OB

Question 1

relaxin

Answer 1

relaxes chest wall-> inc ap diameter

Question 2

progesterone

Answer 2

inc mv by 50%- inc ap diameter

Question 3

what lung volumes decrease

Answer 3

frc, erv, rv

Question 4

what lung volumes inc

Answer 4

mv, tv, rr, o2 compensation

Question 5

progesterone and cardiac

Answer 5

inc nitric oxide-> dec dbp, svr

Question 6

do clotting factors inc or dec

Answer 6

inc- hypercoag state

Question 7

what happens to rbc and plasma volume

Answer 7

both inc but plasma volume inc more- dilutional anemia- prepares mom for hemorrhage with delivery

Question 8

what happens to pt and ptt

Answer 8

decreases 20%

Question 9

mac

Answer 9

dec 30-40% - inc progesterone

Question 10

les tone

Answer 10

decreases

Question 11

what happens to gfr, cr clearance, glucosuria

Answer 11

dec gfr
inc creatine clearance
inc glucosuria

Question 12

what happens to albumin and pche

Answer 12

both dec- no effect on sux

Question 13

what happens to gastric volume and ph

Answer 13

inc gastric volume
dec ph

due to inc gastrin

Question 14

when does gastric emptying slow

Answer 14

with labor

Question 15

where does pain for 1st stage of labor analgesia come from

Answer 15

t10-L1
c fibers hypogastric plexus

Question 16

where does 2nd stage pain come from with labor analgesia

Answer 16

pudendal nerve s2-s4

Question 17

bupivicaine epidural infusion

Answer 17

0.05-0.125%
rate 8-15 mL
bolus 10-15 mL dividided doses

Question 18

s/e with bupivicaine

Answer 18

dec tachyphylaxis
dec placentall transfer- inc protein binding; inc ionization
inc cv toxicity
inc sensory and motor blcok

Question 19

what can be used for walking epidural

Answer 19

ropiviciane- less motor block

Question 20

normal fhr

Answer 20

110-160

Question 21

fetal bradycardia

Answer 21

< or = 110

Question 22

fetal tachycardia

Answer 22

> or = 160

Question 23

causes of fetal bradycardia

Answer 23

fetal: asphyxia and acidosis
maternal: hypoxemia, drugs that decrease placental perfusion

Question 24

causes of fetal tachycardia

Answer 24

fetal: hypoxemia, arrhythmias
maternal: fever, chorioamnionitis, atropine, ephedrine, terbutaline

Question 25

s/e of terbutaline

Answer 25

beta agonist- inc camp -> causes fetal hypokalemia/ hypoglycemia

Question 26

hypermag 2.5-5

Answer 26

asymptomatic

Question 27

hypermag 5-7

Answer 27

diminished dtr, lethargy, drowsy, n/v

Question 28

hypermag 7-12

Answer 28

loss of dtr, hypotension, ecg changes, somnolence

Question 29

hypermag >12

Answer 29

resp depression, apnea, complete ht block, pulm edema, reduced response to ephedrine

Question 30

dose and se of methergine

Answer 30

0.2 mg IM causes vasoconstriction, htn, cerebral hemorrhage

Question 31

dose and se of hemabate

Answer 31

prostaglandin f2 250 mcg IM or intrauterine causes n/v, diarrhea, hotn, htn, bronchospasm

Question 32

dose and se of oxytocin

Answer 32

post pit- augments labor, stimulates uterine contraction, helps with uterine hypotonia/ hemorrhage- causes h2o retention, hyponatremia, hotn, reflex tachycardia, coronary vc

Question 33

do you use defasiculating dose with c section

Answer 33

no

Question 34

should you confirm placment of ett before incision

Answer 34

yes

Question 35

how much mac / anesthetic do you use

Answer 35

low concentration- 0.8% anesthetic and 50% n2o

Question 36

how do you extubate c section pt

Answer 36

fully awake- still full stomach

Question 37

when to do surgery for obstetrics

Answer 37

2-6 weeks post delivery or 2nd trimester

Question 38

when is tertagenicity higest

Answer 38

oranogenesis- 13 to 60 days avoid n2o first 2 trimesters- avoid benzos first trimester

Question 39

when to start rsi

Answer 39

18-20 weeks - gerd prophylaxis

Question 40

when to avoid nsaids

Answer 40

1st trimester- potentially closes ductus arteriosus

Question 41

chronic htn

Answer 41

before 20 weeks ; does not go back to nromal after deluvery

Question 42

gesttaional htn

Answer 42

after 20 weeks-r eturns to normal after dleiveyr no proteinuria

Question 43

preeclampsia

Answer 43

htn > 140/90 after 20 weeks + proteinuria need delivery for tx

Question 44

eclampsia

Answer 44

pree with seizures

Question 45

hellp syndrome

Answer 45

hemolysis elevated liver enzymes low plt

Question 46

hellp syndrome is highest risk for

Answer 46

thrombocytopenia and dic

Question 47

what is placenta previa

Answer 47

covering cervical os painless bleeding

Question 48

apgar normal

Answer 48

8010

Question 49

apgar impending demise

Answer 49

0-3

Question 50

what does apgar look at

Answer 50

HR, RR, muscle tone, reflex irritability, color