Williams 21 edition p.857
.........Approximately 50 to 60 percent of early spontanoeus abortions
are associated with chromosomal anomaly of the conceptus. ................
所以應該可以建議做染色檢查
D應該可以選
手邊沒有22版的Williams
不知道有沒有人有新版Williams?
另外題幹中有提到acrania
不知道有沒有人有Nelson可以查一下是否acrania跟chromosome有無關係?
這樣立論就更清楚了
※ 引述《chihuahua (chihuahua)》之銘言：
: [申覆] 醫學六 31
: 答案: B.懷孕前服用葉酸及多種維生素,懷孕後接受高層次超音波檢查
: 這答案好像已經把etiology設定為:Folic acid deficiency
: 其它的etiology也包括了:Genetic factors
: -->那麼D也應該是答案之一
: Genetic factors — A genetic factor is suggested by the observations that
: NTDs have a high concordance rate in monozygotic twins, are more frequent
: among siblings, and are more common in females compared to males [9].
: In addition, there is a high prevalence of karyotypic abnormalities among
: fetuses with NTDs, especially in the presence of other congenital anomalies.
: For example, a large study evaluating the frequency of chromosomal
: abnormalities in pregnancies with fetal NTDs found these abnormalities in
: 6.5 percent of affected cases (4/167 fetuses with an isolated NTD and 9/33
: fetuses with a NTD and associated anomalies) [10]. A second series reported
: a similar rate (7 percent) of chromosomal abnormalities in fetuses with NTDs
: [11]. Trisomy 18 was the most common aneuploidy in both series. These data
: support the use of fetal karyotyping as an aid in diagnostic
: evaluation and recurrence risk counseling.
: 資料來源: Uptodate.com - Anencephaly and encephalocele
: 建議B,D皆給分
: 覆議的請推文 謝謝
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