62. Gynecology

Question 1

CV changes in pregnancy

Answer 1

Increase. Plasma, erythrocytes, C.O., SV, HR, Femoral Venous pressure
Decrease. SVR, PVR
No changes. CVP, PWCP

Question 2

Pulmonary changes in pregnancy

Answer 2

Increase. MV, RR, TV, Ins capacity, O2 comp
Decrease. Expiratory volume reserve, RV, FRC, TLC

Question 3

Coagulation in pregnancy

Answer 3

Increase. 7, 8 , 9, 10, 12, VW
Decrease 11, 13, antithrombin III, PS
No changes 2, 5, PC

Question 4

Blood gases in pregnacy

Answer 4

Decreased CO2 (30) HCO3 (20)
Increase pH (7.44) p50 (30)

Question 5

Heart changes in pregnancy

Answer 5

Increase Right chamber (20%) left (10-12%), EF
New aortic / T Reg
Left hypertrophic (eccentric)
3rd trimester LIII Q small

Question 6

What drug crosses placental barrier

Answer 6

Lidocaine
Non ionized, low MW, Lipophilic
In general, no Heparin, NDMR, Scoline, Dexm

Question 7

Fetal rate system

Answer 7

I baseline. 110-160
II No 1 or 3
III Bradicardia, No baseline FHR, Recurrent VD/LD, sinusoidal pattern

Question 8

Preeclamsia

Answer 8

SBP > 140 DBP > 90
After 20 weeks
Urine > 300 mg / 24h

Question 9

Severe Preeclamsia

Answer 9

Pre +
Platelets< 100, Impaired liver function, kidney (creat > 1.1)
Right upper quadrant pain

Question 10

Eclampsia

Answer 10

Pre + seizures

Question 11

HELLP

Answer 11

Hemolysis + Elevated liver + low platelet

Question 12

Platelets in pregnacy

Answer 12

Decrease 10%

Question 13

Ephedrine to fetus

Answer 13

No changes in blood supply to the fetus.
Increase BP in the mother

Question 14

Hexakapron in PPH

Answer 14

Improves mortality if taking in the first 3 hours

Question 15

When the blood volume returns to normal after delivery

Answer 15

2 months

Question 16

In pregnancy C.O. higher in

Answer 16

after delivery

Question 17

Supine hypotension syndrome

Answer 17

Decrease MAP 10%, Increase HR 20
Decrease CO / SV 20%
8-10% pregnant

Question 18

Difficult intubation and pregnancy. When the most difficult?

Answer 18

Immediately after delivery

Question 19

VO2 higher in pregnancy

Answer 19

Second trimester

Question 20

Pseudocholinesterase decrease after

Answer 20

10 weeks

Question 21

BUN and creatinine in pregnancy

Answer 21

Decrease both

Question 22

Standard bleeding after c section

Answer 22

1 liter

Question 23

How much CO to the uterus at the end of pergnancy

Answer 23

10%

Question 24

TEG in pregnacy

Answer 24

Short R

Question 25

Fetal Hb compared to mature

Answer 25

More affinity for oxygen

Question 26

Drug that produces ion trapping

Answer 26

Fentanyl

Question 27

Blood of a term newborn

Answer 27

500 ml

Question 28

Dural puncture epidural

Answer 28

No direct injection in spinal cavity but leakage from epidural to spinal

Question 29

Absolute CI to neuraxial anesthesia

Answer 29

Some of the most important include patient refusal, localized sepsis, and an allergy to any of the drugs planned for administration. A patient’s inability to maintain stillness during needle puncture, which can expose the neural structures to traumatic injury, as well as raised intracranial pressure, which may theoretically predispose to brainstem herniation

Question 30

Paracervical block and pain

Answer 30

Similar effect on pain like PCA with fentanyl

Question 31

Gold standard for pain treatment after c section

Answer 31

Neuraxial opioids

Question 32

Von W disease types

Answer 32

Type 1 . Lack of factor. DDAVP Type 2. Lack of function Type 3. Lack of function no DDAVP to type 2b and 3