6-30-10 OB Midterm Summary All Slides - Barry
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| How old does pt need to be to consent to lubal | show 🗑
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| show | No
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| show | No
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| show | No
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| Can consent for tubal be given and surgery performed within 30 days | show 🗑
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| show | No, consent only good for 180 days
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| What does Suxx last longer post-partum | show 🗑
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| What med used for aspiration prevention causes prolonged Suxx time | show 🗑
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| show | Yes
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| Is ESWL safe during pregnancy | show 🗑
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| show | No
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| show | Possibly
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| What respiratory items decrease during pregnancy | show 🗑
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| show | 40%
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| What decreases cardiovascular wise with pregnancy | show 🗑
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| show | Serum creatinine and BUN
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| What increases hematologically during pregnancy | show 🗑
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| What decreases hematologically with pregnancy | show 🗑
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| show | Paralytic agents- they are quaternart ammonium salts
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| If a teratogen is given to effect organogenisis when would it be given | show 🗑
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| show | Controlled studies should no risk to humans
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| show | Risk cannot be ruled out
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| A classification of "D" of teratogen risk means | show 🗑
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| show | It is contraindicated
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| Most anesthetic drug are classified as "B" or "C" teratogen risk except for | show 🗑
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| Thalidomide babies have | show 🗑
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| show | Hypoxia or hypotension in late gestation
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| What is the highest incidence (65-70%) of cogenital abnormalities of fetus | show 🗑
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| show | ACE inhibitors, alcohol, cocaine, coumadin, depakote
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| The most serious fetal risk during pregnant surgery | show 🗑
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| show | 20 weeks when uterous leaves the pelvis at umbilicus level
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| show | After 16 weeks
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| show | Fetal monitor (fetal heart rate)
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| show | No
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| Which trimester has lowest risk for surgery producing preterm labor | show 🗑
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| show | Beta adrenergic agonist, Mg sulfate, Prostaglandin synthetase inhibitors, and Ca channel blockers
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| What fetal effects do Beta blockers cause | show 🗑
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| show | hypotonia, drowsiness, decreased gastric motility, hypocalcemia
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| show | Premature closure of ductus arteriosus, and pulmonary HTN
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| show | Methemoblobinemia
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| Pneumoperitoneum pressures for pregnant laparoscopy should be | show 🗑
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| What is EXIT procedure | show 🗑
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| What is the dose of fetal Fentanyl IM | show 🗑
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| show | 0.2 mg/kg
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| show | 1 mcg/kg
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| What is the dose of fetal atropine | show 🗑
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| show | Incompetent Cervix
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| show | Cervical cerclage (increases fetal survival rate from 20% to 89%
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| Name 3 types of Cervical cerclage | show 🗑
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| When are cervical cerclages performed | show 🗑
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| show | Active bleeding, Active labor, ruptured membranes, dilation > 4 cm, infection, fetal abnormalities, and abruptio placenta
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| show | T8-T10
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| The leading cause of maternal death | show 🗑
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| What is a main cause of Abruptio Placenta | show 🗑
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| Sodium nitroprusside may cause fetal ? | show 🗑
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| show | >70
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| show | Presentation
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| Name 3 cephalic presentations | show 🗑
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| Is a breech position transverse or longitudinal | show 🗑
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| Name 3 Breech positions | show 🗑
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| Name a tranverse presentations | show 🗑
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| Transverse and longitudinal are types of | show 🗑
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| show | Frank
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| What are main causes for abnormal presentations | show 🗑
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| Umbilical cord prolapse is most common with which breech position | show 🗑
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| show | External Cephalic Version (trying to turn the fetus by pushing on the outside of moms abdomen
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| Fetal head entrapment greatest in what gestational age | show 🗑
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| show | C section, Duhrssen incision, GETA (2-3 MAC), Nitroglycerin (IV 50-500 mcg or 2 sublingual sprays)
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| Twins from one ovum are called | show 🗑
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| show | Dizygotic twins (more common in african american)
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| Twin gestation increases blood volume over regular pregnancy by | show 🗑
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| Twin to twin tranfusion occurs in which situation - monozygotic or dizygotic | show 🗑
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| The most common medical disorder of pregnancy | show 🗑
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| What is the definition of perinatal | show 🗑
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| show | 6%-8%
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| show | 4%
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| What is the percent of Eclampsia in pregnancy | show 🗑
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| show | Eclampsia
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| The most common cause of HTN during pregnancy | show 🗑
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| What is the start and stop time of the HTN in gestational HTN | show 🗑
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| Is there proteinurea in Gestational HTN | show 🗑
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| show | Chronic HTN
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| Overall the most commonly essential HTN | show 🗑
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| show | Superimposed preeclampsia
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| Onset of HTN and proteinurea after 20 weeks gestation is called | show 🗑
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| 75% of preeeclampsia are "Mild" defined as (2 things) | show 🗑
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| show | BP >/= 160/110 mmHg (on 2 occasions at least 6 hours apart), proteinurea >/= 5 g/24hr, Oliguria (<500ml/24hr), Elevated Serum Creatinine, Cerebral or visual disturbances (Headache), Pulmonary edema with resp distress, Liver dx, RUQ pain, IUGR, and Thrombo
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| HELLP stands for | show 🗑
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| The "E" ion HELLP is specific for | show 🗑
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| Why are platlets low in HELLP syndrome | show 🗑
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| show | usually by the presents of schistocytes in a peripheral blood smear (microangiopathic - small vessels tear cells apart)
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| What physiologically happens in eclampsia | show 🗑
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| Risk factors for preeclampsia | show 🗑
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| show | Antiangiogenic Protiens
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| The vasospasm that occur in preeclampsia are caused by an increase in circulating levels of | show 🗑
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| show | Aldosterone by retaining Na and H2O
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| What happens to the plasma level in preeclampsia | show 🗑
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| What increases (4 things) that imply hypercoagulation in preeclampsia | show 🗑
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| What decreases (4 things) to imply hypercoagulation in preeclampsia | show 🗑
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| What happens with Renal in preeclampsia | show 🗑
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| show | Preeclampsia/HELLP, hemorrhage, even Liver rupture
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| show | Headache, eclampsia, visual disturbances (including cortical blindness), and seizures
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| show | Hemolysis, thrombocytopenia, platlet disfunction, and increased platlet consumption
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| What effects on the respiratory system does preeclampsia have (4 things) | show 🗑
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| Why does pulmonary edema take place in preeclampsia | show 🗑
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| Does respiratory issues with preeclampsia happen more frequent antepartum or postpartum | show 🗑
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| What placenta effects does preeclampsia have (5 things) | show 🗑
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| Management for preeclampsia includes (6 things) | show 🗑
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| What is used for longterm management of HTN in preeclampsia | show 🗑
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| Name tx for htn in preeclampsia (5 of them) | show 🗑
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| show | Mag Sulfate
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| How does Mag sulfate prevent seizures | show 🗑
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| What is the MgSO4 dose | show 🗑
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| show | 6-8mg/dl
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| MgSO4 causes ECG changes at what plasma level | show 🗑
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| What plasma level does MgSO4 cause resp depression at | show 🗑
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| show | 15 meq/L
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| What plasma level does MgSO4 cause cardiac arrest at | show 🗑
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| show | Thing get weak and floppy (NMB last longer also)
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| show | Decreases acetylcholine release from nerve terminal, decreases sensitivity of acetylcholine at endplate, and depresses the excitability of skeletal muscle membrane
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| show | CVA, Pulmonary edema, Renal failure, Placenta Abruption, and HELLP (Hemolysis, Elevated Liver enzymes and Low Platlets)
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| What is the level of bilirubin in HELLP | show 🗑
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| show | > 600 IU/L
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| What is the level of SGOT in HELLP | show 🗑
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| show | < 100,00/mm3
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| show | Pulmonary edema, ARDS, Placenta abruption, DIC, Ruptured liver (hematoma), Acute renal failure, severe Ascites, Cerebral edema, and materal death
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| show | Nulligravida
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| Time frame after delivery | show 🗑
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| A women who is or has been pregnantirrespective of the pregnancy outcome | show 🗑
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| Time frame before delivery of fetus | show 🗑
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| Refers to a women's previous pregnancies of at least 20 weeks gestation | show 🗑
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| show | Between 37 and 41 weeks
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| A women who is pregnant for the first time beyond the stage of abortion | show 🗑
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| When is the third trimester | show 🗑
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| show | Postterm
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| A women who has completed two or more pregnancies beyond the stage of abortion | show 🗑
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| show | Preterm
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| show | Nullpara
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| show | Second trimester
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| A women that has delivered a viable fetus past the stage of abortion | show 🗑
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| show | First trimester
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| show | Parturient
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| A women who had just given birth | show 🗑
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| show | C-section
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| What is an indicator for PA cath placement | show 🗑
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| show | Pain relief and relaxation, decreased catecholamines, increased uteroplacenta blood flow, no parental narcotic systemic effects, control of BP, permits low outlet forcepts, njo pulm. edema, can use for c-section, and decr. aspiration
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| show | < 20yrs
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| show | Headache, blurred vision, photophobia, RUQ or epigastric pain, hyperreflex, and altered mental status
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| show | Generalized clonic phase with 1 min apnea then postictal and coma
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| First line drug with eclampsia | show 🗑
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| show | Antihypertension agents then thiopental, propofol, versed
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| show | Dyspnea, Cyanosis, Carviovascular Collapse
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| Amniotic fluid embolism - % fatal | show 🗑
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| Amniotic fluid embolism account for what percent of maternal deaths | show 🗑
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| show | Just one - The fact of being pregnant
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| show | Amniotomy, laceration of endocervical or uterine vessel, and Pressure gradient to force fluid into materal circulation
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| show | The Biochemical mediators it contains (prostaglandins, leukotrienes), they cause vasoconstrictions, vasodilation, and inotropic effects
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| How do you diagnose AFE | show 🗑
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| show | Hypoxemia - pulmonary vasospasm
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| Amniotic fluid embolism causes what to cardiovascular system | show 🗑
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| show | Coagulopathy in 66% of pt (DIC 80% of the 66%)
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| show | Resp distress, cerebral hypoperfusion, Hemodynamic collapse, Hemorrage, then multi-organ failure and infection
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| show | Hypotension (100%), Fetal distress (100%), and Pulmonary edema (93%)
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| show | Get the BP up - pressers, fluids
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| Venous Air Embolism (VAE) occurred in 97% of pts receiving | show 🗑
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| Is VAE rare | show 🗑
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| show | > 3 ml/kg
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| 50% of VAE pts had these on the monitor | show 🗑
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| First action with VAE | show 🗑
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| What often is the begining cause of Pulmonary thromboembolism (PTE) | show 🗑
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| When is PTE most likely to occur | show 🗑
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| show | 15-24 % end up with PTE
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| The etiology of PTE (3 things) | show 🗑
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| show | Tachypnea
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| show | Postpartum (it crosses the placent easily - Heparin can be given antepartum)
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| How long after Low molecular weight heparin (LMWH) can a neuraxial be attempted | show 🗑
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