Hematology/Oncology and High Risk OB

Question 1

________ contain hemoglobin and have the ability to carry oxygen.

Answer 1

Erythrocytes

Question 2

What is the purpose of fibrinolysis?

Answer 2

to dissolve clots as vascular injury is repaired

Question 3

T/F: You would expect to see an increased bleeding time in a patient with disseminated intravascular coagulation (DIC).

Answer 3

True

Question 4

T/F: Your patient is in acute septic shock. You would expect her platelet count to be elevated.

Answer 4

False, you would expect her platelet count to be diminished.

Question 5

The international normalized ratio (INR) is used to test patient response to what medication?

Answer 5

blood thinners (i.e. Coumadin)

Question 6

What is the reversal agent (antidote) for a heparin overdose?

Answer 6

Protamine sulfate

Question 7

Fresh frozen plasma would be the best product for which of the following?

a) A patient who is on warfarin and actively bleeding, or requires immediate surgery
b) A patient with hemophilia A
c) A patient with thombocytopenia
d) A patient in hemorrhagic shock

Answer 7

a) A patient who is on warfarin and actively bleeding, or requires immediate surgery

Question 8

T/F: Fresh frozen plasma contains platlets.

Answer 8

False

Question 9

T/F: Cryoprecipitate requires ABO matching before administration for all patients.

Answer 9

False

Question 10

What blood product is typically used for patients having an acute sickle cell crisis?

Answer 10

Packed red blood cells

Question 11

T/F: Disseminated intravascular coagulation (DIC) is a life-threatening combination of clotting at the microscopic level as well as free bleeding at the systemic level.

Answer 11

True

Question 12

T/F: Your patient is in DIC. You would expect this patient’s platelet count to be low.

Answer 12

True

Question 13

Treatment for DIC can vary between giving blood components or low-dose heparin. Which of the following statements is true regarding DIC treatment?

a) All patients in DIC should be given concurrent whole blood to replace lost blood.
b) Patients in DIC will all be given platelets and cryoprecipitate.
c) The decision to give either blood components or heparin depends on whether bleeding predominates, or fibrin deposits predominates.
d) Patients in DIC are rarely given heparin because heparin will accelerate free bleeding.

Answer 13

c) The decision to give either blood components or heparin depends on whether bleeding predominates, or fibrin deposits predominates.

Question 14

What is the most common genetic bleeding disorder?

Answer 14

von Williebrand’s disease

Question 15

Cardiac output usually increases by ___% during pregnancy and increases even higher during labor.

Answer 15

40

Question 16

T/F: Hypotension develops more readily and more markedly following sympathetic blockage in pregnant patients due to vascular tone being more dependent on sympathetic control.

Answer 16

True

Question 17

T/F: Maternal blood glucose is always relatively high (140 - 180 mg/dl) to supply glucose to the growing fetus

Answer 17

False

Question 18

Preterm labor is defined as regular uterine contractions prior to week ____ that are sufficient frequency and intensity to effect effacement and dilation of the cervix.

Answer 18

37

Question 19

What is the mechanism of action of magnesium sulfate?

Answer 19

The exact mechanism of action is unknown

Question 20

What is the reversal agent (antidote) for magnesium sulfate toxicity?

Answer 20

Calcium gluconate

Question 21

Your patient is a 28-week gestation, who develops sudden painless, bright red bleeding that occurred without warning. What should you suspect?

Answer 21

Placenta previa

Question 22

T/F: Your patient has placenta abruption. This patient would typically present with an increased hemoglobin and hematocrit as her body attempts to compensate for the hemorrhage.

Answer 22

False, this patient would have a diminished hemoglobin and hematocrit

Question 23

What position is most appropriate for a patient with a suspected uterine prolapse?

Answer 23

knee-chest position

Question 24

T/F: Once a preeclamptic patient has any signs or symptoms, it becomes severe preeclampsia.

Answer 24

True

Question 25

T/F: Eclampsia does not require seizure activity to make the definitive diagnosis.

Answer 25

False

Question 26

T/F: There is a well-defined correlation between progressive blood pressure elevation and prediction of preeclampsia.

Answer 26

False

Question 27

You have just delivered a baby, and now you are waiting for the placenta to deliver. What stage of labor is this?

Answer 27

3rd stage

Question 28

Which of the following statements regarding PEEP and neonatal resuscitation is correct?

a) PEEP should never be used in neonates as it may cause a pneumothorax
b) Initial lung recruitment may require initially high PEEP to expand the lungs
c) PEEP can only be used in neonates after the initial resuscitation phase
d) PEEP can only be used in neonates as a last resort (i.e. cardiac arrest)

Answer 28

b) Initial lung recruitment may require initially high PEEP to expand the lungs

Question 29

What is the typical range for respiratory rate of a neonate?

Answer 29

40 - 60 breaths per minute

Question 30

T/F: Intubation in any 3rd trimester patient should always be considered a difficult airway because of the failure rate of intubation in these patients.

Answer 30

True

Question 31

T/F: Pregnancy requires an increased amount of sedation and anesthesia to achieve a therapeutic level.

Answer 31

False, pregnant patients typically require a reduced amount of sedation and anesthesia

Question 32

When doing fluid resuscitation of a patient in maternal shock, is it preferred to have massive crystalloid infusion or early blood transfusion?

Answer 32

Early blood transfusion is preferable to massive crystalloid infusion

Question 33

What does the mnemonic “STABLE” stand for in regards to fetal-maternal hemorrhage?

Answer 33

Stay calm
Triage
Assess
Baby
Launch
Evaluate & Evacuate

Question 34

What is the most significant potential side effect of magnesium sulfate administration?

Answer 34

Respiratory depression