Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Anesthesia > OB anesthesia > Flashcards

OB anesthesia Flashcards

0
Q

Deceleration

A

Early: head compression w/ Vagal stimulation
Late: fetal hypoxemia w/ Vagal stimulation or myocardial failure
Variable: umbilical cord compression w/ Vagal stimulation

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

Causes of fetal bradycardia

A
  1. Hypoxemia
  2. Acidosis
  3. Complete heart block
  4. Drugs: neostigmine+glycopyrrolate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Fetal tachycardia

A 
Infection
Fever
Maternal smoking
Fetal SVT
Drugs: ritodrine, terbutaline, atropine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cerebral palsy: etiology of CP occurs most frequently

A

Antepartum

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

Pregnancy diabetes

A

Type I: 1 of 700-1000

Gestational: 2-5% pregnancies

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

PDPH

A

Positional
Bilateral
N/v
Neckstiffness
Ocular (photophobia, diploma, difficulty in accommodation)
Auditory( hearing loss, hype racists, tinnitus)

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

Shivering in normal delivering

A

Epidural: sufentamol 50 mcg, fentanyl 100mcg, or meperidine 25 mg / LA
Warming iv fluids——can decrease rate

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

Normal values from umbilical cord blood

A

ph/ Pco2/ PO2/ bicar (mEq/L)
Arterial: 7.25/50/20/22
Venous: 7.35/40/30/20

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

Severely depressed 3 kg term newborn

A

Clearing airway, drying and stimulating. If apneic, positive pressure ventilation (40 to 60 bpm) x 30 s, if HR<60, CPR: 1:3 breath: compression x 30s, if not improving, epi: 0.1 to 0.3 ml/kg of 1:10,000 solution. (ETT: 0.3 to 1ml/kg).
If need volum: 10ml/kg over 5-10 min, can repeat. If anemia: o- pRBC. If narcotic-induced, naloxone 0.1 mg/kg iv or im. If severe metabolic acidosis, but adequate ventilation, bicar: 2 mEq/kg, slow

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

NO naloxone

A

Newborn if mom addicted to narc, or on methadone maintenance,

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

PIH (pregnancy-induced HTN)

A

High: <20yo, twins, DM I, polyhydramnios, hydatidiform mole, high BMI
Low: smoking

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

Aortocaval syndrome

A

Vena cava: Hypotention, n/v, pallor, changes in cerebration

Aorta: decrease UBF

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

Cocaine abusing pregnant pt

A 
Urine + 24 to 72 hrs
Life threatening: GA>RA
Induction of GA: HTN
MAC: increase in acute; decrease in chronic
RA: risk of Hypotention
Ephedrine: not effective d/t depletion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Infiltration anesthesia

A

Emergency c/s, contra to GA &RA

LA: 100ml, 0.5% lidocaine or ?% chloroprocaine (NOT Bupivacaine)

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

Hypotention post SA or EA in pregnant pt

A
  1. LUD (left uterine displacement)
  2. Fluid
  3. Vasopressors: phenylephrine > ephedrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Threatened abortion

A

Uterine bleating w/o cervical dilation before 20 weeks gestation

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

Inevitable abortion

A

Cervical dilation &/or ROM

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

Incomplete abortion

A

Partial expulsion of tissue

Need D&E

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

Epidural narcotics is antagonized by prior or concomitant ?

A

Chloroprocaine

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

Marcaine = sensorcaine = ?

A

Bupivacaine

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

Chirocaine

A

Levobupivacaine

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

Naropin

A

Ropivacaine

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

TNS (transient neurologic syndrome)

A 
SA w/ lidocaine ( xylocaine )
Back pain radiating to buttocks & legs
Post block resolve
No motor or sensory loss or EMG change
Resolve w/i 1 to 4 day typically
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Prilocaine = citanest

A

Methemoglobinemia

24
LMWH
Low dose: >12 hrs waiting for neuraxial techniques; High fose: >24 hrs If back pain + unexpecred neurologic paralysis-->work for hematoma.
25
Chloroprocaine
Nesacaine Ester-hydrolyzed by pseudocholinesterase T1/2: 21 sec in maternal, 43 sec in fetal blood in homozygous atypical cholinesterase: t1/2 = 2 min
26
Horner's syndrome post epidural Anesthesia
occasionally development even highest dermatome below T5
27
preeclampsia
SBP>140 or DPB>90 plus proteinuria >300 mg /24 hr. Usually >24 wks, unless hydatidiform mole 5-9% of pregancies Higher: hydatidiform mole, multiple gestations, obesity, polyhydramnios or DM If 1st pregancy w/ -->33% in subsequent pregnancies Before EA: check Plt
28
Mg
``` 1.5-2 mEq/L: Normal level 4 to 8 mEq/L: Therapeutic range 10 mEq/L: loss deep tendon reflexes 15 mEq/L: respiratory paralysis >25 mEq/L: cardiac arrest Note: 1 mEq/L = 1.2 mg/dl. decrease release of Ach and sensitivity of motor endplate to ACh; Antagonist aplpha-adrenergic effect, antagonize NMDA receptor. ```
29
normal FHR
120-160
30
Leading direct cause of pregnancy related deaths in US
hypertensive disorders of pregancy
31
side-effects of methylergonovine and hemabate
methylergonovine: HTN, bronchospasm (rarely) | hemabate (carboprost): bronchospasm
32
P50 of Fetal hemoglobin at term
19-21 mmHg (note: in adult 27 mmHg)
33
Side effects of beta-agonists (ritodrine, terbutaline)
tachycardia, hypOtension, myocardial ischemia, pulmonary edema, hypoxemia (inhibitiion of hypoxic pulmonary vasoconstriction), hyperglycemia, metabolic (lactic) acidosis, hypokalemia, anxiety, nervousness.
34
CO
``` 1st trimester: increase to 30 to 40% At term: 50% Latent phase: another 10 to 15% Active phase: 25 to 30% Expulsive stage: 40 to 45% Immediately after delivery: greatest increase (autotransfusion and increased venous return d/t uterine involution). 2 wks: back to nonpregnant value. ```
35
GA induction in Emergent C/S
RSI: sevo not good for induction, versed too slow for induction, for mild asthma: ketamine, thiopental or propofol, but thiopental not for severe asthma (d/t release histamine). Ketamine not good for HTN.
36
asthma for GETA
adequate GA before ETT
37
UBF at term pregancy
700 to 900ml/min (i.e., >1 U blood /min) | 50 to 100 ml/min before pregnancy
38
HIV infected parturient
1. EA, SA, CSE or blood patch: safe 2. vertical transmission: untreated-->15 to 40%; treat + C/S-->2% 3. Needlestick-->develop HIV 0.3% (HBV 30%, HCV 2 to 4 %). 5. protease inhibitor--->(-)cytochrome P-450 --> prolong benzodiazepines and narcotics.
39
At term
1. No change: CVP, PCWP, PADP, LVESV 2. Increase: LVEDV, SV, EF, HR, CO 3. Decrease: SVR
40
AFE (amniotic fluid embolism)
1. acute hypoxemia: pulmonary edema, cyanosis 2. hemodynamic collapse: severe hypotension, cardiopulmonary arrest 3. coagulopathy
41
Fetus: most susceptible to teratogenic agents
15 th to 56 th days (3 to 8 wks) of gestation <---organogenesis
42
New born respiratory depression from chronic narcotic mother
controlled ventilation, but NOT naloxone <---acute withdrawal
43
Respiratory in pregnancy
1. Increase: MV, Vt, PaO2 (d/t fall in PaCO2), O2 consumption 2. decrease: serum bicarb.
44
Uterine
1. Bartiturates: dose-dependent reduction in contraction 2. Diazepam & N2O: no effect 3. Ketamine: oxytocic during 2nd trimester, but NO at term 4. LA: IV increase in tone, at high level--->tetanic
45
Normal term fetus
1. approx. 3 kg 2. O2 consumption: 7 ml/kg/min-->21 ml/min 3. O2 store: 42ml-->but d/t compensatory-->survive 10 min
46
Parturient-->GA for no-obstetric surgery
1. maternal safety 2. avoid teratogenic: current anesthetic drugs OK 3. avoid fetal asphyxia 4. prevent induction of preterm labor: abd surgery
47
MG (masthenia gravis)
1. IgG vs ACh-R: only on skeletal muscle | 2. Newborns: 10 to 20% affected maternal IgG metabolized.
48
DIC
``` placental abruption: MCC dead fetus syndrome AFE G- sepsis severe pregnancy-induced hypertension Note: not placenta previa<--bleeding not induce coagulopathy. ```
50
Eisenmenger's syndrome-->epi in SA?
1. Avoid increase PVR: hypercabia, acidosis, hypoxia 2. Avoid decrease SVR: 3. Narcotic-based analgesic: spinal or epidural 4. CVP, A-line, evaluate shunt 5. Caution with central LA: decrease pre and after load 6. Avoid epi in EA or SA: decrease SVR or increase PVR.
51
h/o c/s + current placenta previa
increase risk of placenta accrete--->emergency cesarean hysterectomy
52
Neonatal brain damage
MC injury in ASA-closed claim project regarding OB anesthesia claims
53
epidural morphine
slow onset (30 to 60 mim @7.5 mg); pruritus, N/V, drowsiness--->not routinely for labor epidural
54
meconium-stained amniotic fluid
if vigorous (i.e., strong respiratory efforts, good muscle tone, HR>100)---->not treatment.
55
Difficult airway + hypovolemic--->emergent C/S
infiltration local anesthetic
56
Epinephrine in local anesthetics
1. check for IV placement of epidural cath 2. decrease vascular uptake of LA 3. increase intensity and duration of block Note: more lipid-soluble the LA, more less effect
57
LA + narcotic effets
meperidine
58
diazepam
Not used in 1st trimester d/t unproven side effect on fetus
59
I.t. opiates (morphine, fentanyl or sufentanil)
1. very effective in relieving visceral pain in 1st stage | 2. inadequate for 2nd stage.

Anesthesia (11 decks)

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