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Anesthesia for cesarean delivery & Anesthesia for non-obstetric

Total questions: 10

Worksheet time: 10mins

Name
Class
Date
1.

A 20-year-old G1 P0 female at 42 weeks of gestation presents to labor and delivery floor with rupture of membranes and onset of early labor. She appears uncomfortable and becomes extremely anxious with peripheral IV placement, and begins to hyperventilate. If allowed to continue hyperventilation, it will cause

a)

Increased placental perfusion

b)

Decreased maternal arterial pH

c)

Increased fetal arterial pH

d)

Decreased maternal uterine artery flow

2.

Which of the following drugs does NOT pass the placenta easily?

a)

Etomidate

b)

Ephedrine

c)

Atropine

d)

Glycopyrrolate

3.

A 38- year-old obese patient is receiving subcutaneous low-molecular -weight

heparin (LMWH) for thromboprophylaxis. Her epidural for an elective cesarean delivery was placed 14 hours after the heparin was stopped. She developed Horner syndrome on the left side 30 minutes after placement of the epidural. On physical examination, a T4 anesthetic level is noted, but aside from the Horner syndrome no other findings are revealed. The most appropriate course of action at this time would be to

a)

Remove the epidural

b)

Consult a neurosurgeon

c)

Obtain a computed tomographic scan

d)

None of the above

4.

Magnesium sulfate (MgSO4) is used as an anticonvulsant in patients with

preeclampsia and for fetal neuroprotection and sometimes for short-term

tocolysis. MgSO4 may produce any of the following effects EXCEPT

a)

Sedation

b)

Respiratory paralysis

c)

Inhibition of acetylcholine (ACh) release at the myoneural

junction

d)

Hypertension when used with nifedipine

5.

A 29- year -old gravida 1, para 0 woman at 8 weeks of gestation is to undergo

an emergency appendectomy under general anesthesia with isoflurane, N2O,

and oxygen. Which of the following is a proven untoward consequence of

general anesthesia in the unborn fetus ?

a)

Congenital heart disease

b)

Cleft palate

c)

Behavioral defects

d)

None of the above

6.

A lumbar epidural is placed in a 24- year -old gravida 1, para 0 parturient with

myasthenia gravis (MG) for labor. Select the TRUE statement regarding neonatal MG.

a)

The newborn is almost always affected with myasthenia

b)

The newborn is affected by maternal immunoglobulin M (IgM)

antibodies

c)

The newborn may require anticholinesterase therapy for up to 4

weeks

d)

The newborn will need lifelong treatment

7.

Which of the following patients is MOST likely to need an emergency

hysterectomy f or uncontrolled bleeding at the time of delivery?

a)

Patient undergoing cesarean section after an unsuccessful trial of

labor after cesarean (TOLA C)

b)

Patient with quadruplets

c)

Patient with a placenta previa (not bleeding) for an elective repeat

cesarean section

d)

Patient with an abdominal pregnancy

8.

General anesthesia is induced in a 35- y ear -old patient for elective cesarean

section. No part of the glottic apparatus is visible after two unsuccessful

attempts to intubate, but mask ventilation is adequate. The most appropriate

step at this point would be to

a)

Wake up the patient

b)

Attempt a blind nasal intubation

c)

Continue mask ventilation and cricoid pressure

d)

Use a laryngeal mask airway

9.

Cigarette smoking is associated with an increase of each of the following

EXCEPT

a)

Spontaneous fetal loss

b)

Placental abruption

c)

Preeclampsia

d)

Sudden inf ant death syndrome (SIDS)

10.

When performing a rapid-sequence induction (RSI) for an emergency

cesarean delivery , which of the following muscle relaxants is LEAST

desirable to use after the IV general anesthetic is administered?

a)

Atracurium

b)

Rocuronium

c)

Succinylcholine

d)

Vecuronium