Obstetrics 6

Question 1

All the risk factors for placental abruption

Answer 1

increase the driving pressure to the placenta

Question 2

Placental abruption is a

Answer 2

partial or complete separation of the placenta from the uterine wall before delivery

Question 3

With placental abruption, ______ is possible if the fetus is stable

Answer 3

vaginal delivery

Question 4

Anesthetic management for the placental abruption includes

Answer 4

obtain large-bore IV access
have blood products available
prepare for C-section

Question 5

Placental abruption increases the risk of

Answer 5

amniotic fluid embolism leading to DIC

Question 6

What is the MOST common cause of postpartum hemorrhage?
a. uterine atony
b. retained placenta
c. disseminated intravascular coagulopathy
d. uterine inversion

Answer 6

A. uterine atony

Question 7

Risk factors for uterine atony include

Answer 7

multiparity
multiple gestations
polyhydramnios
prolonged oxytocin infusion before surgery

Question 8

Etiologies of uterine bleeding include

Answer 8

retained placenta
laceration
uterine inversion
coagulopathy
placenta previa
placental abruption
abnormal placental implantation

Question 9

Risk factors for maternal DIC include

Answer 9

amniotic fluid embolism, placental abruption, intrauterine fetal demise

Question 10

Describe treatments for obstetric bleeding

Answer 10

uterine massage
oxytocin
ergot alkaloids
manual massage
intrauterine balloon

Question 11

Describe what drugs are considered minimally cardiovascular depressive in the bleeding obstetric patient.

Answer 11

ketamine
etomidate
midazolam
opioids

Question 12

In the hemodynamically unstable patient, it may be prudent to

Answer 12

convert a regional anesthetic to a general anesthetic with RSI

Question 13

Five minutes following delivery, a newborn has an irregular respiratory rate with a heart rate of 105. He is grimacing, has some flexion in the extremities, and has a pink body with blue extremities. Calculate his Apgar score.

Answer 13

6
(1+2+1+1+1)

Question 14

The Apgar score at 1 minute correlates with

Answer 14

fetal acid-base status

Question 15

The Apgar score at 5 minutes may be predictive of

Answer 15

neurologic outcome

Question 16

The Apgar score is used to

Answer 16

assess the newborn and guide resuscitative efforts

Question 17

Describe normal, moderate distress, and impending demise Apgar scroes.

Answer 17

normal: 8-10
moderate distress: 4-7
Impending demise: 0-3

Question 18

Describe the points assigned for heart rate with Apgar scores.

Answer 18

absent: 0
<100 bpm: 1
>100 bpm: 2

Question 19

Describe the points assigned for respiratory effort for Apgar scores.

Answer 19

absent: 0
slow, irregular: 1
normal, crying: 2

Question 20

Describe the points assigned for muscle tone for Apgar scores.

Answer 20

limp: 0
some flexion of extremities: 1
active motion: 2

Question 21

Describe the points assigned for reflex irritability for Apgar scores.

Answer 21

Absent: 0
grimace: 1
cough, sneeze, or cry: 2

Question 22

Describe the points assigned for color for Apgar scores.

Answer 22

pale, blue: 0
body pink, extremities blue: 1
completely pink: 2

Question 23

_____ of all newborns require some degree of resuscitation, and _ require full CPR.

Answer 23

10%; 1%

Question 24

______ protects against hypothermia

Answer 24

Radiant heat

Question 25

The normal respiratory rate for newborns is

Answer 25

30-60 bpm

Question 26

The normal heart rate for newborns is

Answer 26

120-160 bpm

Question 27

A heart rate <100 bpm significantly

Answer 27

reduces cardiac output and impairs tissue perfusion for the neonate

Question 28

Breathing begins about _____ after delivery, and a normal pattern is established at

Answer 28

30 seconds; 90 seconds

Question 29

Immediately after delivery, the normal SpO2 for neonates is _____. It should rise to _____ after 10 minutes.

Answer 29

60%; 90%

Question 30

Supplemental oxygen for the neonate increases the risk of

Answer 30

an inflammatory response; if assisted ventilation is required, use room air instead of 100% fiO2

Question 31

If _____________, the use of supplemental O2 must be balanced with the risk of inflammatory response.

Answer 31

bradycardia or inadequate oxygenation persists

Question 32

_______ is the best indicator of adequate ventilation

Answer 32

The resolution of bradycardia

Question 33

While ______ should be removed from the airway, there is no clinical benefit gained from removing ____________

Answer 33

thick meconium; thin or watery meconium

Question 34

If ventilation does not improve cardiovascular performance, then emergency drugs can be given through three possible routes:

Answer 34

umbilical vein endotracheal tube intraosseus

Question 35

Describe the dosage of PRBCs, NS, and LR for neonates.

Answer 35

10 mL/kg over 5-10 minutes

Question 36

Describe the dose of IV epinephrine for the neonate

Answer 36

1:10,000 10-30 mcg/kg IV