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A1 > APEX OB > Flashcards

APEX OB Flashcards

1
Q

What size ETT for pregnants?

A

6-7 d/t narrowed glottic opening

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2
Q

The ___ handle is best for women with large breasts

A

Datta

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3
Q

Airway edema is made worse by ______

A

Preeclampsia
Tocolytics (to prolong pregnancy)
Prolonged Tburg

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4
Q

What hormones cause vascular engorgement/ hyperemia?

A

Progesterone
Estrogen
Relaxin

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5
Q

Progesterone ____ NO release

A

Increases- this lowers SVR

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6
Q

We can prevent aortocaval compression by displacing the right torso ____ degrees

A

15-30

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7
Q

Pregnant patients are ____ sensitive to local anesthetics

A

MORE due to progesterone, which is also why MAC is decreased

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8
Q

IS UBF autoregulated?

A

NO
Map, CO, Uterine resistance

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9
Q

Causes of reduced UBF

A

Decreased perfusion- HOTN, hemorrhage, AO compressino
Increased resistance- Uterine contraction, HTN conditions

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10
Q

Best vasopressor for uterine perfusion?

A

Phenyl (although this is new data)
Levo is gaining traction
Ephedrine is classic teaching

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11
Q

What drug characteristics will favor placental transfer?

A

LMW (<500 Daltons)
Lipophillic
Non ionized
Non polar

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12
Q

What drugs will not transfer the placenta?

A

NMBs
Glycopyrrolate
Heparin
Insulin

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13
Q

Which drugs will pass thru the placenta?

A

LAs
IV anesthetics
Opioids
Benzos
Atropine
Beta blockers
Magnesium

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14
Q

UBF at term

A

700-900ml/min
10% CO

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15
Q

What do the stages of labor begin and end with?

A

1- Contractions/ beginning of cervical filation- 10cm dilation
2- Full dilation (perineal pain)- delivery of newborn
3- Delivery of newborn- delivery of placenta

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16
Q

NPO guidelines for laboring mothers

A

Drink a moderate amount of clear liquids throughout labor
Eat solid foods until a neuraxial block is placed

17
Q

Epidurals ____ prolong the first stage of labor

A

Do not

18
Q

Epidurals _____ increase the need for a C section

A

Do not

19
Q

___ may be needed to help labor progress

A

Oxytocin

20
Q

Latent vs active phases

A

Latent- Cervical dilation <3 cm
Active- Dilation >3cm until placental delivery
For clarification- 1st stage starts in latent and ends in active, 2nd and 3rd stages are in active phase

21
Q

Total neuraxial coverage requires a blockade from ____ to ____

A

T10-S4

21
Q

Uncontrolled pain can cause the blood pressure to ____, and thus ___

A

Rise, Reduce UBF

22
Q

Uncontrolled pain can cause maternal respirations to ____, causing ____

A

increase (hyperventilate)-> left shift- > (alkalosis)
Reduced delivery of O2 to the fetus

23
Q

Is N2O associated with hypoxia, loss of airway reflexes, uterine contractility, unconsciousness, or neonatal depression?

A

No, unless it is used with opioids

24
Q

Which LA antagonizes Mu and Kappa receptors in the spinal cord?

A

2-Chloroprocaine
This reduces the efficacy or epidural morphine

25
Q

Which LA crosses the placenta easiest?

A

Lidocaine!
So it is not used for continuous infusions
Also not popular in labor analgesia d/t strong motor block, but is good for C/S
High risk of neurotoxicity if given in the subarachnoid space

26
Q

When will you notice that an epidural is actually a spinal?

A

10-25 minutes
HOTN + respiratory arrest + LOC

27
Q

Treatment of inadvertant toal spinal after intended epidural

A

Pressors
IVF
Left uterine displacement
Leg elevation
Intubation

28
Q

Category 3 suggests a significant threat to fetal oxygenation, findings include ____

A

Bradycardia
Absent baseline variability
Recurrent late OR variable decels
Sinusoidal pattern

29
Q

Category 1 suggest no threat to fetal oxygenation, findings include ___

A

Baseline HR 110-160
Moderate variability
Early decels or accelerations
NO late or variable decels

30
Q

The incidence prematurity rises with

A

Multiple gestations and premature rupture of membranes

31
Q

Name 6 complications with premature delivery

A

Respiratory distress
hypoglycemia
hypocalcemia
NEC
Hyperbilirubinemia
Intraventricular hemorrhage

32
Q

Dont administer nifedipine with ___ for the risk of SM weakness

A

Magnesium

33
Q

What is methergine used for?

A

Uterotonic drug- increases contractility
It is NOT a tocolytic (uterine relaxant)

34
Q

When should oxytocin be administered during a C/S?

A

After delivery of the placenta

35
Q
A

A1 (125 decks)

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