Obstetrics

Question 1

Maternal GFR and RBF

Answer 1

increases by 50%

Question 2

Maternal BUN and Cr

Answer 2

decreases by 50%

Question 3

Maternal MAC

Answer 3

decreases by 40%

Question 4

Maternal PT, PTT

Answer 4

decrease by 20% (hyper coagulable)

Question 5

Maternal Gastrin

Answer 5

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

Question 6

Maternal Minute Ventilation

Answer 6

Increases by 50%

Question 7

Maternal Functional Residual Capacity

Answer 7

Decreases by 20%

Question 8

Maternal Tidal Volume

Answer 8

Increases by 40%

Question 9

Maternal Respiratory Rate

Answer 9

Increases by 15%

Question 10

Maternal 2,3 DPG

Answer 10

Increases to Offset Maternal Hyperventilation

Question 11

Maternal P-50 for Hemoglobin

Answer 11

Increases from 27-30, to increase 02 delivery

Question 12

In Pregnancy, Maternal AP Diameter of Chest

Answer 12

Increases, thoracic respiratory pattern is favored

Question 13

Maternal Oxygen Consumption

Answer 13

Increases up to 50%

Question 14

Maternal Blood Volume

Answer 14

Increases by 1000-1500ml

Question 15

Maternal Total Blood Volume is xx/kg

Answer 15

90mL/Kg

Question 16

Maternal Plasma Volume

Answer 16

Increases by MORE than blood volume causing anemia of pregnancy

Question 17

Maternal Cardiac Output

Answer 17

Increases by 40%

Question 18

Maternal Stroke Volume

Answer 18

Increases by 30%

Question 19

Maternal Heart Rate

Answer 19

Increases by 20%

Question 20

Maternal PA, PCWP, CVP

Answer 20

UNCHANGED!

Question 21

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

Answer 21

28 Weeks

Question 22

Maternal Heart Rate

Answer 22

Increases by 20%

Question 23

Maternal Blood Pressure

Answer 23

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

Question 24

Maternal dose requirements for Local Anesthetics

Answer 24

Decrease by 30%

Question 25

Immediately Post Delivery, Cardiac Output

Answer 25

Increases by 80%

Question 26

Maternal Plasma Proteins

Answer 26

Decrease

Question 27

Maternal LFT's

Answer 27

Increase

Question 28

Early Decelerations

Answer 28

Head Compression

Question 29

Late Decelerations

Answer 29

Placental Ischemia (Decrease in Pa02 at SA node)

Question 30

Variable Decelerations

Answer 30

Cord Compression

Question 31

Concerning Variable Decelerations

Answer 31

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

Question 32

Sensory Level Needed for Labor

Answer 32

T10

Question 33

Sensory Level Needed for C/S

Answer 33

T4

Question 34

Criteria for Preeclampsia

Answer 34

Triad of 1. HTN 2. Proteinuria 3. Edema

Question 35

Criteria for Severe Preeclampsia

Answer 35

Sys > 160, Dias > 110, Proteinuria 5g

Question 36

Criteria for Eclampsia

Answer 36

Onset of seizures

Question 37

Treatment for Pregnancy Induced HTN

Answer 37

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

Question 38

Criteria for HELLP

Answer 38

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!

Question 39

Preeclampsia affects what % of pregnancies

Answer 39

7-10%

Question 40

Risk Factors for Preeclampsia

Answer 40

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

Question 41

Magnesium Sulfate Dosing

Answer 41

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

Question 42

Maternal Calcium Channel Blockers

Answer 42

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

Question 43

Placenta Previa

Answer 43

Placenta covers Internal Os

Question 44

Placenta Accreta

Answer 44

Placenta Adherent to Uterus

Question 45

Placenta Increta

Answer 45

Placenta Invading Muscle of Uterus

Question 46

Placenta Percreta

Answer 46

Placenta Invading Entirety of Uterus

Question 47

Painless Vaginal Bleeding in 2nd,3rd Trimester

Answer 47

Placenta Previa

Question 48

Risk factors for Placenta Previa

Answer 48

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

Question 49

Highest Risk Subtype of Placentia Previa

Answer 49

Anterior Lying

Question 50

Painful Vaginal Bleeding

Answer 50

Abruptio Placentae

Question 51

Abruptio Placentae Risk Factors

Answer 51

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

Question 52

Fibrinogen 150-250

Answer 52

Indicates moderate abruption

Question 53

Fibrinogen less than 150

Answer 53

IUFD

Question 54

Epidural Effect on Labor

Answer 54

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.

Question 55

1st Stage of Labor

Answer 55

Cervical Dilation

Question 56

2nd Stage of Labor

Answer 56

Pushing

Question 57

3rd Stage of Labor

Answer 57

Placental Phase

Question 58

APGAR

Answer 58

Appearance, Pulse, Grimace, Activity, Respiration

Question 59

APGAR 3-4

Answer 59

Positive Pressure Ventilation

Question 60

APGAR 0-2

Answer 60

Immediate Intubation

Question 61

Indications for PPV after birth

Answer 61

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

Question 62

Indications for Chest Compressions after birth

Answer 62

HR less than 60 BPM

Question 63

Normal APGAR

Answer 63

8

Question 64

Maternal Water Intoxication

Answer 64

Can be caused by Oxytocin

Question 65

Methergine, Carboprost (Hemabate) must be injected

Answer 65

IM, cause intense vasospasm

Question 66

NSAIDS have what effect on fetus

Answer 66

closure of fetal ductal constriction

Question 67

Anti-HTN safe for pregnancy

Answer 67

Labetolol, Hydralazine

Question 68

Tx for Magnesium Hypertoxicity

Answer 68

Calcium Chloride 0.5 g or Calcium Gluconate 1 g

Question 69

Passive Diffusion across placenta affected by what six factors

Answer 69

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

Question 70

Placental Diffusion: High Lipophilicity

Answer 70

Increases Diffusion

Question 71

Placental Diffusion: High pKa

Answer 71

Decreases Diffusion

Question 72

Placental Diffusion: Albumin vs Alpha-1-acid glycoprotein

Answer 72

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

Question 73

Nitrous Oxide affect on Uterine Tone

Answer 73

None!