6-26-10 OB Mid Sess 1 Barry
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| How many kgs of weight gain does the parturient gain | show 🗑
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| show | 1 kg
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| show | 1 kg
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| How many kgs of weight gain does the interstitial fluid account for at term | show 🗑
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| How many kgs of weight gain does the blood volume account for at term | show 🗑
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| show | 4 kg
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| show | 4 kg
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| What major anatomical changes happen during pregnancy with: Pulmonary (4 things) | show 🗑
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| show | Biventricular hypertrophy, heart elevation and leftward rotation
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| What major anatomical changes happen during pregnancy with: Gastrointestinal (2 things) | show 🗑
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| What major anatomical changes happen during pregnancy with: Urogenital (4 things) | show 🗑
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| What major anatomical changes happen during pregnancy with: Circulatory (2 things) | show 🗑
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| T/F: As gestation continues onward from 12 weeks to delivery the following all increase - Alveolar ventilation, minute ventilation, tidal volume, and respiratory rate | show 🗑
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| What respiratory variables have decreased at a term pregnancy (10 of them)(slide 35) | show 🗑
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| show | to the Right
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| show | Slide says HYPO
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| show | UP = RR, TV, MV, DOWN = PaCO2, PaO2 (note: PaO2 rises during preg but decrease with labor)
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| What is a normal BiCarb level for 3rd trimester | show 🗑
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| show | (Sats < 90%)= 1st Obese, 2nd Child, 3rd Mod. ill, and last norm. adult
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| Maternal hyperventilation cause what fetal effects (4 of them) | show 🗑
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| show | Increased stroke volume in 1st 1/2 of pregnancy and increase in stroke volume and HR in 2nd 1/2 of pregnancy (actually SVR also decreases...so..CO = HR x SVR)
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| show | Decreases
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| show | Increase in prostacyclin, progesterone, low resistance pilacental circulation, and blood viscosity
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| What % of blood volume change occurs in pregnancy | show 🗑
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| How much (%) does the peripheral resistance, MAP, systolic, and and diastolic decrease by during pregnancy | show 🗑
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| How many mls of blood in non pregnant and pregnant | show 🗑
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| Since blood plasma increases by up to 50% and RBCs increases to 45 %, what is happening to the viscosity - what is that called | show 🗑
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| show | RBCs continue to increase while plasma starts to decrease
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| Hemaglobin concentration should remain above what % in mom | show 🗑
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| Since RBCs #s are increasing rapidly, are they microcytic or macrocytic | show 🗑
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| show | 500-1000 mls
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| Average mls blood loss for vaginal delivery | show 🗑
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| When in 2nd stage (lithotomy position) and contracting, what happens to CO and stroke volume | show 🗑
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| show | Since the heart move up and rotates left, the axis changes to the left (also non specific ST, T and Q wave changes and minor arrythmias
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| What are the two most common ectopies in pregnancy | show 🗑
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| What are the causes for PACs and PVCs (aka most common ectopies)in pregnancy (4 of them) | show 🗑
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| What is the most significant change that happens during pregnancy | show 🗑
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| show | Decrease by 25-50%
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| show | The vessle are compressed between the fetus and the bodies of the vertabraes
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| Name the 2 components of the phenomenon of "Aortocaval Compression" | show 🗑
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| The second component of "Aortocaval Compression" include (congradulations if "1st and 2nd Components" make sence to you) | show 🗑
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| Of a 30-60-90 degree triangle wedge jammed under mom to prevent aortocaval compression, which angle always touches the bed | show 🗑
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| What role does regional anesthesia have on aortocaval compression syndrome | show 🗑
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| show | Venous engorgement
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| show | XI and XIII (slide 66 says they ARE involved)
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| show | It is enhanced
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| Mendelson's Syndrome is also called | show 🗑
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| show | Witholding food during labor (holding on to fork and knife during contractions not wise), Greater use of regional anesthesia, Administration of antacids, Emptying of stomach prior to general anesthesia, competent general anesthesia administration
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| show | greater than 25 ml (or 0.4ml/kg) with pH less than 2.5 in the stomach at delivery (and stop calling me Shirley)
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| In 1980 when Roberts offered Shirley an antacid with particulates what was her responce | show 🗑
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| When do GI physiologic and anatomic changes start to take place in pregnancy | show 🗑
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| show | 1 1/2 months after delivery
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| show | Hold her with both hand and groan aloud, don't take her swimming, and don't push on her --Treat her like a full stomach
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| What are the two most important risk factor related to aspiration after 8 wks gestation | show 🗑
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| show | Giving narcotics (decreasing peristalsis)
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| show | Yes
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| Why can't an anatomical displaced, 8 wk gestational lower esophagus pass the CRNA board exam | show 🗑
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| show | They diminish them
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| Three agents for aspiration prophylaxis | show 🗑
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| Which of the following should not be utilized in the pregnant patient: RSI with criciod pressure, ETT beyond 8 wks gest., nasal intubation, gastric suctioning prior to emergence, awake extubations, or smaller ETTs | show 🗑
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| It happens in 80% of women by mid-pregnancy | show 🗑
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| show | Both increase 50% - causing higher albumin, protein, glucose and bicarbonate excretion
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| An increase in total body sodium and water are because of | show 🗑
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| In pregnancy, what starts and causes the renal problems | show 🗑
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| show | Increase
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| What happens to hepatic blood flow | show 🗑
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| What happens to plasma cholinesterase levels | show 🗑
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| What happens to colloid oncotic pressures | show 🗑
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| What happens to coagulation factors | show 🗑
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| What are a few drugs that may have a prolonged onset if hepatic problems | show 🗑
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| show | Progesterone
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| STAR!!!(IMPORTANT TEST QUESTION) What decreases epidural and subarachnoid spaces | show 🗑
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| What is associated with pregnancies - Big MACs or small MACs | show 🗑
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| What does the black shaded area represent on slide 85 | show 🗑
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| What does the MAC of inhalation agents, epidural doses, and spinal doses have in common regarding pregnancy | show 🗑
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| show | CNS Toxcity
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| show | 700ml/min
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| show | False
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| show | Can be arterial or venous or both
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| How much does a near term gravid uterus weigh | show 🗑
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| show | 500-800 ml/min
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| How much does a non-pregnant uterus weigh | show 🗑
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| How much blood flow does a nonpregnant uterus receive a minute (ml/min) | show 🗑
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| How many times more blood flow does a pregnant uterus receive over non-pregnant | show 🗑
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| show | Almost 20 times as much (1100g vs 70g)
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| The ovarian, uterine, and vaginal arteries all come from what artery | show 🗑
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| What artery does the ovarian artey directly branch off of | show 🗑
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| show | Uterine artery than hypogastric artery
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| In the "steal" phenomenon, what artery has a decrease blood flow in in turns increases the blood flow of the uterine and common iliac arteries | show 🗑
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| Factors that decrease uterine blood flow (5 of them) | show 🗑
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| show | Not in the pregnant uterus, but yes in the non-pregnant uterous (pregnancy releases a uterine artery vasodilator)
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| show | Estrogen produces the endothelium's ability to synthesize the vasodilator nitric oxide (this does not take place in the peripheral vessels)
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| A lower pH in the fetus after using ephedrine and not phenylephrin is because of | show 🗑
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| show | Amniotic cavity, Amnion, Placenta, Chorion, Uterine cavity,Lining of the uterus (endometrium), and Muscle layer of the uterine wall
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| show | Produces hormones to sustain pregnancy, protects the fetus from the maternal immune system, allows for active and passive transport of nutrients and metabolites
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| Name four types fo transport mechanisms through a membrane | show 🗑
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| Which of the following are important pharmacokinetics regarding fetal effects: Synergistic effects of drugs, level of fetal development at time of drug exposure, distribution in fetal tissue, duration of exposure to drug, rate crosses placenta | show 🗑
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| show | Lipid solubility, ionization, molecular weight, concentration gradient, surface area, membrane thickness, protein binding, injection related to contraction time and metabolism
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