Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anes Final > OB Anes > Flashcards

OB Anes Flashcards

1
Q

Maternal changes

total blood volume

A

5% increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Maternal changes

HR

A

15 beats/min increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Maternal changes

CO

A

40% increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Maternal changes

SV

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Maternal changes

uterine blood flow

A

500 mL/min increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Maternal changes

SVR

A

15% decrease

SVR = systemic venous return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why does SVR decrease in pregnant women?

A

aortocaval compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which is the only CVA parameter that decreases in pregnancy?

A

SVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The enlarging uterus impinges on what vessels?

A

abdominal aorta and IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the ideal position of a pregnancy patient?

A

left lateral tilt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why is left lateral tilt the ideal position in pregnancy?

A

to prevent aortocaval compression producing supine hypotensive syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are two possible clinical implications of CVS changes in pregnant woman?

A

. possible decompensation of cardiac patients

. supine hypotensive syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

in hypotensive pregnant patient, what should be given and why?

A

glucose-free solutions

blood sugar increase results to insulin releases which crosses the placenta and the fetus will become hypoglycemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what fluid loading solution will be given to pregnant patients with hypotension?

A

D5LR, D10W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

maternal changes and why

02 consumption

A

20% increase (100% during labor)

increase metabolic rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

maternal changes and why

minute ventilation/FEV1

A

50% increase

increased TV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

maternal changes and why

arterial pCO2

A

decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

maternal changes and why

FRC

A

decreased (functional reserve capacity)

. decreased mechanically by enlarging uterus
. leads to decreased oxygen reserve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

maternal changes and why

airway mucosa

A

edema and venous engorgement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the importance of decreased FRC in pregnancy

A

oxygen comes from FRG in between breaths, so decrease could lead to hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

preoxygenation in pregnancy is (less/more) effective

A

preoxygenation in pregnancy is LESS effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

(slower/faster) intake of inhalation agents in pregnancy

A

FASTER intake of inhalation agents in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

(lower/higher) inhalation agent requirement in pregnancy

A

LOWER inhalation agent requirement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

(decrease/increase) of MAC 25 to (X) in pregnancy

A

DECREASE of MAC to 40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

(worse/better) Mallampati score in pregnancy

A

WORSE Mallampati score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

(lower/higher) incidence of difficult/failed intubation in pregnancy

A

HIGHER incidence of difficult/failed intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

need (smaller/larger) endotracheal tube

A

need SMALLER endotracheal tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

the higher the Mallampati score the (less/more) difficult to intubate

A

`the higher the Mallampati score the MORE difficult to intubate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

visualization of the soft palate, uvula, and pillars

Mallampati Class I
Class II
Class III
Class IV

A

Class I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

visualization of the soft palate and uvula

Mallampati Class I
Class II
Class III
Class IV

A

Class II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

visualization of the soft palate and the base of the uvula

Mallampati Class I
Class II
Class III
Class IV

A

Class III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

soft palate is not visible at all

Mallampati Class I
Class II
Class III
Class IV

A

Class IV`

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

in pregnancy, epidural veins are (narrowed/distended)

A

epidural veins are DISTENDED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is the importance of distended epidural veins in pregnancy

A

the drug is injected in the epidural space. the distended veins occupy a portion of the space, thereby lessening the drug delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

pregnant patients are given (less/more) spinal anesthesia. why?

A

pregnant patients are given LESS spinal anesthesia.

decreased CSF volume means there is faster onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

in pregnant patients (less/more) local anes is needed

A

in pregnant patients LESS local anes is needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

in pregnancy, (decreased/increased) gastric volume and acidity

A

DECREASED gastric volume and acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

in pregnancy, (shorter/longer) gastric emptying

A

SHORT gastric emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

4 clinical implications of GIT changes in pregnancy with anes

A

. gastric reflux/heartburn
. all are considered on “full stomach”
. increased risk of aspiration
. aspirational prophylaxis for CS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are the aspirational prophylaxis given for CS

A

. clear antacid

. h2 blocker or metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what is moa of metoclopramide as an aspirational prophylaxis

A

gastrokinetic which enhances the movement of the gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

the perineum is supplied by which nerve that originates from?

A

pudendal nerve which originates from S2 to S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is the anesthetic consideration in second stage delivery?

A

you have to increase the dose of the anesthetic because in addition to T10 to L1, you also have to block S2 to S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what are the nociceptive pathways involved in pain of childbirth?

A

. T10 to L1 during labor
. S2 to S4 for delivery (plus T10 to L1)
. T10 to S4 for short mothers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

psychological stress from pain can cause what (2) things?

What is the implication?

A

. increased levels of catecholamines
. hyperventilation

. both may result in decreased uterine blood flow leading to hypoxia and acidosis in the fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

factors affecting pain perception in labor (10)

A 
. mental prep
. family support
. medical support
. cultural expectations
. parity
. size and presentation of fetus
. maternal pelvic anatomy
. medications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

important consideration of opioid analgesics and sedatives in pregnancy

A

nearly all parenteral opioid analgesics and sedatives readily cross the placenta and can affect the fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

(hardly any/most) opioid analgesics and sedatives cross the placenta

A

MOST opioid analgesics and sedatives cross the placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

(regional/general) anesthesia is preferred for management of labor pain

A

REGIONAL anesthesia is preferred for management of labor pain

50
Q

what is the most versatile and most commonly employed anesthetic technique used during labor

A

continuous lumbar epidural anesthesia

51
Q

(single shot/continuous lumbar epidural anesthesia) allows better control over the sensory block level during labor

A

continuous lumbar epidural anesthesia allows better control over the sensory block level

52
Q

danger of lumbar epidural anesthesia

A

danger of having inadvertent intravasclar or intrathecal anesthesia in epidural anesthesia

53
Q

how is the risk of systemic toxicity in EA minimized in pregnancy?

A

by slowly administering dilute solutions for labor pain and by fractionating the total dose for CS into 5 ml increments

54
Q

what is the fractionated dosing of anes in CS?

A

5 ml per for a total of 15 ml

55
Q

what is done in during labor to significantly reduce drug requirement?

A

local anesthetic-opioid mixture

56
Q

what maybe be given to patients experiencing severe pain during labor?

A

combined spinal-epidural technique

57
Q

in combined spinal-epidural technique for labor, what is the purpose of each?

A

spinal - rapid onset

epidural - longer duration

58
Q

what is the advantage of SAB in labor?

A

more rapid, predictable onset, more dense block without the potential for serious systemic drug toxicity

59
Q

onset of spinal anes

A

5 min

60
Q

onset of epidural anes

A

15 min

61
Q

what is a common side effect of regional anesthesia in labor? how is it treated?

A

hypotention; treated aggressively with vasopressors, supplemental O2, left uterine displacement, and IV fluid boluses to prevent fetal compromise

62
Q

what vasopressor is used in regional anesthesia in labor?

A

ephedrine sulfate

63
Q

why is left uterine displacement done?

A

to prevent aortocaval compression and promote venus return

64
Q

what type of anes is preferred in CS? why?

A

spinal or epidural anesthesia because of their association to lower maternal mortality

65
Q

types of analgesia for labor and delivery (4)

A

non-pharmacological, parenteral, inhalational, regional

66
Q

non-pharmacological analgesics for delivery (7)

A 
. breathing exercises
. autohypnosis
. acupuncture
. white noise/music
. massage/walking
. TENS
. water bath
67
Q

3 major classes of parenteral analgesics for delivery

A

. narcotics
. sedatives/antianxiety
. ketamine

68
Q

narcotics used in delivery (5) - acronym

A

MeN FeM

. meperidine
. nalbuphine
. fentanyl
. morphine

69
Q

advantage and disadvantage of narcotics in labor

A

pro: relatively good analgesia
con: nausea, vomiting, sedation, neonatal depression, short duration of action

70
Q

sedatives/anti-anxiety used in labor (3) - acronym

A

BPH

. benzodiazepines
. promethazine
. hydroxyzine

71
Q

disadvantage of sedatives/anti-anxiety used in labor

A

respiratory depression

72
Q

4 considerations of ketamine in labor

A

. can increase HR (all other used are depressants)
. contraindicated for hypertensive
. sometimes given with benzodiazepine
. at large dose can produce hypertonic uterine contraction

73
Q

inhalation analgesics in pregnant pt

A

EIN

. enflurane 1%
. (low dose) isoflurane in oxygen 0.7%
. nitronox

74
Q

what is the preparation of nitronix in pregnant pt and why?

A

50:50 mixture of oxygen and nitrous oxide; NO can produce hypoxia so it’s combined with oxygen

75
Q

what is the advantage of inhalation analgesics?

A

. awake patient with protective laryngeal reflexes; even if they vomit will not aspirate

76
Q

overdose of inhalation analgesics indicated by

A

confusion, excitement, drowsiness

77
Q

what are the regional techniques of anesthesia

A

epidural, spinal, combined spinal-epidural

78
Q

6 advantages of regional tech in pregnant patient

A

. excellent pain control
. minimal impact on progress of labor with low doses (especially epidural)
. less drug transfer to fetus
. improved uterine blood flow
. decrease in birth trauma (use of forceps)
. minimal neonatal depression

79
Q

4 disadvantages of regional technique in pregnant patient

A

. invasive
. side effects
. nerve damage
. infection

80
Q

what are the side effects of regional anesthesia in pregnant patient

A

hypotension, headache, itching, nausea, urinary retention, limited mobility

81
Q

the uterovaginal plexus is also known as

A

frankenhauser plexus

82
Q

anesthesia to the frankenhauser plexes is also known as

A

paraservical block

83
Q

how is the paracervical bock done?

A

3 o’clock and 9 o’clock

84
Q

what is possible complication for paracervical block?

A

if artery is hit, it can cause retroperitoneal hematoma compromising blood flow which would produce acidosis in the baby

85
Q

maternal consideratons in anes

A

. altered physiology
. altered response to anesthesia and other drugs
. decrease in MAC
. increased sensitivity to neuraxial agents
. decreased plasma cholinesterase
. decreased protein binding (more free drug)

86
Q

(few/many) anesthetic agents are proven teratogens

A

none are

87
Q

what are some anesthetic agents deemed safe for use on pregnant patient

A

thiopental, morphone, meperidine, fentanyl, succinylcholine, NDMRs

88
Q

succinylcholine is a (depolarizing/nondepolarizing) muscle relaxant

A

succinylcholine is a DEPOLARIZING muscle relaxant

89
Q

question

A

answer

90
Q

6 considerations in anesthetic management in the prturient

A 
. Avoidance of hypoxemia
. Avoidance of hyotension
. Avoidance of acidosis
. Maintain PaCO2 in the normal range
. Minimize effects of aortocaval compression
. Prevent aspiration
91
Q

what is preffered anestheic technique for CS in pre-eclamptic patient? Why?

A

epidural is preferred since there is a grdual decrease in BP; SAB not contraindicated if you can manage the sudden drop in BP

92
Q

what is preffered anestheic technique for CS in patient with seizures? Why?

A

general anesthesia because you have to wait 15-30 min for epidural to take effect

93
Q

CS prep for anes

A

. Premeds (antacids: sodium nitrate)
. IV access and fluid bolus within 30 min of operating
. Left lateral tilt with wedge under righ pelvis
. Routine monitors: ECG, NOBP, pulse ox, fetal monitoring
. Monitor for GA: ETCO2, nerve stimulator, temp probe

94
Q

what premed is giving before anes for CS?

A

antacid: sodium nitrate

95
Q

what position is partruient patient placed in for CS?

A

left lateral tilt

96
Q

what are the routine monitors used in CS?

A

ECG, NIBP, pulse ox, fetal monitoring

97
Q

anesthetics techniques for CS

A

. Local infiltration by surgeon
. Regional anesthesia
. General anesthesia

98
Q

with local infiltration how must it be done?

A

via midline incision, gentle retrction, no exteriorization

99
Q

what is the technique of choice for uncomplicatred elective CS and many emergency CS?

A

regional spinal

100
Q

when is regional epidural anesthesia used in CS?

A

. When a slower onset is needed
. Used when already placed for labor analgesia
. Allows prolongation fo block should surgery be complicated

101
Q

potential complication of regional spinal anesthesia (12) in CS

A 
. Hypotension
. Headahce
. Backache
. Nausea, vomiting
. Urinary retention
. Neurological damage
. Anaphylaxis
. Hypotension
. Unintentional spinal injection
. Intrvascular injection of local anesthetic
. Neurological damage
. Infection
102
Q

when is regional combined spinal-epidural used in CS?

A

when the speed and density of a spinal anesthetic, with the flexibility of prolonging the block by supplemental increments of local anesthesia via the epidural cathertor is required

103
Q

indications for GA in CS

A

. Fetal distress during the second stage
. Tetanic uterine contractions
. Breech extraction
. Version and extraction
. Manual removal of a retained placenta
. Replacement of an interted uterus
. Psychiatric patients who became uncontrollable

104
Q

effects of GA on fetus

A

. Lower APGAR score at 1 minute but no difference at 5 minutes
. No significant alteration in neurobehavioral scores as compared to regional techniques

105
Q

how are the effects of GA on fetus minimized?

A

by limiting time between uterine incision and delivery to less than 3 minutes

106
Q

what is the anesthesia of choice in pegnancy-induced hypertension?

A

epidural anesthesia

107
Q

mitral valve disease

CS
regional anesthesia
general anesthesia

A

regional anesthesia

108
Q

aortic insufficiency

CS
regional anesthesia
general anesthesia

A

regional anesthesia

109
Q

congenital lesions with left to right shunting

CS
regional anesthesia
general anesthesia

A

regional anesthesia

110
Q

aortic stenosis

CS
regional anesthesia
general anesthesia

A

general anesthesia

111
Q

congenital lesions with right to left shunting

CS
regional anesthesia
general anesthesia

A

general anesthesia

112
Q

congenital lesions with right to bidirectional shunting

CS
regional anesthesia
general anesthesia

A

general anesthesia

113
Q

CS
regional anesthesia
general anesthesia

A

general anesthesia

114
Q

primary pulmonary hypertension

CS
regional anesthesia
general anesthesia

A

general anesthesia

115
Q

why is GA in preferred in obstetric patient with aortic stenosis?

A

the outflow of blood is low; regional anesthesia causes hypotension thereby aggrevating the condition

116
Q

CSF clue

subarachnoid block
epidural block

A

subarachnoid

117
Q

< 5 min onset

subarachnoid block
epidural block

A

subarachnoid

118
Q

2 to 4 ml

subarachnoid block
epidural block

A

subarachnoid

119
Q

LOR clue

subarachnoid block
epidural block

A

epidural

120
Q

HDM clue

subarachnoid block
epidural block

A

epidural

121
Q

3o min onset

subarachnoid block
epidural block

A

epidural

122
Q

15 to 20 ml

subarachnoid block
epidural block

A

epidural

Anes Final (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions