Flashcards in Week 4 OB Complications & VBAC - Exam 2 Deck (135)
A multivariate analysis identified five independent risk factors for difficult face mask ventilation:
(1) age older than 55 years
(2) body mass index (BMI) greater than 26 kg/m2
(3) presence of a beard
(4) lack of teeth
(5) a history of snoring
Difficult tracheal intubation has been variously defined by
(1) the time taken to intubate
(2) the number of attempts
(3) the view at laryngoscopy
(4) the requirement for special equipment
when are the the majority of obstetric general anesthetics administered for emergency deliveries?
often during off-hours;
these anesthetic procedures may be conducted by inexperienced anesthesia providers with less proficiency in difficult airway management.
larynx visualization - various strategies can minimize this problem, the most important is
optimizing the pts position
Comprehensive airway evaluation, prophylactic administration of nonparticulate antacids, and use of regional anesthesia decrease
the risk of aspiration.
General anesthesia may be unavoidable occasionally; therefore, awake intubation may be indicated in women in whom
airway difficulties are anticipated.
At term gestation the pregnant woman who requires anesthesia should be regarded as having an incompetent
lower esophageal sphincter.
When does LES return to normal? post partum
1-4 weeks for pyloric sphincter tone to return
chestnut p 35
what two "things" likely account for the slight decrease in PaO2 and increase in shunting that are observed in asp pneumonitis?
Bronchospasm and disruption of surfactant
Mild to moderate headache, lasting 30 minutes to 7 days. Often bilateral, non pulsating, and not aggravated by physical activity
*often circumferential and constricting, can be associated with scalp tenderness, and are usually of mild to mod severity.
Recurrent moderate to severe headache, lasting 4 to 72 hours. Often unilateral, pulsating, and aggravated by physical activity. Associated with nausea, photophobia, and phonophobia
*rare to manifest for the first time during pp period
examples of :
dopamine receptor antagonist
**matching category of drug**
Hypertension and/or HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome Headache
often bilateral, pulsating, and aggravated by physical activity
Severe and diffuse headache with an acute or gradual onsetPossible focal neurologic deficits and seizures
Posterior reversible (leuko)encephalopathy syndrome (PRES)
Ischemic or hemorrhagic.Cerebral infarction/ischemia: new headache that is overshadowed by focal signs and/or disorders of consciousness.Subarachnoid hemorrhage: abrupt onset of an intense and incapacitating headache.Often unilateral accompanied by nausea, nuchal rigidity, and altered consciousness.
Headache usually without typical features Often overshadowed by focal neurologic signs and/or altered consciousness
Late developing headache that is constant in nature Bilateral or unilateral location
Carotid artery dissection
Nonspecific headache that may have a postural component.Often accompanied by focal neurologic signs and seizures
Cerebral venous and sinus thrombosis
Progressive and often localized headacheOften worse in the morningAggravated by coughing/straining
Progressive non pulsating headacheAggravated by coughing/strainingAssociated with increased CSF pressure and normal CSF chemistry
Idiopathic intracranial hypertension (pseudotumor cerebri/benign intracranial hypertension)
No history of dural trauma Diffuse, dull headache worsening within 15 minutes of sitting or standing Associated with neck stiffness, nausea, tinnitus, and photophobiaCSF opening pressure < 60 mm H2O in the sitting position
Spontaneous intracranial hypotension
Frontal headacheOften an abrupt onset immediately after dural punctureSymptoms can worsen with upright posture
Headache is most frequent symptomOften diffuseIntensity increases with timeAssociated with nausea, photophobia, phonophobia, general malaise, and fever
Frontal headache with accompanying facial painDevelopment of headache coincides with nasal obstructionPurulent nasal discharge, anosmia, and fever
Onset of headache within 24 hours of cessation of regular caffeine consumptionOften bilateral and pulsatingRelieved within 1 hour of ingestion of caffeine 100 mg
Mild to moderate headache associated temporally with onset of breast-feeding or with breast engorgement
the classic presentation of subarachnoid hemorrahage:
"worst headache of my life"
sudden onset of a severe h/a that is unlike any previous h/a
Mild to moderate headache associated with ondansetron intake
Headache within 5 days of dural punctureWorsens within 15 minutes of sitting or standingAssociated with neck stiffness, tinnitus, photophobia, and nausea
Post–dural puncture headache