Questions

Question 1

The body compensates for the increase in O2 demand by increasing MV. This is primarily accomplished by what means?

Answer 1

Increasing TV with slight increase in respiratory rate

Question 2

FRC is greatly reduced in pregnancy leading to rapid desaturation during apnea. T/F

Answer 2

True

Question 3

What causes dilutional anemia

Answer 3

Plasma volume increases by 50% but red cell volume increases by a smaller amount.

Question 4

Primary treatment for aortocaval compression

Answer 4

LUD

Question 5

GI changes in the paturient causes

Answer 5

Esophageal sphincter to relax

Question 6

Early changes are primarily caused by

Answer 6

Progesterone

Question 7

A patient is scheduled for an elective procedure which requires general anesthetic. She is 22 weeks pregnant what is required?

Answer 7

RSI

Question 8

Relaxin causes what?

Answer 8

Softening of the cervix
Inhibition of uterine contractions
Relaxation of pelvic joints

Question 9

Ion trapping in the fetus occurs most commonly with which of the following combination?

Answer 9

Weak base in presence of decrease in fetal pH

Question 10

Which order reflects vascular absorption from most to least?

Answer 10

Paracervical
Caudal
Lumbar
Spinal

Question 11

Under normal conditions blood as a whole from the umbilical cord will bypass the liver of the fetus as it initially enters the fetus

Answer 11

True

Question 12

Probably causes of fetal tachycardia

Answer 12

Thyrotoxicosis, fetal anemia, recovery from asphyxia

Question 13

What is not a cause of fetal tachycardia?

Answer 13

Cord compression

Question 14

What is not a probable cause of fetal bradycardia?

Answer 14

Prematurity

Question 15

Early decel

Answer 15

Occurs with contraction has smooth shape not a bad sign.

Question 16

An accurate description of late decel is

Answer 16

Occurs after the start of the contraction has a smooth shape is a BAD sign

Question 17

List four different treatments for fetal bradycardia and or late decels. Ultimate fallback plan?

Answer 17

Fluids ephedrine/phenylephrine
Turn down epidural
LUD RUD
O2

Emergent c/s if this doesnt work

Question 18

RA and MS symptoms worsen with pregnancy. T/F

Answer 18

False improve

Question 19

Acute vs chronic cocaine abuse and MAC

Answer 19

Decreased chronic

Increased acute

Question 20

Drug of choice for htn with cocaine

Answer 20

Labetalol

Question 21

Which of the following would you expect to be the plan for delivery for an HIV+ paturient?

Answer 21

C/S with antiviral therapy

Question 22

How would drug dosing change in HIV patient?

Answer 22

Decrease doses

Question 23

Scoliosis and harrington rods extending below what level are NOT contraindications to epidural?

Answer 23

L1

Question 24

Infection, trauma, and failure to administer insulin could all lead to what?

Answer 24

Excarbation of insulin deficiency in the diabetic patient

Question 25

Obstetric patients with diabetes are more likely to need C/s t/f

Answer 25

T

Question 26

Aortic Stenosis?

Mitral Stenosis?

Answer 26

Normal HR SVR Preload

Question 27

Mitral Regurg?

Aortic insufficiency?

Answer 27

Increased HR Preload

Decreased SVR

Question 28

Patients with which disease are most likely to develop complications with continuous laboring epidurals?

Answer 28

Aortic stenosis

Question 29

What is not a listed complication of VBAC?

Answer 29

Placenta Previa

Question 30

What has painless vaginal bleeding?

Answer 30

Placenta previa

Question 31

What may have bleeding or may not if baby is block cervix so bleeding is not seen?

Answer 31

Placental abruption

Question 32

Watch maternal state and severity of bleeding when considering regional

Answer 32

Tachy, pale, dont do regional do GETA

Question 33

Should surgical field be above heart for VAE?

Answer 33

NOPE!

Question 34

Describe pain during 2nd stage of labor

Answer 34

Pain is somatic and due to distention and frank injury to the perineum and pelvic floor
Comes from S2-4

Question 35

What is dosage and concentration of test dose? What effects?

Answer 35

3 ml lidocaine 1.5% so 45mg and 1:200,000 epi so 15 mcg

Cant lift legs 5 min inj SAB
Circumoral numbness, tinnitus, increased HR IV

Question 36

List 3 advantages and 2 disadvantages to epidural opioids

Answer 36

Advantages: Increased onset time, duration, density, no motor block, decreases SE of local, synergy, used for long term pain control, decreased concentration of LA

Disadvantages: Disguises poor epidural, Narc SE, cant be used in 2nd stage of labor

Question 37

Epidurals are contraindicated in VBACs due to possibility of delaying recognition and treatment of complications T/F

Answer 37

F

Question 38

Catheter is threaded out of the epidural needle 2cm and will no longer advance. Next action?

Answer 38

Withdraw the needle and catheter entirely, withdraw catheter from needle and start over.

Question 39

What are some reasons for inadequate block of labor epidural?

Answer 39

Inadequate dose of LA, patient increased metabolism or tolerance of LA or opiates
Catheter migration
Unilateral block

Question 40

What are the hallmark signs associated with PDPH?

Answer 40

Postural HA severe when sitting up and resolves when lying flat

Question 41

What treatment is over 90% effective for PDPH

Answer 41

Blood patch 20 - 30 ml of own blood

Question 42

Obese patient consider what?

Answer 42

Ramping
Longer needles
Positioning as supine leads to hypoxia
Higherpeak pressures 
C/S- hypoxia due to pannus over abdomen and chest wall.