OB

Question 1

What hormones contribute to vascular engorgement and hyperemia during pregnancy?

Answer 1

Progesterone
Estrogen
Relaxin

Question 2

The uterus receives __% of cardiac output

Answer 2

10

Question 3

How much does CO increase through the stages of labor?

Answer 3

1st stage= ^ 20%
2nd stage= ^ 50%
3rd stage= ^ 80%

Question 4

What causes decreased SVR/PVR in pregnancy?

Answer 4

Progesterone causes:
•increased nitric oxide -> vasodilation
• a decreased response to angiotensin & NE

Question 5

Answer 5

Question 6

Which stage of labor begins with the onset of perineal pain?

Answer 6

Second stage

Question 7

Answer 7

Question 8

Which local anesthetic reduces the efficacy of epidural morphine?

Answer 8

2-Chloroprocaine
(It antagonizes mu and kappa receptors in the spinal cord)

Question 9

Why is lidocaine not used for continuous epidural infusion?

Answer 9

Tachyphylaxis and I crossed the placenta to a greater degree

Question 10

Answer 10

Question 11

Answer 11

Question 12

Answer 12

Question 13

What medications should be given for prophylaxis against aspiration?

Answer 13

Sodium citrate
H2 receptor antagonist (ranitidine)
Gastrokinetic agent (metoclopramide)

Question 14

At what point are pregnant patients considered full stomachs?

Answer 14

18-20 weeks gestation

Question 15

When is the highest risk for teratogenicity in the pregnant patient?

Answer 15

Organogenesis (day 13-60)

Question 16

Answer 16

Question 17

A healthy placenta produces thromboxane Nd prostacyclin in equal amounts; what is the ratio produced in a or with preeclampsia?

Answer 17

7 x more thromboxane than prostacyclin

Question 18

The presence of _____ differentiates eclampsia from preeclampsia

Answer 18

Seizures

Question 19

What is the antidote for mag toxicity?

Answer 19

10mL of 10% calcium gluconate IV

Question 20

Answer 20

Question 21

What type of placental disorder is a/w painless vaginal bleeding?

Answer 21

Placenta previa

Question 22

6 risk factors for placental abruption

Answer 22

PIH
Preeclampsia
Chronic HTN
Cocaine abuse
Smoking
Excessive alcohol use

Question 23

Answer 23

Question 24

List 3 causes of DIC that occurs during labor and delivery

Answer 24

Amniotic fluid embolism
Placenta abruption
Intrauterine fetal demise

Question 25

List 4 risk factors of uterine atony

Answer 25

Multiparty Multiple gestations Polyhydramnios Prolonged oxytocin infusion before sx

Question 26

Answer 26

6

Question 27

Answer 27

Question 28

What is the normal SpO2 of the newborn immediately after delivery? How long before it reaches 90%?

Answer 28

60% 10 min

Question 29

Which analgesic technique is a/w the highest incidence of fetal bradycardia?

Answer 29

Paracervical block (especially with bupivacaine)