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Anesthesiology > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

Maternal GFR and RBF

A

increases by 50%

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2
Q

Maternal BUN and Cr

A

decreases by 50%

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3
Q

Maternal MAC

A

decreases by 40%

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4
Q

Maternal PT, PTT

A

decrease by 20% (hyper coagulable)

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5
Q

Maternal Gastrin

A

increases 2/2 placental secretion, lowers pH and increases volume

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6
Q

Maternal Minute Ventilation

A

Increases by 50%

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7
Q

Maternal Functional Residual Capacity

A

Decreases by 20%

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8
Q

Maternal Tidal Volume

A

Increases by 40%

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9
Q

Maternal Respiratory Rate

A

Increases by 15%

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10
Q

Maternal 2,3 DPG

A

Increases to Offset Maternal Hyperventilation

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11
Q

Maternal P-50 for Hemoglobin

A

Increases from 27-30, to increase 02 delivery

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12
Q

In Pregnancy, Maternal AP Diameter of Chest

A

Increases, thoracic respiratory pattern is favored

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13
Q

Maternal Oxygen Consumption

A

Increases up to 50%

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14
Q

Maternal Blood Volume

A

Increases by 1000-1500ml

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15
Q

Maternal Total Blood Volume is xx/kg

A

90mL/Kg

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16
Q

Maternal Plasma Volume

A

Increases by MORE than blood volume causing anemia of pregnancy

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17
Q

Maternal Cardiac Output

A

Increases by 40%

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18
Q

Maternal Stroke Volume

A

Increases by 30%

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19
Q

Maternal Heart Rate

A

Increases by 20%

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20
Q

Maternal PA, PCWP, CVP

A

UNCHANGED!

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21
Q

Decreases in Cardiac Output when Supine can occur at xx weeks gestation

A

28 Weeks

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22
Q

Maternal Heart Rate

A

Increases by 20%

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23
Q

Maternal Blood Pressure

A

Decreases by 5-15% at 20 weeks, then returns to normal

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24
Q

Maternal dose requirements for Local Anesthetics

A

Decrease by 30%

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25
Q

Immediately Post Delivery, Cardiac Output

A

Increases by 80%

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26
Q

Maternal Plasma Proteins

A

Decrease

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27
Q

Maternal LFT’s

A

Increase

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28
Q

Early Decelerations

A

Head Compression

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29
Q

Late Decelerations

A

Placental Ischemia (Decrease in Pa02 at SA node)

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30
Q

Variable Decelerations

A

Cord Compression

31
Q

Concerning Variable Decelerations

A

greater than 60 beats/minute, lasts more than 60 seconds, concerning pattern for 30 minutes

32
Q

Sensory Level Needed for Labor

A

T10

33
Q

Sensory Level Needed for C/S

A

T4

34
Q

Criteria for Preeclampsia

A

Triad of 1. HTN 2. Proteinuria 3. Edema

35
Q

Criteria for Severe Preeclampsia

A

Sys > 160, Dias > 110, Proteinuria 5g

36
Q

Criteria for Eclampsia

A

Onset of seizures

37
Q

Treatment for Pregnancy Induced HTN

A

bed rest, sedation, antihtn (labetolol, hydrazine, methyldopa), magnesium sulfate

38
Q

Criteria for HELLP

A

HELLP is characterized by hemolysis on peripheral blood smear with serum lactate dehydrogenase >600 IU/L; serum aspartate aminotransferase >70 IU/L; and platelet count <100,000/μL. Can also look for fibrin breakdown i.e. D DIMER INCREASES!

39
Q

Preeclampsia affects what % of pregnancies

A

7-10%

40
Q

Risk Factors for Preeclampsia

A

Primagravida, Multiple Gestations, HTN, Diabetes, obesity, Family History, IVF

41
Q

Magnesium Sulfate Dosing

A

4g IV loading, followed by 1-3 g hr

42
Q

Maternal Calcium Channel Blockers

A

not used due to tocolytic action and potentiation of magnesium induced circulatory depression

43
Q

Placenta Previa

A

Placenta covers Internal Os

44
Q

Placenta Accreta

A

Placenta Adherent to Uterus

45
Q

Placenta Increta

A

Placenta Invading Muscle of Uterus

46
Q

Placenta Percreta

A

Placenta Invading Entirety of Uterus

47
Q

Painless Vaginal Bleeding in 2nd,3rd Trimester

A

Placenta Previa

48
Q

Risk factors for Placenta Previa

A

previous c section or myomectomy, multiparty, advanced maternal age, large placenta

49
Q

Highest Risk Subtype of Placentia Previa

A

Anterior Lying

50
Q

Painful Vaginal Bleeding

A

Abruptio Placentae

51
Q

Abruptio Placentae Risk Factors

A

HTN, trauma, short umbilical cord, multiparity, PPROM, etoh, cocaine, abnormal uterus

52
Q

Fibrinogen 150-250

A

Indicates moderate abruption

53
Q

Fibrinogen less than 150

A

IUFD

54
Q

Epidural Effect on Labor

A

Epidural causes slight increase in the duration of the second stage of labor. There is no evidence that this prolongation causes adverse effects in newborns.

55
Q

1st Stage of Labor

A

Cervical Dilation

56
Q

2nd Stage of Labor

A

Pushing

57
Q

3rd Stage of Labor

A

Placental Phase

58
Q

APGAR

A

Appearance, Pulse, Grimace, Activity, Respiration

59
Q

APGAR 3-4

A

Positive Pressure Ventilation

60
Q

APGAR 0-2

A

Immediate Intubation

61
Q

Indications for PPV after birth

A
  1. Apnea 2. Gasping 3. Persistent central cyanosis 4. HR less than 100
62
Q

Indications for Chest Compressions after birth

A

HR less than 60 BPM

63
Q

Normal APGAR

A

8

64
Q

Maternal Water Intoxication

A

Can be caused by Oxytocin

65
Q

Methergine, Carboprost (Hemabate) must be injected

A

IM, cause intense vasospasm

66
Q

NSAIDS have what effect on fetus

A

closure of fetal ductal constriction

67
Q

Anti-HTN safe for pregnancy

A

Labetolol, Hydralazine

68
Q

Tx for Magnesium Hypertoxicity

A

Calcium Chloride 0.5 g or Calcium Gluconate 1 g

69
Q

Passive Diffusion across placenta affected by what six factors

A
  1. Size 2. Lipid Solubility 3. pKa 4. Placental Efflux Transporter Proteins (ie P-glycoprotein 5. Binding Protein Type 6. Free drug fraction
70
Q

Placental Diffusion: High Lipophilicity

A

Increases Diffusion

71
Q

Placental Diffusion: High pKa

A

Decreases Diffusion

72
Q

Placental Diffusion: Albumin vs Alpha-1-acid glycoprotein

A

Albumin has a lower protein binding affinity and therefore relatively allows more diffusion

73
Q

Nitrous Oxide affect on Uterine Tone

A

None!

Anesthesiology (19 decks)

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