Spina Bifida Quiz: Neural Tube Defects Decoded

1. Spina bifida occulta differs from spina bifida cystica primarily in that occulta:

Always causes severe neurological deficits

Involves no protrusion of meninges or neural tissue

Occurs later in gestation

Is always detected at birth

2. Which vitamin deficiency is most strongly associated with increased risk of neural tube defects?

Vitamin A

Vitamin B12

Folic acid

Vitamin D

3. A meningomyelocele is characterized by herniation of which structures through the vertebral defect?

Meninges only

Spinal cord and meninges

Bone and skin only

Cerebrospinal fluid only

4. Elevated maternal serum alpha-fetoprotein (AFP) and low estriol are biochemical markers associated with:

Gestational diabetes

Neural tube defects

Preeclampsia

Placental insufficiency

5. Which spinal level is most commonly affected in spina bifida?

Cervical

Thoracic

Lumbosacral

Sacral

6. Chiari malformation is a frequent complication of spina bifida cystica. What does it involve?

Herniation of cerebellar tissue into the spinal canal

Cerebellar tissue protruding through the foramen magnum

Expansion of the fourth ventricle

Absence of the corpus callosum

7. Hydrocephalus occurs in approximately what percentage of patients with meningomyelocele?

20–30%

40–50%

70–90%

95–100%

8. The Arnold-Chiari malformation associated with spina bifida is classified as Type II, which features downward displacement of:

The medulla and cerebellum

The pons only

The midbrain

The thalamus

9. Neurogenic bladder in spina bifida results from dysfunction of which spinal nerve roots?

L1–L2

L3–L4

S2–S4

S5 and coccygeal

10. The "tethered spinal cord" complication in spina bifida occurs when:

Scar tissue anchors the spinal cord, limiting its mobility

The spinal cord fails to develop completely

Cerebrospinal fluid accumulates around the cord

The vertebral column fuses prematurely

11. The "club foot" deformity (talipes equinovarus) is a common orthopedic complication in spina bifida. This occurs due to:

Intrauterine compression

Muscle imbalance from lower limb denervation

Calcium deficiency in utero

Vitamin D deficiency

12. During which week of embryonic development does the neural tube typically close?

Weeks 2–3

Weeks 3–4

Weeks 5–6

Weeks 7–8

13. Prenatal diagnosis of spina bifida is most reliably confirmed by:

Maternal serum AFP alone

Ultrasound visualization of the spinal defect

Amniocentesis with AFP measurement

MRI of the fetus

14. Recommended daily folic acid supplementation to reduce neural tube defect risk is:

0.4 mg

1 mg

4 mg

10 mg

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