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OB S.Horvath > final review > Flashcards

final review Flashcards

1
Q

T/F Compensatory metabolic acidosis by excretion of bicarb maintains normal pH

A

True

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2
Q

how does vital capacity and TLC change in pregnancy

A

it doesnt

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3
Q

p50 of hb ____ from __ to ___

A

increases 27 to 30

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4
Q

dead space ___

A

decreases

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5
Q

airway resistance ___

A

decreases

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6
Q

Hyperventilation - alkalosis causes uterine ___ and ___ placental blood flow

A

vasoconstriction decreased

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7
Q

alkalosis will shift HgbO2 curve to the ___, ___ the release of O2 to the fetus

A

left, decrease

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8
Q

response to adrenergic drugs is ____, and plasma colloid osmotic pressure ___

A

blunted, declines

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9
Q

RBF and GFR are ____ by about ___ by 16th week, remains elevated until delivery

A

increased , 50%

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10
Q

BUN and Cr are ____

A

mildly reduced

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11
Q

T/F Mom has a decrease in pseudocholinesterase levels, but simultaneous increase in VOD counters any clinically significant prolongation of NMB with succs

A

TRUE

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12
Q

Fetal oxy-hemoglobi curve is ___ shifted and maternal is ___ shifted

A

left, right

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13
Q

transfer of CO2 occurs by

A

simple diffusion

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14
Q

first stage of labor

A

onset of true labor until complete cervical dilation

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15
Q

2nd stage of labor

A

time from complete dilation until infant delivered

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16
Q

third stage of labor

A

time from silvery of infant until placenta delivered

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17
Q

high serum LA levels can result in uterine ____

A

vasoconstriction

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18
Q

dermatomes for first stage of labor

A

T10-L1

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19
Q

dermatomes for second stage of labor

A

S2-S4

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20
Q

T/F Nearly all opioids cross the placenta and depress the fetus

A

TRUE

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21
Q

neonatal depression is unlikely if demerol is given….

A

less than 1h prior to delivery

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22
Q

whats the major side effect of IH

A

decreased uterine tone

23
Q

paracervical block is used for

A

first stage of labor

24
Q

pudendal block is used for

A

second stage of labor

25
Q

A1 acid glycoprotein = ___ affinity, ___ capacity

A

high, low

26
Q

albumin = ___ affinity, ____ capacity

A

low , high

27
Q

___ amounts of LA are required in mom, and ____ onset

A

smaller, faster

28
Q

what drugs for labor epidural

A

bupiv, ropiv, lido

29
Q

what drugs for operative epidural

A

lido, 2choloro

30
Q

what drugs for spinal

A

tetra, bupiv

31
Q

which drug isnt great for continuous infusion bc it has a lot of motor block

A

lidocaine

32
Q

which drug has a rapid onset, very short duration, lot of motor block, low risk of toxicity, very rapidly metabolized

A

2-cholor

33
Q

which drug has a long duration but less of a motor block

A

bupiv

34
Q

rank the drugs in terms of CV toxicity

A

ropiv < levobupiv < bupiv

35
Q

what spinal levels do you wanna cover

A

T10-S4

36
Q

in adults the spinal cord ends at

A

L1

37
Q

turns out most providers are actually ___ than they think

A

higher

38
Q

T/F Drugs delivered via spinal route are __x more potent and ____ needles are used

A

10x, smaller

39
Q

____ paCO2 and ____ lowers seizure threshold

A

increased acidosis

40
Q

acidosis decreases protein binding so you have _____

A

more free LA

41
Q

what type of drug is sodium citrate? why is it given? how long does it last?

A

antacid. raises gastric pH. lasts 15min.

42
Q

what type of drug is ranitidine? when is the max effect?

A

H2 blocker, usually used in addition to antacids as it does nothing for acid already there. 50mg IV dose. max effect seen 2h after admin.

43
Q

reglan effects may be inhibited by ___

A

opioids

44
Q

which drug is useful in the face of maternal hemorrhage, decreases risk of bronchospasm, but has side effects of htn and dysphoria

A

ketamine

45
Q

____ causes more neonatal depression than other agents

A

midazolam

46
Q

avoid block for ___ if therapeutic anti coagulated, avoid block for ___ if prophylactic anti-coagulated

A

24, 12

47
Q

for neruaxial block an LWMH - remove catheter at least __h after last dose, and dont administer LWMH until ___h after block is placed or catheter is removed

A

2-4

48
Q

epidural abscess - if an infection is present it takes ___days for sx (usually pain; loss of function) to occur. treatment (abx and lammy) have a ___hr window before permanent damage

A

4-10. 6-12

49
Q

where is the conus

A

T12-L3

50
Q

stop injecting for epidural blood patch when

A

patient says HA is gone or they have a pressure sensation in the ears

51
Q

causes of total spinal

A

migrated epidural cath, unrecognized dural puncture, SAB after failed epidural

52
Q

deficiency of protein C&S make a person ____coaguable

A

hyper

53
Q

T/F Hypotension d/t dec. afterload will reverse a left to R shunt, with resulting R to L shunting and cyanosis - beware SAB in these patients

A

true

OB S.Horvath (5 decks)

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