Nerual Tube Defects and alpha-fetoprotein

[nowai]

So I know that levels alpha-fetoprotein is raised in neural tube defects but I was wondering if this was the case for Spina Bifida Occulta as well. I always thought so but Kaplan neuro specifically says alpha-fetoprotein is up for meningocelem, meningomylocele, and myeloschisis but not for spina bifida occulta.

---

Members don't see this ad.

 

[45408]

I wouldn't think so, because the neural tissue isn't exposed to the amniotic fluid, so no AFP is released into the amniotic fluid. Could be barking up the wrong tree though.

 

[RxnMan]

I wouldn't think so, because the neural tissue isn't exposed to the amniotic fluid, so no AFP is released into the amniotic fluid. Could be barking up the wrong tree though.

+1

The concept I remember is that the tube has to be open (AFP being fetal albumin) for it to leak out. Check the Merck Manual for more. Kinda like low and high levels of beta hCG.

 

[nowai]

Thanks guys, I missed that the dura wasn't broken in occulta *rubs eyes*.

 

[Tiger26]

It's also raised due to underestimation of fetal age, something we're apparently supposed to know as newly finished M2s according to UW . . .

 

[45408]

It's also raised due to underestimation of fetal age, something we're apparently supposed to know as newly finished M2s according to UW . . .

holding a grudge there, are we?

 

[Tiger26]

holding a grudge there, are we?

We have to draw the line somewhere . . . if there's no restraint, I envision a step 1 where we'd have to do intubations on a simulator, try and juggle 15 different medications in the multi-diseased pt, or have practice depositions where you've got to say to right things to prevent getting sued.

I for one will not stand for this unwarranted expansion of step 1 required knowledge. It should be based on M1/M2 years and on the facts, just the facts.

 

[osli]

We have to draw the line somewhere . . . if there's no restraint, I envision a step 1 where we'd have to do intubations on a simulator, try and juggle 15 different medications in the multi-diseased pt, or have practice depositions where you've got to say to right things to prevent getting sued.

I for one will not stand for this unwarranted expansion of step 1 required knowledge. It should be based on M1/M2 years and on the facts, just the facts.

I think this just highlights the differences between medical schools. At ours, they pounded into our heads the importance of having an accurate estimate of gestational age for interpreting all serum or amniotic fluid markers. An error in that estimate is apparently the most common reason for a seemingly abnormal test result, and that applies to both AFP and HCG. I think we had at least three different questions concerning that concept during the course of our OB section.

And then there are times where I see something in UW and think WTF? only to come to SDN and realize that it must be common knowledge at all other medical schools.

 

[RxnMan]

I think this just highlights the differences between medical schools...

See, In my school, the only reason I know about either is because I've been studying Goljan + FA on the side, not from my class notes.

The faculty said have something about having to learn "how to be doctors," and not "teaching to an exam." If we can't pass this exam, then we won't get to be doctors, no matter how pefect our "real doctor" knowledge is.

...And then there are times where I see something in UW and think WTF? only to come to SDN and realize that it must be common knowledge at all other medical schools.

Amen. What the heck is with all of these crazy questions that I feel proud for getting right, only to see 70% of you guys out there got it right?

 

[Rogue Synapse]

I missed one the other day for which UW said "81% of people answered this question correctly." It was a drug I had never even remotely heard of, but is apparently the first drug everyone at other med schools learns. I mean seriously, even the real basic diuretics/beta blockers questions have ~60-70% right, and this one was just almost unanimous. I wish I could remember when drug it was...

 

[osli]

I miss plenty of questions that are 70-80% averages... mostly because I've been focusing on details that I'm weak in and haven't reviewed the bulk of stuff that I know "pretty well but have forgotten some details" like basic anatomy and such. Guess it's about time to get started on that.