Fetal assessment, prenatal screening and counselling — branching viva

Station opening

Examiner: "The cell-free DNA screen is positive for trisomy 21. What do you tell the patient?" ^[1]

Strong candidate (must-hit)

• A positive screen is not a confirmed diagnosis; it raises probability and warrants counselling and an offer of diagnostic testing. ^{[1] [16]}
• Names chorionic villus sampling or amniocentesis as diagnostic options, gated by gestation, with contemporary procedure-related risk. ^[11]
• Counsels non-directively, offers written information and time, and does not push a decision in the same breath as the result. ^[18]
• Names the next step and a named owner before the patient leaves. ^[18]

Weak candidate

• "Your baby has Down syndrome." ^[1]
• Quoting a high legacy procedure-related loss rate to deter diagnostic testing. ^[11]