1. On Day 8, the trophoblast differentiates into two layers. What are these layers?

A. Epiblast and Hypoblast

B. Cytotrophoblast and Syncytiotrophoblast
C. Cytotrophoblast and Epiblast
D. Hypoblast and Syncytiotrophoblast

2. The amniotic cavity begins to form between which structures?

A. Cytotrophoblast and Syncytiotrophoblast
B. Embryoblast and Cytotrophoblast
C. Epiblast and Amnioblasts
D. Hypoblast and Epiblast

3. Which layer of cells forms the floor of the amniotic cavity?

A. Syncytiotrophoblast
B. Cytotrophoblast
C. Hypoblast
D. Epiblast

4. The bilaminar germ disc is composed of:

A. Epiblast and Cytotrophoblast
B. Epiblast and Hypoblast
C. Hypoblast and Syncytiotrophoblast
D. Cytotrophoblast and Syncytiotrophoblast

5. Which structure is first formed by the hypoblast?

A. Primitive streak
B. Primitive yolk sac
C. Amniotic cavity
D. Chorionic cavity

6. On Day 9, the exocoelomic membrane lines the blastocyst cavity, forming:

A. Secondary yolk sac
B. Chorionic cavity
C. Primitive yolk sac
D. Amniotic cavity

7. The penetration defect in the uterine lining is closed by:

A. Decidua basalis
B. Fibrin coagulum
C. Syncytiotrophoblast
D. Cytotrophoblast

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8. Maternal blood begins to flow into the trophoblastic lacunar system during:
A. Day 8
B. Day 9
C. Days 11–12
D. Day 14

9. The extraembryonic mesoderm splits into somatopleuric and splanchnopleuric layers

by:
A. Day 10
B. Day 12
C. Day 14
D. Day 8

10. The secondary yolk sac is formed from cells derived from:
A. Cytotrophoblast
B. Hypoblast
C. Epiblast
D. Syncytiotrophoblast

11. The primary chorionic villi are formed by:

A. Epiblast cells
B. Cytotrophoblast projections into syncytiotrophoblast
C. Hypoblast cells
D. Extraembryonic mesoderm

12. The chorionic cavity is synonymous with:

A. Gestational sac
B. Amniotic sac
C. Yolk sac
D. Primitive streak

13. The connecting stalk suspends the bilaminar embryonic disc in the:
A. Amniotic cavity
B. Chorionic cavity
C. Primitive yolk sac
D. Maternal endometrium

14. Primary chorionic villi appear by:

A. Day 10
B. Day 12
C. Day 13
D. Day 14

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15. The definitive chorion includes contributions from all EXCEPT:
A. Cytotrophoblast
B. Syncytiotrophoblast
C. Extraembryonic somatic mesoderm
D. Epiblast

16. High levels of hCG are produced by:

A. (A) Cytotrophoblast
B. (B) Syncytiotrophoblast
C. (C) Hypoblast
D. (D) Amnioblasts

17. Placenta previa is caused by the implantation of the blastocyst:

A. In the uterine fundus
B. Near the internal os of the cervix
C. In the ovary
D. In the abdominal cavity

18. Hydatidiform moles are characterized by:

A. High levels of hCG
B. Absence of trophoblast
C. Complete embryonic development
D. Reduced syncytiotrophoblast function

19. Genetic analysis of hydatidiform moles often shows a genome that is:
A. Diploid and maternal
B. Haploid and paternal
C. Diploid and paternal
D. Triploid and mixed

20. The leading cause of antepartum hemorrhage is:

A. Placenta previa
B. Hydatidiform mole
C. Ectopic pregnancy
D. Abnormal yolk sac development

21. Which structure gives rise to the earliest blood cells?

A. Epiblast
B. Yolk sac
C. Chorionic villi
D. Amnion

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22. The prochordal plate is the precursor of the:
A. Umbilical cord
B. Mouth
C. Heart
D. Anus
23. The syncytiotrophoblast plays an active role in:
A. Formation of the amniotic cavity
B. Implantation and invasion of the endometrium
C. Splitting the extraembryonic mesoderm
D. Differentiation of the bilaminar germ disc
24. The amniotic cavity develops:
A. Within the epiblast
B. Between the hypoblast and cytotrophoblast
C. Within the extraembryonic coelom
D. From the exocoelomic membrane
25. By the end of the second week, the embryonic disc consists of:
A. Ectoderm, mesoderm, and endoderm
B. Epiblast and hypoblast
C. Epiblast, mesoderm, and hypoblast
D. Epiblast only

26. What structure appears in the cephalic region and defines the buccopharyngeal
membrane?
A. Primitive streak
B. Prochordal plate
C. Notochord
D. Neural plate

27. By the end of week two, what significant hormonal activity begins in the
syncytiotrophoblast?
A. Progesterone production
B. Estrogen secretion
C. hCG production
D. Relaxin secretion

28. The extraembryonic coelom is another name for:

A. Chorionic cavity
B. Primitive yolk sac
C. Amniotic cavity
D. Connecting stalk

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29. What marks the transition of primary chorionic villi to secondary villi?
A. Penetration by cytotrophoblast
B. Invasion by extraembryonic mesoderm
C. Differentiation into tertiary structures
D. Formation of maternal blood sinusoids

30. The primitive yolk sac loses contact with remnants of which structure by day 14?
A. Chorionic cavity
B. Amniotic cavity
C. Primary yolk sac
D. Cytotrophoblast

31. What term describes the appearance of cavities in the extraembryonic mesoderm by
day 12?
A. Chorionic villi
B. Lacunar networks
C. Extraembryonic coelom
D. Decidualization

32. Which process ensures the establishment of uteroplacental circulation?

A. Formation of chorionic villi
B. Erosion of maternal capillaries by syncytiotrophoblast
C. Development of secondary yolk sac
D. Splitting of the extraembryonic mesoderm

33. What marks the transition of secondary to tertiary chorionic villi?

A. Development of blood vessels within mesoderm
B. Invasion of syncytiotrophoblast into endometrium
C. Differentiation of cytotrophoblast into syncytiotrophoblast
D. Formation of lacunae in extraembryonic mesoderm

34. By the end of the second week, the embryonic disc is suspended in the chorionic
cavity by:
A. Amnion\n
B. Yolk sac
C. Connecting stalk
D. Cytotrophoblast

35. The chorionic plate forms from which two layers?

A. Extraembryonic mesoderm and cytotrophoblast
B. Syncytiotrophoblast and amnion
C. Cytotrophoblast and hypoblast
D. Epiblast and mesoderm

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36. The primitive yolk sac is replaced by the secondary yolk sac by which process?
A. Proliferation of epiblast cells
B. Migration of hypoblast cells
C. Formation of the amniotic cavity
D. Erosion of maternal capillaries

37. Lacunar networks in the syncytiotrophoblast contribute to:

A. Amniotic fluid production
B. Uteroplacental circulation
C. Formation of the yolk sac
D. Differentiation of chorionic villi

38. Which of the following is NOT associated with abnormal blastocyst implantation?
A. Placenta previa
B. Hydatidiform mole
C. Formation of primary chorionic villi
D. Ectopic pregnancy

39. The hormone detectable by pregnancy tests during the second week is:
A. Progesterone
B. Human chorionic gonadotropin (hCG)
C. Estrogen
D. Relaxin

40. Abnormal blastocysts that form trophoblasts without embryoblasts result in:
A. Complete molar pregnancies
B. Partial molar pregnancies
C. Ectopic pregnancies
D. Anembryonic gestations

41. Placenta previa typically presents with:

A. First-trimester miscarriage
B. Late-term gestational diabetes
C. Antepartum hemorrhage
D. Preterm labor

42. Genetic analysis of hydatidiform moles shows:

A. Maternal-only genome
B. Paternal-only genome
C. Mixed genome
D. Triploidy with maternal dominance

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43. The connecting stalk eventually contributes to:
A. Umbilical cord
B. Placental tissue
C. Amniotic cavity
D. Yolk sac formation

44. Chorionic villi are categorized as tertiary when they:

A. Contain cytotrophoblasts only
B. Develop vascularized mesoderm
C. Protrude into maternal sinusoids
D. Differentiate into syncytiotrophoblasts

45. The amniotic cavity is lined by:

A. Epiblast cells
B. Cytotrophoblast cells
C. Amnioblasts
D. Hypoblast cells

46. Early uteroplacental circulation is established by:

A. Syncytiotrophoblast invasion of maternal capillaries
B. Formation of the chorionic cavity
C. Migration of hypoblast cells
D. Proliferation of cytotrophoblast cells

47. By Day 13, the primary yolk sac is replaced by the secondary yolk sac, which is
entirely lined by,
A. Endoderm
B. Mesoderm
C. Cytotrophoblast
D. Syncytiotrophoblast

48. What specific structure begins hormone production, including hCG, by the end of the
second week?
A. Epiblast
B. Hypoblast
C. Syncytiotrophoblast
D. Cytotrophoblast

49. The development of the amniotic cavity occurs within the

A. Cytotrophoblast layer
B. Epiblast layer
C. Hypoblast layer
D. Extraembryonic mesoderm

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50. The lacunae within the syncytiotrophoblast are significant because they
A. Form the basis of uteroplacental circulation
B. Develop into the yolk sac
C. Differentiate into the amniotic cavity
D. Secrete amniotic fluid

51. Hydatidiform moles are characterized by trophoblast proliferation and

A. Normal embryonic development
B. Absence of embryonic tissue
C. Reduced hCG levels
D. Formation of functional placenta

52. Placenta previa is a condition where the placenta

A. Attaches to the fundus of the uterus
B. Covers the internal cervical os
C. Develops abnormally within the chorionic cavity
D. Forms excessive lacunar networks

53. Early pregnancy loss is often associated with abnormalities in

A. Bilaminar germ disc
B. Chorionic villi
C. Syncytiotrophoblast function
D. Connecting stalk development

54. Genetic evidence suggests that hydatidiform moles arise primarily from
A. Fertilization with normal oocyte and sperm
B. Duplication of paternal chromosomes in an enucleated oocyte
C. Triploid contribution from both parents
D. Single maternal genome

55. The primitive yolk sac is a source of

A. Primordial germ cells
B. Syncytiotrophoblasts
C. Amnioblasts
D. Extraembryonic somatic mesoderm

56. What marks the completion of implantation into the endometrium?

A. Formation of the secondary yolk sac
B. Closure of the penetration defect by fibrin coagulum
C. Appearance of the connecting stalk
D. Development of primary chorionic villi

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57. Proliferation and migration of which cells contribute to the secondary yolk sac
formation?
A. Cytotrophoblast
B. Hypoblast
C. Epiblast
D. Syncytiotrophoblast

58. The prochordal plate appears by

A. Day 8
B. Day 10
C. Day 13
D. Day 15

59. The splanchnopleuric layer of the extraembryonic mesoderm is associated with

A. Amnion
B. Yolk sac
C. Chorionic cavity
D. Connecting stalk

60. Which structure gives rise to the buccopharyngeal membrane?

A. Primitive streak
B. Prochordal plate
C. Epiblast
D. Amnion

61. What marks the initial differentiation of the trophoblast into two layers?
A. Formation of the amniotic cavity
B. Appearance of lacunae in the syncytiotrophoblast
C. Invasion of maternal capillaries
D. Partial embedding of the blastocyst in the endometrium

62. The definitive yolk sac replaces the primitive yolk sac on approximately which day?
A. Day 8
B. Day 10
C. Day 12
D. Day 14

63. What is the key role of the cytotrophoblast in early embryonic development?
A. Hormone production
B. Structural support and villi formation
C. Formation of the amniotic cavity
D. Differentiation into the bilaminar disc

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64. The bilaminar germ disc lies between which two cavities?
A. Chorionic and yolk sac cavities
B. Amniotic and chorionic cavities
C. Amniotic and yolk sac cavities
D. Chorionic and exocoelomic cavities

65. By Day 12, maternal blood enters the lacunar system to establish
A. The fetal circulation
B. Uteroplacental circulation
C. The primitive streak
D. The prochordal plate

66. Abnormal implantation of the blastocyst can lead to all of the following EXCEPT
A. Placenta previa
B. Ectopic pregnancy
C. Hydatidiform mole
D. Premature placental abruption

67. Which hormone, produced by the syncytiotrophoblast, is critical for maintaining the
corpus luteum?
A. Progesterone
B. Human chorionic gonadotropin (hCG)
C. Estrogen
D. Relaxin

68. In placenta previa, the placenta develops near or over

A. The uterine fundus
B. The internal os of the cervix
C. The fallopian tube
D. The endometrium

69. Hydatidiform moles are often characterized by

A. High levels of estrogen
B. High levels of hCG
C. Absence of trophoblast tissue
D. Normal embryonic development

70. Genetic studies of complete molar pregnancies indicate that their genomes are
A. Maternal-only
B. Paternal-only
C. Mixed paternal and maternal
D. Triploid

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71. The connecting stalk later contributes to which structure?
A. Yolk sac
B. Umbilical cord
C. Chorionic villi
D. Placental barrier

72. What is the role of the somatopleuric mesoderm in development?

A. Lining the yolk sac
B. Supporting the chorionic villi
C. Forming the amniotic cavity
D. Nourishing the embryoblast

73. The definitive chorion consists of which of the following?

A. Cytotrophoblast, syncytiotrophoblast, and somatic mesoderm
B. Hypoblast, epiblast, and extraembryonic coelom
C. Extraembryonic mesoderm and endoderm
D. Epiblast and trophoblast layers

74. What is the primary function of the primary chorionic villi?

A. Gas exchange
B. Structural anchoring to the endometrium
C. Nutrient absorption
D. Establishing uteroplacental circulation

75. By the end of the second week, the syncytiotrophoblast begins producing which
hormone?
A. Progesterone
B. hCG
C. Estrogen
D. Relaxin

76. The primary role of the prochordal plate is to

A. Form the primitive streak
B. Establish the future mouth region
C. Develop the amniotic cavity
D. Differentiate into the neural tube

77. The chorionic cavity grows due to

A. Expansion of the extraembryonic coelom
B. Proliferation of hypoblast cells
C. Formation of the secondary yolk sac
D. Secretion of amniotic fluid

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78. Cavities in the extraembryonic mesoderm eventually coalesce to form
A. Amniotic cavity
B. Chorionic cavity
C. Lacunae
D. Yolk sac

79. The definitive yolk sac contributes primarily to

A. Early nutrient transfer
B. Formation of primordial germ cells
C. Gas exchange
D. Development of the amnion

80. The bilaminar germ disc becomes suspended in the chorionic cavity by the
A. Extraembryonic mesoderm
B. Amnioblasts
C. Connecting stalk
D. Cytotrophoblast layer

81. What distinguishes secondary chorionic villi from primary villi?

A. Presence of cytotrophoblasts
B. Invasion by maternal capillaries
C. Formation of vascularized mesoderm
D. Extension into the syncytium

82. The amniotic cavity expands due to

A. Secretion of fluid by amnioblasts
B. Proliferation of epiblast cells
C. Migration of cytotrophoblast cells
D. Absorption of maternal blood plasma

83. The prochordal plate is derived from which layer?

A. Hypoblast
B. Epiblast
C. Cytotrophoblast
D. Amnioblast

84. What is the main function of the lacunar networks in the syncytiotrophoblast?
A. Formation of the amniotic cavity
B. Exchange of gases and nutrients
C. Development of the secondary yolk sac
D. Formation of the prochordal plate

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85. The secondary yolk sac is lined entirely by
A. Epiblast
B. Hypoblast-derived endoderm
C. Extraembryonic mesoderm
D. Cytotrophoblast

86. The bilaminar embryonic disc consists of two layers separated by

A. Chorionic cavity
B. Amniotic cavity
C. Blastocyst cavity
D. No separation, it is a single structure

87. Which day marks the full embedding of the blastocyst into the endometrium?
A. Day 8
B. Day 10
C. Day 12
D. Day 14

88. The extraembryonic somatic mesoderm contributes to which structure?

A. Amnion
B. Yolk sac
C. Connecting stalk
D. Chorion

89. What is a key diagnostic feature of a hydatidiform mole?

A. Low hCG levels
B. High hCG levels
C. Presence of embryoblast tissue
D. Formation of functional chorionic villi

90. Placenta previa most often results in which complication during pregnancy?
A. Preterm labor
B. Gestational diabetes
C. Antepartum hemorrhage
D. Fetal growth restriction

91. Complete hydatidiform moles are most often genetically

A. Haploid
B. Diploid with paternal origin
C. Triploid with maternal dominance
D. Diploid with maternal origin

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92. Abnormal implantation in locations other than the uterine endometrium results in
A. Placenta previa
B. Ectopic pregnancy
C. Hydatidiform mole
D. Premature placental abruption

93. What is the fate of the connecting stalk as development progresses?

A. It becomes part of the yolk sac
B. It develops into the umbilical cord
C. It merges with the amniotic cavity
D. It fuses with the chorionic plate

94. The definitive yolk sac is essential for the development of

A. Amniotic fluid
B. Early blood cells and vessels
C. Primitive streak
D. Placental villi

95. The syncytiotrophoblast invades maternal tissue by

A. Producing hCG
B. Secreting enzymes to erode the endometrium
C. Proliferating into cytotrophoblast
D. Creating cavities for uteroplacental circulation

96. The chorionic cavity grows rapidly, pushing the embryonic disc to the
A. Center of the yolk sac
B. Side of the amniotic cavity
C. Periphery of the chorionic cavity
D. Center of the chorionic cavity

97. The primary function of the amnion during the second week is:
A. Gas exchange
B. Protection of the embryo
C. Hormone production
D. Nutrient absorption

98. Uteroplacental circulation begins with the erosion of which maternal structures?
A. Endometrial glands
B. Maternal sinusoids
C. Cytotrophoblast layers
D. Amniotic membranes

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99. Which structure produces the earliest recognizable sign of pregnancy?
A. Syncytiotrophoblast via hCG production
B. Amniotic cavity expansion
C. Formation of the yolk sac
D. Development of primary villi

100. The chorionic villi achieve tertiary status when they

A. Extend into maternal blood vessels
B. Form vascularized mesoderm
C. Differentiate from cytotrophoblast cells
D. Begin producing hCG

15