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Obstetrics Anesthesia MCQs

Total questions: 20

Worksheet time: 10mins

Name
Class
Date
1.

Which physiological change in pregnancy most significantly affects the minimum alveolar concentration (MAC) of volatile anesthetics?

a)

Increased cardiac output

b)

Decreased functional residual capacity

c)

Increased progesterone levels

d)

Decreased plasma protein binding

2.

What is the most common neuraxial technique used for labor analgesia in advanced labor due to its rapid onset?

a)

Epidural analgesia

b)

Combined spinal-epidural (CSE) analgesia

c)

Spinal analgesia

d)

Dural puncture epidural

3.

A 28-year-old woman in labor receives an epidural with 10 ml of 0.5% bupivacaine with epinephrine 1:200,000. Fifteen minutes later, her blood pressure is 70/50 mmHg, and fetal heart rate is 90 bpm with loss of variability. What is the most likely cause?

a)

Local anesthetic systemic toxicity

b)

Hypotension from sympathetic blockade

c)

Amniotic fluid embolism

d)

Uterine hyperstimulation

4.

Which medication is commonly administered preoperatively to reduce the risk of aspiration in pregnant patients undergoing general anesthesia?

a)

Ranitidine

b)

Bicitra (sodium citrate)

c)

Metoclopramide

d)

Ondansetron

5.

Why is fetal exposure to chloroprocaine lower than to bupivacaine following maternal epidural injection?

a)

Chloroprocaine has a shorter half-life

b)

Chloroprocaine is metabolized by plasma cholinesterase

c)

Bupivacaine has higher lipid solubility

d)

Chloroprocaine is less protein-bound

6.

A 30-year-old woman undergoes cesarean delivery under spinal anesthesia with tetracaine. Twelve hours later, she develops bilateral loss of pain and temperature sensation below T8 and leg paralysis. What is the most likely cause?

a)

Epidural hematoma

b)

Anterior spinal artery syndrome

c)

Cauda equina syndrome

d)

Transient neurologic symptoms

7.

Which of the following is the LEAST likely clinical finding in a parturient with amniotic fluid embolism?

a)

Hypotension

b)

Hypoxemia

c)

Coagulopathy

d)

Hypertension

8.

What is the most appropriate anesthetic technique for a woman in the second stage of labor requiring analgesia for vaginal delivery?

a)

General anesthesia

b)

Pudendal nerve block

c)

Epidural analgesia

d)

Intravenous opioids

9.

Which of the following best explains the more rapid rise of alveolar concentration of volatile anesthetics in pregnant women?

a)

Increased tidal volume

b)

Decreased functional residual capacity

c)

Increased cardiac output

d)

Decreased minute ventilation

10.

A parturient receives magnesium sulfate for preeclampsia. Which anesthetic drug's dose requirement is LEAST affected by magnesium sulfate?

a)

Vecuronium

b)

Rocuronium

c)

Succinylcholine

d)

Atracurium

11.

What is the most appropriate initial action for a newborn with thick meconium, flaccid, apneic, bradycardic, and cyanotic at cesarean delivery?

a)

Immediate endotracheal intubation and suctioning

b)

Administer naloxone

c)

Start chest compressions

d)

Provide positive pressure ventilation

12.

A 26-year-old woman develops headache, nausea, and photophobia 36 hours after cesarean delivery with subarachnoid block. Her temperature is 38.8°C, and leukocyte count is 14,200/mm³. What is the next step?

a)

Administer antibiotics

b)

Perform a lumbar puncture

c)

Administer a blood patch

d)

Order a CT scan

13.

Which spinal cord segments transmit pain from uterine contractions and cervical dilatation during the first stage of labor?

a)

T6-T8

b)

T10-L1

c)

L2-L4

d)

S2-S4

14.

Which of the following reduces the risk of post-dural puncture headache (PDPH) during epidural placement?

a)

Using a larger gauge needle

b)

Orienting the needle perpendicular to meningeal fibers

c)

Using a rounded point needle

d)

Placing the patient in a lateral position

15.

A parturient receives 1000 ml of 5% dextrose in lactated Ringer's solution before delivery, resulting in a blood glucose of 580 mg/dl. What is the most likely neonatal risk?

a)

Intraventricular hemorrhage

b)

Neonatal hypoglycemia

c)

Respiratory distress syndrome

d)

Hyperbilirubinemia

16.

Which technique is most appropriate for anesthesia during removal of a retained placenta after delivery with a pudendal block?

a)

General anesthesia

b)

Spinal anesthesia

c)

Epidural top-up

d)

Intravenous sedation

17.

Why does succinylcholine 1 mg/kg rarely cause fetal neuromuscular blockade in pregnant women?

a)

Low placental transfer

b)

Rapid maternal metabolism

c)

High fetal cholinesterase activity

d)

Low fetal sensitivity to succinylcholine

18.

Which of the following is NOT a recognized side effect of magnesium sulfate in preeclampsia that concerns anesthesiologists?

a)

Potentiation of neuromuscular blockers

b)

Respiratory depression

c)

Hypotension

d)

Increased MAC of volatile anesthetics

19.

A woman at 40 weeks' gestation with a breech presentation requires uterine relaxation for vaginal delivery. Which agent is most effective?

a)

Nitroglycerin

b)

Magnesium sulfate

c)

Terbutaline

d)

Oxytocin

20.

What is the recommended dose of anti-D immunoglobulin for a rhesus-negative woman undergoing amniocentesis at 16 weeks?

a)

250 IU

b)

500 IU

c)

1000 IU

d)

1500 IU