final review

Question 1

T/F Compensatory metabolic acidosis by excretion of bicarb maintains normal pH

Answer 1

True

Question 2

how does vital capacity and TLC change in pregnancy

Answer 2

it doesnt

Question 3

p50 of hb ____ from __ to ___

Answer 3

increases 27 to 30

Question 4

dead space ___

Answer 4

decreases

Question 5

airway resistance ___

Answer 5

decreases

Question 6

Hyperventilation - alkalosis causes uterine ___ and ___ placental blood flow

Answer 6

vasoconstriction decreased

Question 7

alkalosis will shift HgbO2 curve to the ___, ___ the release of O2 to the fetus

Answer 7

left, decrease

Question 8

response to adrenergic drugs is ____, and plasma colloid osmotic pressure ___

Answer 8

blunted, declines

Question 9

RBF and GFR are ____ by about ___ by 16th week, remains elevated until delivery

Answer 9

increased , 50%

Question 10

BUN and Cr are ____

Answer 10

mildly reduced

Question 11

T/F Mom has a decrease in pseudocholinesterase levels, but simultaneous increase in VOD counters any clinically significant prolongation of NMB with succs

Answer 11

TRUE

Question 12

Fetal oxy-hemoglobi curve is ___ shifted and maternal is ___ shifted

Answer 12

left, right

Question 13

transfer of CO2 occurs by

Answer 13

simple diffusion

Question 14

first stage of labor

Answer 14

onset of true labor until complete cervical dilation

Question 15

2nd stage of labor

Answer 15

time from complete dilation until infant delivered

Question 16

third stage of labor

Answer 16

time from silvery of infant until placenta delivered

Question 17

high serum LA levels can result in uterine ____

Answer 17

vasoconstriction

Question 18

dermatomes for first stage of labor

Answer 18

T10-L1

Question 19

dermatomes for second stage of labor

Answer 19

S2-S4

Question 20

T/F Nearly all opioids cross the placenta and depress the fetus

Answer 20

TRUE

Question 21

neonatal depression is unlikely if demerol is given….

Answer 21

less than 1h prior to delivery

Question 22

whats the major side effect of IH

Answer 22

decreased uterine tone

Question 23

paracervical block is used for

Answer 23

first stage of labor

Question 24

pudendal block is used for

Answer 24

second stage of labor

Question 25

A1 acid glycoprotein = ___ affinity, ___ capacity

Answer 25

high, low

Question 26

albumin = ___ affinity, ____ capacity

Answer 26

low , high

Question 27

___ amounts of LA are required in mom, and ____ onset

Answer 27

smaller, faster

Question 28

what drugs for labor epidural

Answer 28

bupiv, ropiv, lido

Question 29

what drugs for operative epidural

Answer 29

lido, 2choloro

Question 30

what drugs for spinal

Answer 30

tetra, bupiv

Question 31

which drug isnt great for continuous infusion bc it has a lot of motor block

Answer 31

lidocaine

Question 32

which drug has a rapid onset, very short duration, lot of motor block, low risk of toxicity, very rapidly metabolized

Answer 32

2-cholor

Question 33

which drug has a long duration but less of a motor block

Answer 33

bupiv

Question 34

rank the drugs in terms of CV toxicity

Answer 34

ropiv < levobupiv < bupiv

Question 35

what spinal levels do you wanna cover

Answer 35

T10-S4

Question 36

in adults the spinal cord ends at

Answer 36

L1

Question 37

turns out most providers are actually ___ than they think

Answer 37

higher

Question 38

T/F Drugs delivered via spinal route are __x more potent and ____ needles are used

Answer 38

10x, smaller

Question 39

____ paCO2 and ____ lowers seizure threshold

Answer 39

increased acidosis

Question 40

acidosis decreases protein binding so you have _____

Answer 40

more free LA

Question 41

what type of drug is sodium citrate? why is it given? how long does it last?

Answer 41

antacid. raises gastric pH. lasts 15min.

Question 42

what type of drug is ranitidine? when is the max effect?

Answer 42

H2 blocker, usually used in addition to antacids as it does nothing for acid already there. 50mg IV dose. max effect seen 2h after admin.

Question 43

reglan effects may be inhibited by ___

Answer 43

opioids

Question 44

which drug is useful in the face of maternal hemorrhage, decreases risk of bronchospasm, but has side effects of htn and dysphoria

Answer 44

ketamine

Question 45

____ causes more neonatal depression than other agents

Answer 45

midazolam

Question 46

avoid block for ___ if therapeutic anti coagulated, avoid block for ___ if prophylactic anti-coagulated

Answer 46

24, 12

Question 47

for neruaxial block an LWMH - remove catheter at least __h after last dose, and dont administer LWMH until ___h after block is placed or catheter is removed

Answer 47

2-4

Question 48

epidural abscess - if an infection is present it takes ___days for sx (usually pain; loss of function) to occur. treatment (abx and lammy) have a ___hr window before permanent damage

Answer 48

4-10. 6-12

Question 49

where is the conus

Answer 49

T12-L3

Question 50

stop injecting for epidural blood patch when

Answer 50

patient says HA is gone or they have a pressure sensation in the ears

Question 51

causes of total spinal

Answer 51

migrated epidural cath, unrecognized dural puncture, SAB after failed epidural

Question 52

deficiency of protein C&S make a person ____coaguable

Answer 52

hyper

Question 53

T/F Hypotension d/t dec. afterload will reverse a left to R shunt, with resulting R to L shunting and cyanosis - beware SAB in these patients

Answer 53

true