MCQs on cerebroplacental ratio (CPR)

By | June 4, 2024
  1. What does the cerebroplacental ratio (CPR) measure in gestational ultrasound?
    • A) Blood flow between the brain and the heart
    • B) Ratio of blood flow between the fetal middle cerebral artery and the umbilical artery
    • C) Blood flow from the placenta to the fetus
    • D) Blood flow between the fetal lungs and liver
  2. What is the primary clinical significance of an abnormal CPR in pregnancy?
    • A) Fetal gender determination
    • B) Indication of fetal anemia
    • C) Predictor of adverse perinatal outcomes
    • D) Estimation of fetal weight
  3. Which arteries are assessed to calculate the cerebroplacental ratio (CPR)?
    • A) Umbilical artery and uterine artery
    • B) Middle cerebral artery and femoral artery
    • C) Middle cerebral artery and umbilical artery
    • D) Umbilical artery and renal artery
  4. A decreased CPR is most commonly associated with which condition?
    • A) Fetal macrosomia
    • B) Fetal growth restriction (FGR)
    • C) Polyhydramnios
    • D) Fetal cardiac anomalies
  5. How is CPR calculated?
    • A) CPR = Middle Cerebral Artery Pulsatility Index / Umbilical Artery Pulsatility Index
    • B) CPR = Umbilical Artery Pulsatility Index / Middle Cerebral Artery Pulsatility Index
    • C) CPR = Middle Cerebral Artery Diameter / Umbilical Artery Diameter
    • D) CPR = Umbilical Artery Diameter / Middle Cerebral Artery Diameter
  6. What is considered a normal CPR value at term?
    • A) Greater than 1.0
    • B) Less than 1.0
    • C) Exactly 1.0
    • D) Greater than 2.0
  7. A CPR less than the 5th percentile is indicative of:
    • A) Fetal overgrowth
    • B) Adequate fetal oxygenation
    • C) Increased risk of intrapartum fetal distress
    • D) Decreased risk of neonatal intensive care admission
  8. In which trimester is CPR most commonly assessed?
    • A) First trimester
    • B) Second trimester
    • C) Third trimester
    • D) Immediately after birth
  9. What is the Doppler finding in the middle cerebral artery in cases of brain-sparing effect due to fetal hypoxia?
    • A) Increased pulsatility index
    • B) Decreased pulsatility index
    • C) Normal pulsatility index
    • D) Absent end-diastolic flow
  10. Which condition is NOT typically associated with an abnormal CPR?
    • A) Preeclampsia
    • B) Fetal growth restriction
    • C) Gestational diabetes with normal fetal growth
    • D) Maternal anemia
  11. A low CPR in late pregnancy may suggest a need for:
    • A) Immediate cesarean section
    • B) Closer fetal surveillance and possible early delivery
    • C) Increased maternal fluid intake
    • D) Postponing delivery until full term
  12. Which ultrasound modality is primarily used to assess the CPR?
    • A) B-mode ultrasound
    • B) Doppler ultrasound
    • C) 3D ultrasound
    • D) M-mode ultrasound
  13. In a fetus with growth restriction, an abnormal CPR suggests:
    • A) Normal placental function
    • B) Decreased placental resistance
    • C) Increased risk of perinatal morbidity and mortality
    • D) Increased placental blood flow
  14. An elevated CPR in early gestation is most likely to be:
    • A) Normal
    • B) Pathological
    • C) Indicative of fetal compromise
    • D) Indicative of maternal hypertension
  15. The cerebroplacental ratio can help distinguish between:
    • A) Symmetrical and asymmetrical fetal growth restriction
    • B) Congenital infections
    • C) Chromosomal abnormalities
    • D) Types of maternal anemia
  16. What is the clinical significance of an increased umbilical artery pulsatility index (UA-PI) in conjunction with a decreased CPR?
    • A) Normal fetal well-being
    • B) Impaired placental function and fetal hypoxia
    • C) Maternal hypertension
    • D) Increased risk of gestational diabetes
  17. In fetal surveillance, a persistently low CPR may prompt:
    • A) No change in management
    • B) Consideration of preterm delivery
    • C) Reduction in maternal activity
    • D) Increase in caloric intake for the mother
  18. Which fetal outcome is NOT commonly associated with an abnormal CPR?
    • A) Preterm birth
    • B) Low Apgar scores
    • C) Normal birth weight
    • D) Stillbirth
  19. In the presence of normal fetal growth, a low CPR may indicate:
    • A) Fetal anemia
    • B) Impending fetal asphyxia
    • C) Normal fetal well-being
    • D) Maternal malnutrition
  20. Which of the following does NOT directly affect the CPR?
    • A) Maternal blood pressure
    • B) Placental resistance
    • C) Fetal brain oxygenation
    • D) Amniotic fluid volume
  21. What is the significance of finding an abnormal CPR in a patient with preeclampsia?
    • A) It indicates normal placental function
    • B) It suggests a high risk of fetal compromise
    • C) It is of no clinical significance
    • D) It indicates maternal heart disease
  22. Which intervention may be considered in a fetus with a persistently low CPR and signs of compromise?
    • A) Prolongation of pregnancy
    • B) Early delivery
    • C) Increased maternal rest
    • D) Increased maternal fluid intake
  23. What does a high middle cerebral artery pulsatility index (MCA-PI) indicate in the context of CPR?
    • A) Normal fetal condition
    • B) Brain-sparing effect
    • C) Reduced cerebral blood flow
    • D) Increased risk of fetal infection
  24. When assessing CPR, a finding of reversed end-diastolic flow in the umbilical artery suggests:
    • A) Normal fetal circulation
    • B) Severe placental insufficiency
    • C) Mild placental insufficiency
    • D) Increased placental blood flow
  25. A fetus with a low CPR is monitored with Doppler studies. Which additional test might be used to assess fetal well-being?
    • A) Non-stress test (NST)
    • B) Maternal blood pressure
    • C) Biophysical profile (BPP)
    • D) Fetal fibronectin test
  26. In a high-risk pregnancy, how often might CPR be assessed?
    • A) Once in each trimester
    • B) Weekly or bi-weekly
    • C) Only at term
    • D) Only if fetal growth is abnormal
  27. What physiological adaptation is indicated by a low CPR in a fetus?
    • A) Increased cerebral blood flow due to hypoxia
    • B) Decreased cerebral blood flow
    • C) Increased placental blood flow
    • D) Normal adaptation to intrauterine environment
  28. A decreased CPR in the third trimester is a predictor of:
    • A) Fetal macrosomia
    • B) Intrauterine growth restriction (IUGR)
    • C) Normal term delivery
    • D) Fetal polycythemia
  29. Which of the following best describes the relationship between CPR and fetal hypoxia?
    • A) Direct correlation
    • B) Inverse correlation
    • C) No correlation
    • D) Random correlation
  30. A low cerebroplacental ratio (CPR) can indicate which of the following conditions?
    • A) Fetal macrosomia
    • B) Fetal anemia
    • C) Fetal hypoxia
    • D) Fetal renal agenesis