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OB Anesthesia
| Question | Answer |
|---|---|
| T/F. Pregnancy causes a plasma volume increase up to 50% at term and RBC increase by 30% which causes delusional anemia | True |
| Cardiac Output increases 40% beginning the 5th week, uterus gets 10%, how much would this be in ml per min? | accepted 500-700 or 700-900 but she leaned towards 500-700. |
| DIC serum lab values: | <50,000 platlets or 50% decrease in platlets, fibrogen decrease, 40> fibrogen byproducts |
| By week 12 of pregnancy, PaCO2 decreased by 5-12 mmHG which equals: | Respiratory alkalosis compensated by the kidneys. Kidneys will excrete more bicarb, 16-21. |
| Respiratory changes that occur in pregnant mom: | She accepted both answers, I think: A. Increase in O2demand and decrease O2 delivery. D. Closing volume increases with normal tidal volumes. |
| What causes GI system to increase volume and slow motility? | Progesterone and gastrin |
| When does special airway considerations in pregnancy begin? | Beginning of the second trimester |
| When should non-emergent surgery occur for the pregnant woman? | Second or third trimester |
| When the placenta completely penetrates (through)the myometrium | placenta percreta |
| Late deceleration are | uniform |
| Early decelerations are | benigning |
| Local anesthetics in spinal/epidural in pregnant women | have smaller space, increase sensitivity, increases engorged veins. |
| T/F. LA have increased risk of LA toxicity due to venous engorgement, smaller space | True |
| Obese pregnant women do not have: A. GD B. Abnormal labor patterns. C. Shorten gestation. D. | C. Shorten gestation time |
| Switching from labor to C-section you have bupivacaine running, what should you switch to? | Lidocaine 2% at 5ml increments. |
| T/F. Succx is good cuz its almost completely ionized, does not cross the BBB readily. | True |
| You need to switch the gas up due to ( I cant remember) what out of these choice should you choose? | nitric oxide 75% and decrease sevo |
| Pregnant women have a decreased MAC due to: | Progesterone |
| Uterine blood flow is directly related to: | maternal arterial pressure |
| > 1MAC will______ uterine vasodilation: increase, decrease, nothing | Increase |
| Intrathecal fentanyl: A.doesn't cause fetal depression B. hardly if any cross placenta C. does not affect uterine blood flow D. All above | D. all are true |
| Uterine displacement | >15 degrees |
| Multiple gestations what could be causing hypotension? | Aorta compression |
| Increase risk of capillary engorgement causes airway issues: | increase in edema |
| These drugs are ok to administer just prior to spinal except: | cemetidine(ion trapping?) |
| Pregnant women can have these drugs except: A. Reglan B. Ranitidine C. Cemitidine D. | C. Cemetidine |
| Pregnant women can have this drug: A. Reglan B. Toradol C. Cemitidine D. | A. Reglan |
| What causes GI changes: | Progesterone and Gastrin |
| Obese pregnant women are increase risk for all except: A. Bleeding/hemorrhage B. Coagulapathy C. issues with fat necrosis/loss D. All the above | C. issues with necrosis/loss of fact |
| T/F. Fetal liver enzymes take longer to metabolize than MOM. | True |
| Which need cross matched? A. O neg B. platlets C. FFP D. cyropercpitate | FFP need cross matched |
| Which is wrong? | FRC doesn't increase in pregnant women |
| Drug of choice to use with aortic stenosis pts having low BP? | Neo |
| Which one is the worst for anesthesia when anesthesia causes a decrease in SVR? | aortic stenosis, |
| T/F. C-section requires a T-4 block and can cause hypotension | True |
| T/F. Placenta previa that requires removing remainder of placenta causes an increase in epidural or spinal or saddle block | True |
| Which drug should you induce with for a pregnant women with low BP? A. Propofol B. Versed. C. Ketamine D. Kool-aid | C. Ketamine 1mg/kg |
| Mag causes all these except: A. hypotonic B. Depression C. Hypertonic D. hyporeflexia | C. Hypertonic |
| When is Mag for preeclampsia is stopped after delivery? A. 6-8hrs B. Immediately. C. 24-48 hours. D. Switch to po and take for two weeks after delivery. | C. 24-48 hours after delivery |
| Which is not apart of HELLP syndrome? A. Hemolysis B. Elevated liver enzymes. C. low platlet count. D. Proturnia | D. Proteinuria |
| What are the usual symptoms of placenta preveria? A. painful vaginal bleeding B. HELLP syndrome C. painless vaginal bleeding at 32 wks gestation. D. RUQ pain and shoulder pain. | C. Painless vaginal bleeding at 32 weeks gestations |
| Risk of VBAC? | uterine rupture |
| Uterine rupture can see: A. hypertension and SVT B. severe abdominal pain C. Sinalod fetal pattern D. All the above. | B. severe abdominal pain |
| T/F. Uterine rupture can be masked by an epidural block for labor pain? | False |
| T/F. Preeclampesia may be due to thrombixan/prostaglin abnormalities? | True |
| Who is at risk for increase preterm labor, death, overweight pregnancies? | African Americans |
| T/F. Long term variability is 15 sec periods of 15 bpm increase in HR | True |
| Increase in _____ increases CO in pregnant person. A. Blood volume B. HR. C. SV D. | C. Stroke volume |
| When is CO highest in pregnancy? A. 1st Trimester B. 2nd trimester C. 3rd. D. postpartum | D. Postpartum |
| DIC causes are: A. amniotic embolism B. Abruto placenta C. Placenta previa with blood loss and mass transfusion. D. all above | D. All above. |
| PDPH are less likely with: A. needle point. B. Tuoley needle C. pencil point. D. bevel point | C. Pencil point. |
| T/F. Methergine can not be used IV | True |
| Pt with severe hemorrhage can have: A. Epidural B. Spinal C. RSI D. All the above | C. RSI |
| T/F. Spinal causes a sympathectomy due to decrease preload, decrease CO and decrease SVR | True |
| What is not true: A. ephedrine have better fetal outcomes than Neo B. Ephedrine can cause fetal acidosis C. Both Ephedrine or Neo can be used safely to tx low BP in Mom. D. Neo can be used to tx Mom | A. Ephedrine have better fetal outcomes than Neo. |
| How doe you treat aortaca compression? A. < 15 degress LUD. B. RUD C. >15 degree LUD D. supine | C. > 15 degree LUD |
| Need to get placenta out what can you use? A. spinal B.epidural c. nitroglycerin 100mcg D. | C. Nitroglycerin 100mcg |
| Mom has amniotic fluid embolism what is mom's mortality risk?: A. 30% B. 40% C. 45% D. >50% | D. > 50% |
| What causes an increase risk of placenta accerate? | placenta previa and hx of multiple c-sections |
| T/F. Twins should always be delivered C-section? | False |
| Baby's head is coming out first is called? A. oblique B. Transverse C. cephalad D. Complete | C. cephalad |
| T/F. Postpartum hemmorhage can cause myocardia ischemia? | True |
| Placenta abruto can be delivered vaginally if: A. mom stable. B. Baby stable C. no bleeding D. if all above true | D. If all above are true |
| Doesn't happen antepartum? A. placenta pervera B. uterine rupture C. abrupto placenta D. retained placenta | D. Retained placenta |
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