Test #2 OB review Flashcards
Esmolol was initially thought to hold promise for attenuating the HTN and Tachycardia of laryngoscopy in preeclampsia pts b/c
I dunno we need to find the answer!!
the answer she gave is
both A and B
CO increaes ______% by the 3rd trimester of pregnancy, due mainly to an increase in SV and to a lesser extent in resting HR
40%
General anesthestic considerations require a basic understanding of the physiologic changes in the parturient? True or False
True
with regard to systemic decline in B/P related to aortocaval compression, supine hypotension syndrome results in what?
a significant decline of venous return to the heart for which the CV system cannot compensate
in regards to natural physiologic compensation r/t aortocaval compression: compensation occurs as venousreturn is routed to the SVC via the paravertebral venous plexuses and azygos vein
true or false
true
a decrease in Systolic B/P with a value of _____mmhg is considered a problem and requires intervention when r/t uncompensated or untreated hypotension in the parturient
100mmhg
One of the most effective means for treatment of supine hypotension syndrome is placing the patient in the lateral decubitis position; right uterine displacement via left hip elevation
True or False
false
When considering laboring epidural for the parturient , these patients can develop profound decreases in systolic bp as result of the sympathectomy r/t regional anestesa? True or false
True
Parturiets pulmonary physiological changes are a RR increase of 3%? true false
False
exception question
Increases in minute ventilation and decreases in FRC result higher concentrations of inhaled anesthectics. true or false
True
Which of the following hey points regarding physiologic changes in the parturient are true:
A) plasma volume increases to a greated extent than RBC, resulting in dilutional anemia
B) CO increases are mostly due to the increase in SV but are also due to an increase in HR
C) Blood volume is markedly increased and prepares the parturient for blood loss associated with delivery
D) the greatest demand of HR is immediately after delivery when cardiac output increases
all
Should you use Nasal Trumpets as standard practice in the parturient
nope unless your an AA
What factors contribute to a decrease in dose requirement for LA by 30-50%
(all of the above)
Labor pain asoociated with the first stage of labor is what?
Visceral
caused by uterine contractions and dilation of the cervix (t-10-L1)
EBL for C-section
750-1000ml
Late decels are normal during labor and usually not associated with fetal distress
True or False
False
Early decels are abnormal during labor and are indicative of fetal distress? true or false
false
Normal fetal HR
120-160 BPM
You are called to the prop area to evaluate a patient for elective c-section. Your assessment results 30y/o female healthy no PMH, No PSHx, prenatal vitamins throughout pregnancy, 62 inches, 141 lbs, G1P0000, good physical condition, Airway MP I, TM >3fb, MO > 3fb, FROM, No GERD during pregnancy. VSS , no fetal distress, C-section planned due to pts small pelvic girth and est large fetal head. which anesthesia course would you chose as MOST appropriate?
meds
anesthesia
backup
Meds: zantac 50 mg/ reglan 10 mg/ nonparticulate antacid
Anesthesia: SAB using bupivicaine
Backup: convert to general if SAB unsuccessful
What % (fuck you and the%) of OB pts annually require nonOB surgical intervention
2%
From the list below which are the most commonly performed surgical procedures on the OBpts A) Neurosugical B) Trauma C) Appendectomy d) cholecystectomy E) Ovarian
B,C,D,E
It is safe for the OB to undergo extracorporal shock wave lithotripsy! true or false
False
Trauma is the leading cause of maternal death; fetal death is secondary two:
Both A and B!!!
we need to look this up
The OB undergoing an Appy has an 18% incidence of postoperative pulmonary edema or ARDS; risk factors include all the following except.
Preop temp <99.0F
Benefits of laparscopic sx in prego 1st trimester
all of the above ????
Why is cervacal cerclage performed
incompetent cervix resulting in weakness of the cervical OS related to trauma, congenital abnormalities or multiple pregnancies
All of the following are true EXCEPT what one regarding Thalidomide babies
thought to be safe treatment for severe nausea in 1960, Thalidomise was initially over the counter to pregnant mothers in the US
distinguishing drug exposure VS natural occuring incidence of congenital anomalies has NO bearing on teratogenicity! true or false
False
Is lasix a known teratogen
NOPE
The anesthetic management objectives of the OB pt can be summerized into what 4 main components which should be maintained during the course of surgery?
Maternal O2
CO
O2 delivery
Uterine blood flow