In addition to oxytocin (Pitocin) administration, what other methods can induce labor?

Choice A rationale:

A positive contraction stress test (CST) indicates that the fetal heart rate decelerates late in response to uterine contractions, suggesting potential uteroplacental insufficiency. However, the scenario does not describe a CST being performed, as it does not mention any assessment of uterine contractions or their relationship to fetal heart rate changes.

Choice C rationale:

A negative contraction stress test (CST) would demonstrate no late decelerations in response to contractions, suggesting adequate placental function. However, as mentioned earlier, a CST is not the test being performed in this scenario.

Choice D rationale:

A non-reactive nonstress test (NST) means that there were not enough fetal heart rate accelerations (at least 2, each lasting at least 15 seconds and peaking at least 15 beats above baseline) within a 20-minute period. This finding sometimes warrants further evaluation of fetal well-being. However, the scenario clearly states that 3 accelerations meeting the criteria for reactivity were observed.

Choice B rationale:

A reactive nonstress test (NST) is considered reassuring and indicates that the fetal heart rate is responding appropriately to fetal movement, suggesting that the fetus is likely healthy and well-oxygenated. The presence of 3 accelerations meeting the criteria for reactivity within a 20-minute period is the hallmark of a reactive NST.

The correct answer is C. Only one copy of the variant gene is needed for expression of the disease.

Choice A rationale:

Huntington's disease (HD) is not typically diagnosed in childhood. While symptoms can sometimes manifest in adolescence or early adulthood, the average age of onset is between 30 and 50 years old.

Early-onset HD, which occurs before the age of 20, is much rarer and accounts for only about 5-10% of cases.

It's crucial to convey accurate information about the typical age of onset to avoid unnecessary anxiety and unwarranted testing in children.

Choice B rationale:

The statement "If you are a carrier, there is a 25% chance your child will inherit the gene" is not entirely accurate for autosomal dominant disorders like HD.

If a parent has HD, each child has a 50% chance of inheriting the mutated gene, not 25%. This is because the parent with HD has one mutated copy of the gene and one normal copy.

During conception, each child randomly receives one copy of the gene from each parent. Therefore, there's a 50% chance the child will receive the mutated copy and a 50% chance they'll receive the normal copy.

Choice D rationale:

Referral to a genetic counselor is essential for all individuals with a family history of HD, regardless of their carrier status.

Genetic counselors can provide comprehensive information about HD, including: Inheritance patterns

Risk assessment

Testing options

Reproductive options

Support resources

Psychosocial counseling

They can assist individuals in making informed decisions about testing, family planning, and management of the condition.

Choice C is the correct answer because:

HD is indeed an autosomal dominant disorder, meaning that only one copy of the mutated gene is needed for an individual to develop the disease.

This contrasts with autosomal recessive disorders, which require two copies of the mutated gene (one from each parent) for the disease to manifest.

Understanding the pattern of inheritance is crucial for accurate risk assessment and genetic counseling.