cells
Question 14
Which of the following are not a constituent of the tertiary placental villus?
A
Cytotrophoblast
B
Syncytiotrophoblast
C
Extraembryonic mesoderm
D
Cotyledon artery
E
Paraxial mesoderm
Question 14 Explanation: 
Paraxial mesoderm is derived from the embryoblast inner cell mass - specifically the mesoderm of the trilaminar disc
Question 15
Which two structures fuse to obliterate the uterine cavity during gestation?
A
Decidua basalis
B
Decidua capitalis
C
Decidua parietalis
D
Chorion plate
E
Chorion laeve
Question 16
The amniotic cavity is lined with which type of cell?
A
Epiblast
B
Mesoderm
C
Ectoderm
D
Endoderm
E
Syncytiotrophoblast
Question 17
What finding on dipstick would suggest pre-eclampsia of the gravid patient?
A
Albuminuria
B
Frank haematuria
C
Glycosuria
D
Ketonuria
E
Pyouria
Question 18
A placenta accreta is a penetration to which mural layer?
A
Stratum functionalis
B
Stratum basilis
C
Myometrium
D
Perimetrium
E
Peritoneal cavity
Question 19
Which cell type is more likely deficient in a placental abruption?
A
Cytotrophoblast
B
Syncytiotrophoblast
C
Extraembryonic mesoderm
D
Intermediate mesoderm
E
Ectoderm
Question 20
Which of the following toxins is least likely to be involved in placental transfer?
A
Cytomegalovirus
B
SARSCOV2
C
Syphilis
D
HIV
E
Rubella
Question 21
Which hormone is mostly responsible for gestational hyperglycaemia?
A
hCG
B
hPL
C
hCT
D
Oestrogen
E
Progesterone
Question 21 Explanation: 
Human placental lactogen decreases glucose utilisation. This increases the osmotic potential of the serum, thereby the filtrate, causing osmotic diuresis.
Question 22
Where is the most common site of ectopic pregnancy?
A
Fimbrae
B
Ampulla
C
Infundibulum
D
Isthmus
E
Uterine body
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