Olson, Ob Finalreview

Front 1

The incidence of headache following unintentional dural puncture during epidural anesthesia is approximately __%

Back 1

80%

Front 2

The dermatome level that allows a patient to most comfortably tolerate a C-section is at?

Back 2

T4, Nipple line

Front 3

Therapeutic serum levels of magnesium for managment of pre-eclamplia are?

Back 3

4.0-8.0 meq/L

Front 4

True or False:
The classic triad of pre-eclampsia includes oliguria.

Back 4

False

Front 5

Epidural use of which narcotic results in the greatest incidence of delayed respiratory depression?

Back 5

Morphine

Front 6

True or False:
Ritodrine is tocolytic.

Back 6

True

Front 7

True or False:
Methergine is tocolytic.

Back 7

False

Front 8

A 38 year old term, multiparous patient with a history of two previous c-sections presents with painless, active vaginal bleeding. systolic BP is 90. Fetal HR is 80. A C-section is planned. The anesthetic plan most appropriate for this patient would be what?

Back 8

General induction with 0.5-1 mg/kg ketamine and 100mg Anectine.

Front 9

A likely cause of painless vaginal bleeding in the parturient is what?

Back 9

Placenta previa

Front 10

General induction is induced in a 35yr old patient scheduled for an elective C-section. No part of the glottic apparatus is visible after 2 unsuccessful attemps to intubate. mask ventilation is adequate. The most appropriate action at this point is what?

Back 10

Wake her up

Front 11

What is normal fetal HR?

Back 11

110-160

Front 12

The leading cause of maternal mortality related to anesthesia is what?

Back 12

failed intubation or aspiration

Front 13

True or False:
Generalized vasodilation is associated with preeclampsia.

Back 13

False

Front 14

True or False:
Toxic side effects of magnesium sulfate include renal failure.

Back 14

False

Front 15

True or False:
Hypertension is associated with amniotic fluid embolism.

Back 15

False

Front 16

What is the most common side effect of intrathecal narcotics in the OB patient?

Back 16

Pruritis

Front 17

Variable decelerations are most likely to occur in response to what?

Back 17

Umbilical cord compression

Front 18

True or False:
Weakness of a lower extremity after delivery is more likely to be from the placement of an epidural than from labor and positioning during deliver.

Back 18

False

Front 19

After uterine incision, how many minutes does it take for fetal hypoxia and acidosis to occur?

Back 19

three minutes

Front 20

True or False:
Methergine should not be given to the hypertensive OB patient.

Back 20

True

Front 21

What do the letters HELLP stand for?

Back 21

Hemolysis
Elevated Liver enzymes
Low Platelets

Front 22

When is the most common time for a postdural puncture headache to occur?

Back 22

24-48 hrs after dural puncture

Front 23

Fetal heart rate monitoring should be performed on all patients starting at ___ weeks.

Back 23

15-17 weeks

Front 24

True or False:
The pre-eclamptic patient has increased sensitivity to endogenous and exogenous adrenergics.

Back 24

True

Front 25

True or False:
A PDPH will be less severe with a large dural hole

Back 25

False - more severe

Front 26

True or False:
Decreased variability in fetal heart rate is due to fetal activity.

Back 26

False

Front 27

Your OB patient has a continuous labor epidural in place when she starts to complain of an increase in pressure sensation and experience early decelerations. A plan of action should include what?

Back 27

Ask the nurse to check the patients progress

Front 28

Uteroplacental insufficiency is indicated by what?

Back 28

late decelerations

Front 29

True or False:
Drugs commonly used to treat HTN in the pregnant patient include esmolol.

Back 29

False

Front 30

True or False:
Causes of late fetal decelerations include head compression

Back 30

False

Front 31

A 29year old gravida 1, para 0 at 25 weeks gestation is to undergo an emergent Appy under GA with Desflurane, N2O, and O2. WHich of the those agents is proven to cause untoward consequences to the fetus?

Back 31

None of them

Front 32

Your OB patient has just delivered a 6500 gram infant with Apgar scores of 8 and 9. you would expect to assist with resuscitation of the infant by doing what?

Back 32

Drying the infant and keeping it warm

Front 33

The OB patient is at greatest risk for delayed respiratory depression ___ hours after the administration of epidural or intrathecal morphine.

Back 33

4-8 hours

Front 34

You have administered spinal anesthesia to your patient for a scheduled C-section. The patient is supine, prepped and draped with incision made. She states "I feel like I cant breathe" SaO2 is 99%, BP is 142/84, HR is 108. what is the most appropriate treatment?

Back 34

Maintain oxygenation with simple O2 mask, reassure, and continue to monitor respirations and SaO2

Front 35

After administration of a SAB your patients BP is 60/35, shes becoming restless and grasping for air. she is unable to raise her arms from her sides. Sat is 92% and dropping. Her weight is 260lbs. what is the most appropriate treatment?

Back 35

administer 150mg thiopental and 120mg succinylcholine with criocoid pressure and intubate

Front 36

Upon your arrival to L & D you are handed a neonate that has just delivered. The baby is floppy, cyanotic, not breating and has a HR of 60. There is thick meconium on the babys skin. Your first action should be what?

Back 36

Place the neonate under the warmer, suction the posterior oropharynx, intubate with a meconium aspirator and suction before ventilating

Front 37

What is the drug of choice to treat bradycardia that has not resolved with proper ventilation in the neonate?

Back 37

Epinephrine

Front 38

Your 28 yr old patient delivered a term infant at 3:42 AM. The surgeon wants to perform a post partum tubal ligation at 7:00 AM. Is it true that this patient is at increased risk? why?

Back 38

Yes, physiological changes of pregnancy are still present in this patient, placing her at increased risk for GA.

Front 39

You patient has just had an ultrasound that show breech presentation, is vaginal delivery possible?

Back 39

Yes, if it is frank breech

Front 40

Your 51 yr old female is delivering triplets, which baby will most likely have a higher APGAR at one minute: the first or third baby?

Back 40

the first baby

Front 41

You have been asked your opinion regarding anesthesia for a cholechystectomy for a parturient in her tenth week of gestation, what is your recommendation?

Back 41

Elective surgeries should be delayed until after delivery and urgent surgeries until after the 2nd trimester.

Front 42

True or False:
You are assigned to provide anesthesia for a chole for a female in her 28th week of gestation. Risk/benefits include informing her that the greatest risk at this time in her pregnancy is birth defects.

Back 42

False