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dd72d18a-33f8-5758-adf1-317fd4a67179 | Select the TRUE statement regarding complex regional pain syndrome (CRPS) in children | More common in males than females | Upper extremity is more frequently involved than the lower extremity | Best treated with sympathetic blocks | Often associated with depression and anxiety | 4 | D | 1 | null | null | null | null | null |
70faf36d-5d2a-51ea-96be-3538b864731c | Which of the following statements regarding perioperative cardiac arrest in children is NOT correct? | Cardiac arrest is more common in neonates than in infants or older children | "Equipment related" causes occur in more than 25% of cardiac arrests | Resuscitation is more often successful if the cause is anesthesia related rather than nonanesthesia related | Emergency surgery is associated with greater than four times the chance of a cardiac arrest | 4 | B | 1 | null | null | null | null | null |
6876028a-969f-56cc-8408-6ae0d9a24194 | Which of the following represents the greatest risk for postoperative apnea in an infant? | PCA of 60 weeks | Hemoglobin 10 g/dL | Recovery in the postanesthesia care unit (PACU) after pyloric stenosis repair | 20th weight percentile on growth chart | 4 | C | 3 | null | null | null | null | null |
7f7c7b12-bf49-5594-8e20-5c21ee3ec697 | Which of the following statements regarding the Mapleson D breathing circuit is FALSE? | It has a proximal fresh gas inflow and a distal overflow valve | With an inspiratory-to-expiratory (I:E) breathing ratio of 1:2, rebreathing is eliminated with spontaneous ventilation when the fresh gas flow is three times the minute ventilation | The Mapleson D circuit requires lower fresh gas flows with spontaneous ventilation compared with controlled ventilation | The Bain circuit is a modification of the Mapleson D circuit | 4 | C | 1 | null | null | null | null | null |
737577b1-fb53-5ed6-9a78-70a71c94e319 | Which of the following is LEAST likely to reduce the incidence of postoperative apnea in preterm infants undergoing surgery for inguinal hernia repair? | Delaying operation until 60 weeks' PCA | Preoperative correction of anemia | Caffeine administration | Spinal anesthetic with ketamine sedation | 4 | D | 3 | null | null | null | null | null |
0b552a43-5451-58d5-a70b-3f31da9824b5 | A 32-week-EGA, 2-kg newborn born a few hours ago is to undergo a repair of his gastroschisis under general anesthesia. Which of the following sizes of uncuffed ETTs should you use, and how far should it be positioned to most likely be properly placed in the trachea (gums to midtrachea distance)? | 2.0-internal diameter (ID) ETT placed at 6 cm | 2.5-internal diameter (ID) ETT placed at 8 cm | 3.0-internal diameter (ID) ETT placed at 10 cm | 3.5-internal diameter (ID) ETT placed at 12 cm | 4 | B | 2 | null | null | null | null | null |
01abb434-3e33-57bc-abb4-0412b1d6941e | Induction of general anesthesia for an elective operation should be | 2 hours | 4 hours | 6 hours | No fasting needed because breast milk is OK | 4 | B | 1 | null | null | null | null | null |
3a457653-a56f-59be-846d-17c78ed71ee7 | In the infant, hypothermia would LEAST likely manifest as | Metabolic acidosis | Prolonged duration of action of nondepolarizing muscle relaxants | Hyperglycemia | Impaired coagulation | 4 | C | 1 | null | null | null | null | null |
5193a5f3-ead0-5e7c-8b88-ea63a5842622 | Necrotizing enterocolitis (NEC) has all of the following characteristics EXCEPT | Most have thrombocytopenia (< 70,000/mm3 ) and a prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) | Commonly associated with decreased cardiac output in the presence of fetal asphyxia or postnatal respiratory complications | Umbilical artery catheters are useful to assess acid-base status | Occurs in 10% to 20% of newborns weighing less than 1500 g | 4 | C | 1 | null | null | null | null | null |
41205312-44f1-5d91-872d-d719b9bcbdd0 | Which of the following statements concerning codeine is INCORRECT? | Codeine is a weak opioid and is used for the treatment of mild to moderate pain | Peak blood level after oral or IM administration is about 30 minutes | Codeine is metabolized to morphine | Codeine is the postoperative analgesic of choice, after acetaminophen, for the treatment of pain after tonsillectomy in children < 12 years of age | 4 | D | 1 | null | null | null | null | null |
4043ba9f-773f-55c5-ad65-0fc19f57bd13 | Which of the following drugs is LEAST likely to be used for a 4-yearold receiving proton beam radiation treatment for his medulloblastoma? | EMLA cream | Propofol | Rocuronium | Dexmedetomidine | 4 | C | 2 | null | null | null | null | null |
93cd66d5-4d5b-56cd-af41-aa6367354f8a | A 5-year-old girl with hemolytic-uremic syndrome (HUS) is brought to the OR for placement of a dialysis catheter. Medical issues typical for this disease include | Thrombocytopenia | Increased intracranial pressure | Pancreatitis | All of the above | 4 | D | 1 | null | null | null | null | null |
bcea7431-9e20-503d-bc49-181c27b98d91 | A 3-year-old child status post resection of Wilms tumor at age 2 years is receiving doxorubicin (Adriamycin) and cyclophosphamide for metastatic disease. The patient is scheduled for placement of a Hickman catheter for continued chemotherapy. Anesthetic concerns related to this patient's chemotherapeutic treatment incl... | Thrombocytopenia | Inhibition of plasma cholinesterase | Cardiac depression | Pulmonary toxicity | 4 | D | 1 | null | null | null | null | null |
d295a5c9-be67-5964-b5bd-25ce4686c9e1 | Hypotension in children is characterized by a systolic blood pressure | Less than 60 mm Hg for the term neonate (0-28 days old) | Less than 70 mm Hg for infants 1 to 12 months old | Less than 70 mm Hg + (2 × age in years) mm Hg for children 1 to 10 years old | All of the above | 4 | D | 1 | null | null | null | null | null |
16111876-3470-5d9b-a669-76d2286918b0 | What percent of the adult's glomerular filtration rate, or GFR, does a 1 year-old possess? | 30% | 50% | 75% | 100% | 4 | D | 1 | null | null | null | null | null |
c029ee82-c4ac-5768-9e22-f7b659706ba8 | Each of the following results in a reduction of the incidence of postoperative vomiting (POV) in children undergoing strabismus surgery EXCEPT | IV hydration of 30 mL/kg/hr | Dexamethasone 0.15-0.5 mg/kg IV | Ondansetron 50 to 200 μg/kg IV | Anticholinergics (atropine 10-20 μg/kg or glycopyrrolate 10 μg/kg)# Pediatric Physiology and Anesthesia | 4 | D | 1 | null | null | null | null | null |
8e189cf5-b6f0-5218-af12-c84a6876b91c | Which of the following drugs does NOT pass the placenta easily? | Etomidate | Ephedrine | Atropine | Glycopyrrolate | 4 | D | 1 | null | null | null | null | null |
e98ce3c4-c686-5d2d-88c8-27700e142622 | A 38-year-old obese patient is receiving subcutaneous low-molecularweight 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 examin... | Remove the epidural | Consult a neurosurgeon | Obtain a computed tomographic scan | None of the above | 4 | D | 3 | null | null | null | null | null |
af2e7c62-ddf6-5774-9166-3991631883ba | What percentage of all pregnancies is affected by hypertension? | 3%-5% | 7%-10% | 15% | 20% | 4 | B | 1 | null | null | null | null | null |
cc24970a-ebf4-54b5-8045-82060d55e998 | 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 | Sedation | Respiratory paralysis | Inhibition of acetylcholine (ACh) release at the myoneural junction | Hypertension when used with nifedipine | 4 | D | 1 | null | null | null | null | null |
f23b8e4f-741d-592c-a512-a325acb15c61 | Normal fetal heart rate (FHR) is | 60 to 100 beats/min | 90 to 130 beats/min | 110 to 160 beats/min | 150 to 200 beats/min | 4 | C | 1 | null | null | null | null | null |
95078886-95de-5f24-952a-5201d3a4b4e2 | Which of the following is the MOST likely cause of pregnancy-related deaths in the United States (2011-2013)? | Anesthesia complications | Hemorrhage | Cardiovascular disease | Hypertensive disorders of pregnancy | 4 | C | 1 | null | null | null | null | null |
991b877d-cc82-5eff-b243-13d19aed57ae | Drugs useful in the treatment of uterine atony in an asthmatic patient with severe preeclampsia include | Oxytocin (Pitocin) only | Ergonovine (Ergotrate) or methylergonovine (Methergine) only | 15-Methyl prostaglandin F2α (PGF2α ) (Carboprost, Hemabate) only | All of the above are safe and can be used alone or in combination with the others | 4 | A | 2 | null | null | null | null | null |
9c2cd3e0-cbf4-5845-9002-3aac329472d7 | What is the P50 of fetal hemoglobin at term? | 12 mm Hg | 18 mm Hg | 24 mm Hg | 30 mm Hg | 4 | B | 1 | null | null | null | null | null |
a7aed22a-9943-5a63-912e-14c603adc69c | Side effects of terbutaline include all of the following EXCEPT | Hypertension | Hyperglycemia | Pulmonary edema | Hypokalemia | 4 | A | 1 | null | null | null | null | null |
febb7327-1d72-56d9-8828-16b5eda08877 | Cardiac output increases dramatically during pregnancy and delivery. The cardiac output returns to nonpregnant values by how long postpartum? | 12 hours | 1 day | 2 weeks | 6 months | 4 | C | 1 | null | null | null | null | null |
b3a021e8-1b1c-57e1-af15-c16317dd17a9 | A 32-year-old parturient with a history of spinal fusion, severe asthma, and hypertension (blood pressure 180/110) is brought to the operating room wheezing. She needs an emergency cesarean section under general anesthesia for a prolapsed umbilical cord. Which of the following induction agents would be MOST appropriate... | Sevoflurane | Midazolam | Ketamine | Propofol | 4 | D | 3 | null | null | null | null | null |
9b75c2d6-4104-54a9-8966-a6adeaf30eda | Uterine blood flow at term pregnancy typically increases to about | 100 mL/min | 250 mL/min | 500 mL/min | 750 mL/min | 4 | D | 1 | null | null | null | null | null |
f937982b-d93f-514b-95c0-bb1e5fbcea57 | Which one of the following statements is TRUE regarding human immunodeficiency virus (HIV) infected parturients? | Central neurologic blockade and epidural blood patches increase the chance of neurologic complications | Ninety percent of newborns of untreated HIV-seropositive mothers become infected in utero, during vaginal delivery,or with breastfeeding | The pharmacologic effects of benzodiazepines and narcotics are prolonged in patients taking protease inhibitors | The risk of seroconversion after percutaneous exposure to HIV-infected blood is about 5% | 4 | C | 1 | null | null | null | null | null |
b8064eaa-4ad2-58c1-8a62-700057afb66d | Which of the following cardiovascular parameters is decreased at term? | Central venous pressure | Pulmonary capillary wedge pressure | Systemic vascular resistance | Left ventricular end-systolic volume | 4 | C | 1 | null | null | null | null | null |
b3bc590c-81da-56a8-8c1b-000316f4119b | Which of the following signs and symptoms is NOT associated with amniotic fluid embolism (AFE)? | Chest pain | Bleeding (disseminated intravascular coagulation [DIC]) | Pulmonary vasospasm with severe pulmonary hypertension and right heart failure | Left ventricular failure and pulmonary edema | 4 | A | 1 | null | null | null | null | null |
cbc57c92-c89f-5565-93e4-0277e2dda81c | When is the fetus most susceptible to the effects of teratogenic agents? | 1 to 2 weeks of gestation | 3 to 8 weeks of gestation | 9 to 14 weeks of gestation | 15 to 20 weeks of gestation | 4 | B | 1 | null | null | null | null | null |
e2e6553e-0fe8-52bb-b927-f6e548eb94da | A 28-week estimated gestational age (EGA), 1000-g male infant is born to a 24-year-old mother who is addicted to heroin. The mother admits taking an extra "hit" of heroin before coming to the hospital because she was nervous. The infant's respiratory depression would be best managed by | 0.1 mg/kg naloxone intramuscularly (IM) in the newborn's thigh muscle | 0.1 mg/kg naloxone down the endotracheal tube | 0.4 mg naloxone IM to the mother during the second stage of labor | None of the above | 4 | D | 2 | null | null | null | null | null |
80db68b8-9539-5cef-bc64-70a185992908 | Cardiac output is GREATEST | During the first trimester of pregnancy | During the third trimester of pregnancy | During labor | Immediately after delivery of the newborn | 4 | D | 1 | null | null | null | null | null |
2c99aaba-4eb4-5de9-bf51-abdb25628b10 | A 1000-g, 27-week EGA boy is born with a heart rate of 80 beats/min. He has slow irregular respiratory efforts, grimaces when a suction catheter is inserted into the mouth and nose for suctioning, and flexes his limbs some but is totally cyanotic. The umbilical cord has only two vessels. The 1-minute Apgar score would ... | 3 | 4 | 6 | 7 | 4 | B | 2 | null | null | null | null | null |
fff85a0a-3c53-5794-9676-86deeb257684 | Which of the following respiratory parameters is NOT increased in the parturient? | Minute ventilation (MV) | Tidal volume (Vt) | Arterial Pao2 | Serum bicarbonate | 4 | D | 1 | null | null | null | null | null |
b7df4541-0c4a-56a3-8807-2b9914da6f0f | Which of the following drugs should NOT be used during transvaginal oocyte retrieval (TVOR) for assisted reproductive technology (ART)? | Propofol | Ketamine | Midazolam | All are safe and can be used | 4 | D | 1 | null | null | null | null | null |
9cc1df7b-9c70-57ab-a22b-03a7e48bdcfb | Which of the following conditions is associated with increased bleeding during pregnancy? | Lupus anticoagulant | Factor V Leiden mutation | Protein C deficiency | None of the above | 4 | D | 1 | null | null | null | null | null |
de3b483c-22e1-52da-b60d-cb301111ffee | What is the BEST way to prevent autonomic hyperreflexia in a quadriplegic woman who is to undergo induction of labor? The complete spinal cord lesion occurred 2 years ago. | Only IV drugs should be used; spinal and epidural anesthesia are contraindicated | Spinal or epidural lumbar local anesthetics such as bupivacaine alone are effective | Spinal or epidural narcotics such as fentanyl alone are effective | Autonomic hyperreflexia appears only when the complete spinal cord lesion is below T6, so there is no need to worry | 4 | B | 2 | null | null | null | null | null |
2098d859-c60d-54fc-b966-343cb72ff124 | A 24-year-old gravida 2, para 1 parturient is anesthetized for emergency cesarean section. On emergence from general anesthesia, the endotracheal tube is removed and the patient becomes cyanotic. Oxygen is administered by positive-pressure bag and mask ventilation. High airway pressures are necessary to ventilate the p... | Amniotic fluid embolus (AFE) | Mucus plug in trachea | Tension pneumothorax | Aspiration | 4 | D | 2 | null | null | null | null | null |
0aa6b0d7-258c-5188-b49b-56d8769da26f | 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. | The newborn is almost always affected with myasthenia | The newborn is affected by maternal immunoglobulin M (IgM) antibodies | The newborn may require anticholinesterase therapy for up to 4 weeks | The newborn will need lifelong treatment | 4 | C | 1 | null | null | null | null | null |
91462985-036e-5930-8458-02d77e9c3fa3 | A patient having which of the following conditions is LEAST likely to develop DIC? | Severe preeclampsia | Placental abruption | Placenta previa (bleeding) | Dead fetus syndrome | 4 | C | 1 | null | null | null | null | null |
835e3f61-5ea0-53c6-affd-afbd6b95f440 | A 28-year-old gravida 1, para 0 parturient with Eisenmenger syndrome (pulmonary hypertension with an intracardiac right-to-left or bidirectional shunt) is to undergo placement of a lumbar epidural for analgesia during labor. It may be wise to avoid a local anesthetic with epinephrine in this patient because it | Lowers pulmonary vascular resistance | Lowers systemic vascular resistance | Increases heart rate | Causes excessive increases in systolic blood pressure (SBP) | 4 | B | 2 | null | null | null | null | null |
ef166ff9-aa93-5221-b765-72eab8c777c6 | Which of the following patients is MOST likely to need an emergency hysterectomy for uncontrolled bleeding at the time of delivery? | Patient undergoing cesarean section after an unsuccessful trial of labor after cesarean (TOLAC) | Patient with quadruplets | Patient with a placenta previa (not bleeding) for an elective repeat cesarean section | Patient with an abdominal pregnancy | 4 | C | 3 | null | null | null | null | null |
08624a03-6afa-541c-aaea-5591a25f97fc | The MOST common injury recorded in the American Society of Anesthesiologists' (ASA's) Closed Claims Project regarding obstetric anesthetic claims is | Pain during anesthesia | Maternal nerve damage | Headache | Aspiration pneumonitis | 4 | B | 1 | null | null | null | null | null |
47e2e7b7-f524-5a6f-b30e-97f7e413f265 | Which of the following statements about chorioamnionitis is FALSE? | Chorioamnionitis occurs in about 1% of all pregnancies | Clinical signs include temperature higher than 38° C, maternal and fetal tachycardia, and uterine tenderness | Antibiotics are administered only after delivery, because intrapartum antibiotics may "obscure the results of neonatal blood cultures" | Epidural anesthesia can be safely administered | 4 | C | 1 | null | null | null | null | null |
542a739b-7751-5571-b97a-8851efd3a930 | Which of the following statements regarding newborns with thick meconium-stained amniotic fluid is TRUE? | Only oral or nasal suctioning with a bulb syringe is needed in newborns that are vigorous | Intubation is required for all such newborns | Antibiotics and steroids are often needed to treat the infection | Respiratory distress syndrome (RDS) is common | 4 | A | 1 | null | null | null | null | null |
9c1a218a-d67f-5f11-802c-fc05653c3940 | A 38-year-old primiparous patient with placenta previa and active vaginal bleeding arrives in the operating room with a systolic blood pressure (SBP) of 85 mm Hg. A cesarean section is planned. The patient is lightheaded and scared. Which of the following anesthetic induction plans would be most appropriate for this pa... | Spinal anesthetic with 12 to 15 mg bupivacaine | General anesthetic induction with 2 to 2.8 mg/kg propofol and paralysis with 1 to 1.5 mg/kg succinylcholine | General anesthesia induction with 0.75 to 1 mg/kg ketamine and paralysis with 1 to 1.5 mg/kg succinylcholine | Replace lost blood volume first, then use any anesthetic the patient wishes | 4 | C | 3 | null | null | null | null | null |
7fbb0335-3188-529d-aee3-3943552b6f09 | Which of the following lung volumes or capacities change the LEAST during pregnancy? | Tidal volume (Vt) | Functional residual capacity (FRC) | Expiratory reserve volume (ERV) | Vital capacity (VC) | 4 | D | 1 | null | null | null | null | null |
3536d425-e527-5f94-9d4d-9581b433338a | General anesthesia is induced in a 35-year-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 | Wake up the patient | Attempt a blind nasal intubation | Continue mask ventilation and cricoid pressure | Use a laryngeal mask airway | 4 | A | 2 | null | null | null | null | null |
486942ac-8bc4-5ec8-9862-0fcd13e4a163 | Which patients describe their labor pain as being the MOST intense? | Primipara patients attending prepared childbirth classes | Primipara patients not attending prepared childbirth classes | Multipara patients attending prepared childbirth classes | Multipara patients not attending prepared childbirth classes | 4 | B | 2 | null | null | null | null | null |
4bab1db3-1088-5478-b5fa-6aa1be508cf3 | Cigarette smoking is associated with an increase of each of the following EXCEPT | Spontaneous fetal loss | Placental abruption | Preeclampsia | Sudden infant death syndrome (SIDS) | 4 | C | 1 | null | null | null | null | null |
96eaf1b4-3fbf-5ace-839d-8eb2be0d03e9 | All of the following are TRUE regarding the use of nitrous oxide for labor analgesia EXCEPT | Significant anxiolysis occurs | Do not need to have an IV line in place | Needs to be administered by anesthesia personnel | Only the patient can hold the mask or mouthpiece | 4 | C | 1 | null | null | null | null | null |
d81188b5-f6c8-5924-87b9-5ba028ffebcd | 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? | Atracurium | Rocuronium | Succinylcholine | Vecuronium | 4 | A | 2 | null | null | null | null | null |
394c3194-8a0c-5d80-a651-72c847df50b8 | True statements regarding inclusion of intrathecal morphine, fentanyl, or sufentanil in obstetric anesthesia practice include each of the following EXCEPT | The chief site of action is the substantia gelatinosa of the dorsal horn of the spinal column | There is no motor and no sympathetic blockade | Pain relief is adequate for the second stage of labor | Lipophilic narcotics are associated with less respiratory depression than nonlipophilic narcotics | 4 | C | 1 | null | null | null | null | null |
301cbb2c-662f-522e-a614-19ae5d035d68 | The MOST common side effect of intraspinal narcotics in the obstetric population is | Pruritus | Nausea and vomiting | Respiratory depression | Urinary retention | 4 | A | 1 | null | null | null | null | null |
16f71641-fba2-592f-bc8f-781f50ba7b99 | A 110-kg (242-lb), gravida 1, para 0 woman has a blood pressure of 180/95 during an office visit at the 16th week of gestation and 175/90 1 week later. She has some ankle but no facial edema, and no protein detected in her urine. Her serum creatinine is 1.2. These findings would be classified as | Preeclampsia | Chronic hypertension | Chronic hypertension with superimposed preeclampsia | Gestational hypertension | 4 | C | 3 | null | null | null | null | null |
0d332e14-47c9-5ed6-ac51-e1ed7c3d29ec | An epidural is placed into a 32-year-old parturient in active labor receiving magnesium therapy for preeclampsia. Five minutes after administration of the test dose, the loading dose of bupivacaine and fentanyl is administered. The patient becomes panic-stricken, wrestles briefly with the reassuring nurses, gasps for a... | Amniotic fluid embolism | High spinal | Intravascular bupivacaine injection | Eclampsia | 4 | A | 3 | null | null | null | null | null |
71b8150b-bc50-53b5-83fb-e870f7183dcd | Which of the following narcotics has the LONGEST duration of action when added during a cesarean section under epidural anesthesia? | 50 to 100 μg fentanyl | 10 to 20 μg sufentanil | 3 to 4 mg morphine | 50 to 75 mg meperidine | 4 | C | 1 | null | null | null | null | null |
4010ca38-d129-5c2f-b9c1-afd7596a35d2 | Which of the following is NOT increased during pregnancy? | Renal plasma flow | Creatinine clearance | Blood urea nitrogen (BUN) | Glucose excretion | 4 | C | 1 | null | null | null | null | null |
fb719c0e-8cd5-5bfe-ae26-b423caf4971a | Which inhalation anesthetic does NOT produce uterine relaxation? | Isoflurane | Sevoflurane | Nitrous oxide | All produce uterine relaxation | 4 | C | 1 | null | null | null | null | null |
ad17dd7a-6d44-50f3-a98f-b519a5b41b5d | Passive diffusion of substances across the placenta is enhanced by all of the following EXCEPT | Low molecular weight of the substance | High water solubility of the substance | Low degree of ionization of the substance | Large concentration gradient of the drug | 4 | B | 1 | null | null | null | null | null |
401a9ab4-474b-5e7e-8066-b0e82c83de90 | Cesarean delivery is associated with a blood loss of about | 250 mL | 500 mL | 750 mL | 1000 mL | 4 | D | 1 | null | null | null | null | null |
4a0aa139-3d17-52ad-a234-b860d9dd3ab0 | Which of the following statements is CORRECT in describing differences between fetal and maternal blood during labor? | Fetal blood has a lower hemoglobin concentration than does maternal blood | Fetal placental blood flow is twice maternal placental blood flow | Fetal hemoglobin has a greater affinity for O2 than does maternal hemoglobin | The fetal oxyhemoglobin dissociation curve is shifted to the right of the maternal oxyhemoglobin dissociation curve | 4 | C | 1 | null | null | null | null | null |
199c6c09-240d-5c3a-b4ad-2cde815af7e0 | In general, morbidly obese patients have a higher incidence of all of the following EXCEPT | Cesarean deliveries | Postdural puncture headaches (PDPHs) | Preeclampsia | Thromboembolic diseases | 4 | B | 1 | null | null | null | null | null |
0e07613a-a2d4-57a6-be2a-fcf87d5040bd | A term infant with good muscle tone and a strong cry has an oxygen saturation of 83%, breathing room air 5 minutes after delivery. The MOST appropriate action at this point would be | Supplemental increased oxygen concentration with a blender up to 50% by a face mask | Spontaneous breathing with 100% oxygen by face mask | Positive-pressure ventilation with 100% oxygen | Observation | 4 | D | 2 | null | null | null | null | null |
af8fecdb-52c2-5d58-baa6-e589ffd0a2db | Which condition BEST describes the third-trimester maternal condition with the following signs and symptoms: new-onset vaginal bleeding that stops, no pain, no fetal distress? | Placental abruption | Placenta previa | Uterine rupture | Vasa previa | 4 | B | 1 | null | null | null | null | null |
57d182bd-2442-5bc9-bdc9-e74d5e2de60e | During the second stage of labor, complete pain relief can be obtained with | Paracervical block | Neuraxial block with fentanyl and morphine | Pudendal nerve block | Lumbar epidural block with bupivacaine and no narcotic | 4 | D | 1 | null | null | null | null | null |
d9f0637e-d36e-5c4f-bb8a-ddcc53abc6ca | Anesthetic considerations for open fetal surgery include all of the following EXCEPT | Uterine relaxation is essential | Maternal hypotension (mean blood pressure < 65 mm Hg) can be treated with phenylephrine or ephedrine | Vecuronium at the ED95 dose of 0.04 mg/kg should be administered IM or IV by the obstetrician or surgeon if fetal muscle relaxation is needed | Normal fetal oxygen saturation is 50% to 70% | 4 | C | 1 | null | null | null | null | null |
edd1cf86-28b0-50f4-b9e0-31db402081be | 15-Methyl PGF2α is administered directly into the myometrium to treat uterine atony in a 28-year-old mother. Possible effects from treatment with this drug include | Nausea and vomiting | Bronchospasm | Hypoxia | All of the above | 4 | D | 1 | null | null | null | null | null |
2ddfe911-d131-5673-8490-5a177423034d | Which of the following statements regarding MgSO4 therapy for preeclampsia is TRUE? | The therapeutic range for serum magnesium is 10 to 15 mEq/L | High serum magnesium levels can be estimated by changes in deep tendon patellar reflexes in a patient with an epidural anesthetic loaded for a cesarean section | Excessive serum magnesium levels cause widening of the QRS complex | As soon as delivery occurs, the chance for eclampsia no longer exists and the magnesium should be reversed so that postpartum bleeding is less likely to occur | 4 | C | 1 | null | null | null | null | null |
e273efe3-c4e7-5878-98c6-b48416eaf497 | While moving a parturient from the birthing room to the operating room for an emergency cesarean section for a prolapsed umbilical cord, the patient develops cough, wheezing, and stridor and becomes cyanotic. | Intravenous lidocaine to suppress the cough | Glucocorticoids | 100% oxygen and positive end-expiratory pressure (PEEP) | Saline lavage | 4 | C | 2 | null | null | null | null | null |
ad13c2d1-3ad6-5932-8ed3-53e2418017d4 | Aortocaval compression starts to become significant in a normal pregnancy at how many weeks EGA? | 10 weeks | 15 weeks | 20 weeks | 25 weeks | 4 | C | 1 | null | null | null | null | null |
9c80f21c-1aeb-51dd-a916-a120d20f53c7 | Which agent is the MOST useful for raising the gastric pH just before induction of general anesthesia for emergency cesarean section? | Ranitidine | Sodium citrate | Metoclopramide | Magnesium hydroxide and aluminum hydroxide | 4 | B | 1 | null | null | null | null | null |
468702f4-1b58-5900-8f81-5e3cda2b0b8c | Causes of fetal bradycardia include all of the following EXCEPT | Maternal smoking of cigarettes | Neostigmine and glycopyrrolate reversal of neuromuscular blockers | Acidosis | Umbilical cord compression | 4 | A | 1 | null | null | null | null | null |
3d5fb97c-7dc0-5094-bec5-1998816e2b57 | Most cases of cerebral palsy (CP) are due to conditions during | Antepartum | Labor | Delivery | The first 30 days of life | 4 | A | 1 | null | null | null | null | null |
3d62821d-ad1f-59d2-9df3-aaca93738ff4 | All of the following statements regarding pregnant diabetic patients are true EXCEPT | Gestational diabetes mellitus (DM) occurs in about 7% of all pregnancies in the United States | Insulin readily crosses the placenta and causes larger babies | Cesarean section is more common in diabetic pregnancies | Diabetic ketoacidosis (DKA) occurs in 1% to 2% of Type- 1 DM pregnancies | 4 | B | 1 | null | null | null | null | null |
0f4ef80c-ae0d-5618-8982-b7ddfe883231 | In addition to the postural component of a postdural puncture headache (PDPH), signs and symptoms may include any of the following EXCEPT | Double vision | Hearing changes | Neck stiffness | Fever | 4 | D | 1 | null | null | null | null | null |
36232e30-4d32-515b-b0d0-2abc0a37b2bb | Early decelerations may occur in response to | Fetal head compression | Uteroplacental insufficiency | Maternal hypotension | Umbilical cord compression | 4 | A | 1 | null | null | null | null | null |
b849c55b-4f4b-55d9-8f02-b13605b676e2 | Agents that are useful for decreasing the incidence of shivering during cesarean section under regional anesthesia or for treating shivering include all of the following EXCEPT | Administration of intrathecal local anesthetic with fentanyl and/or morphine | Intravenous magnesium sulfate | Administration of epidural local anesthetic solutions with epinephrine | Intravenous meperidine | 4 | C | 1 | null | null | null | null | null |
f032bed0-9ccb-5ed8-864c-16f5584436a4 | An umbilical arterial blood gas sample at the time of an emergency cesarean delivery shows a Po2 of 20 mm Hg, a Pco2 of 50 mm Hg, a | Severe hypoxemia | Respiratory acidosis | Metabolic acidosis | Normal values | 4 | D | 1 | null | null | null | null | null |
e797e0e7-67f9-5862-8ea4-6ae7ab2e909b | Which is the MOST frequent condition requiring blood transfusions during or after a cesarean delivery? | Multiple gestations | Placental abruption | Placenta previa | Postpartum hemorrhage | 4 | D | 1 | null | null | null | null | null |
15658b8a-30ca-5d25-9e03-638fbe3ebdec | All of the following are appropriate techniques or drug doses to be used in resuscitating a depressed term newborn EXCEPT | Begin ventilation with air rather than 100% oxygen | If the heart rate is less than 60 beats/min, start chest compressions (ratio of chest compressions to ventilations is 3:1) | After adequate ventilation and chest compressions, administer 0.1 mg/kg of epinephrine IV | After 10 minutes of no detectable heart rate, it may be reasonable to discontinue resuscitation efforts | 4 | C | 1 | null | null | null | null | null |
e574a396-8aaa-590a-b09b-fa8f7684dd31 | Compared with a healthy 25-year-old primigravida, which of the following conditions is NOT associated with a significantly higher incidence of hypertensive disorders of pregnancy? | Multiple gestations | Cigarette smoking (> 1 pack/day) | Obesity | Placental abruption | 4 | B | 1 | null | null | null | null | null |
7e9ef673-1038-56dc-918d-b832aee88353 | Adverse effects (on the mother) associated with aortocaval compression by the gravid uterus include | Nausea and vomiting | Changes in cerebration | Fetal distress | All of the above | 4 | D | 1 | null | null | null | null | null |
1d0ad9e0-aba3-503d-8043-e7dbe06e149c | Which of the following statements regarding a pregnant patient abusing cocaine is FALSE? | Hypertension, arrhythmias, myocardial ischemia, and tachycardia may occur with the rapid-sequence induction of general anesthesia in the acutely intoxicated patient | The minimum alveolar concentration (MAC) for general anesthetics is increased in chronic cocaine addicts | Some states consider in utero drug exposure to be a form of child abuse and require physicians to report these patients | If a vasopressor is needed to treat hypotension, phenylephrine is preferred over ephedrine | 4 | B | 1 | null | null | null | null | null |
702deaec-4a0e-5462-ad7f-4dbe62a016a2 | Each of the following is correct when advising the surgeon to perform infiltration anesthesia for an emergency cesarean delivery when general and neuraxial anesthesia are contraindicated EXCEPT | A midline incision is most desirable | The rectus muscle should be injected to provide good skin analgesia | Bupivacaine with bicarbonate is the local anesthetic of choice | Mild sedation with ketamine and midazolam is permissible | 4 | C | 2 | null | null | null | null | null |
bf5b6382-3869-5111-b652-798182c3c1d8 | A 24-year-old primiparous woman is undergoing an elective cesarean section (breech position). After prehydration with 1500 mL of saline, a spinal anesthetic is performed; 5 minutes later, the blood pressure is noted to be 80/40 mm Hg and the heart rate is 110 beats/min. The BEST treatment (best fetal pH) after ensuring... | Phenylephrine | Ephedrine | Epinephrine | 1000 mL 5% dextrose in lactated Ringer solution | 4 | A | 2 | null | null | null | null | null |
7ef9368f-55e9-5661-ba53-8883228d79f6 | A woman has been admitted for a dilation and evacuation (D&E) at 10 weeks' EGA. She has some persistent bleeding and cramping after the expulsion of some tissue. Her obstetric condition is called | A threatened abortion | An inevitable abortion | A complete abortion | An incomplete abortion | 4 | D | 1 | null | null | null | null | null |
60619cae-b9c8-50b3-ae53-13c387ab024c | Which of the following treatments has proven effective in decreasing the incidence of PDPHs after an accidental dural puncture with an epidural needle? | Bed rest | Prophylactic hydration | Prophylactic epidural blood patch after delivery | None of the above | 4 | D | 1 | null | null | null | null | null |
651ce2fb-bcca-5d0f-b24a-caa6317a05a9 | Factors associated with advanced molar pregnancy (i.e., > 14 to 16 week size uterus) include all of the following EXCEPT | Hypertensive disorders of pregnancy | Hypothyroidism | Acute cardiopulmonary distress | Hyperemesis gravidarum | 4 | B | 1 | null | null | null | null | null |
e2958dfc-6a1a-5efe-8836-36bbce87957c | Refractory cardiac arrest is MOST likely after the rapid unintentional IV injection of which of the following local anesthetics? | Lidocaine | Bupivacaine | Ropivacaine | Chloroprocaine | 4 | B | 1 | null | null | null | null | null |
83650d57-d4d2-59eb-8bda-4f9fd432f1c0 | American Society of Regional Anesthesia (ASRA) guidelines for the treatment of local anesthetic systemic toxicity (LAST) for cardiac arrhythmias include the use of Intralipid and the AVOIDANCE of all of the following drugs EXCEPT | Vasopressin | β-Blockers | Calcium channel blockers | Low-dose epinephrine (< 1 μg/kg) | 4 | D | 1 | null | null | null | null | null |
c0eb56bf-27fb-55d5-86f3-147c0a639de4 | Transient neurologic syndrome (TNS) is MOST commonly seen after the spinal anesthetic injection of which local anesthetic? | Lidocaine | Bupivacaine | Prilocaine | Tetracaine | 4 | A | 1 | null | null | null | null | null |
cdd026b0-0855-5df4-8642-507ce54b0407 | You have a well-working T10 labor epidural in a woman with a questionable difficult airway and have just been informed that an urgent cesarean section is needed for a nonreassuring FHR tracing. Which of the following local anesthetics would give you the SLOWEST onset of surgical anesthesia? | 3% chloroprocaine with freshly added epinephrine (1:200,000) | 2% lidocaine with freshly added epinephrine (1:200,000) | 2% lidocaine and epinephrine with added bicarbonate | 0.5% levobupivacaine with fentanyl | 4 | D | 1 | null | null | null | null | null |
8d49b35c-2e8f-5ba1-918c-66cbdbafeab2 | Which local anesthetic has the SHORTEST plasma half-life after being injected into the epidural space? | Bupivacaine | Chloroprocaine | Lidocaine | Ropivacaine# Obstetric Physiology and Anesthesia | 4 | B | 1 | null | null | null | null | null |
a8888356-d99e-51a5-91f6-16353a402b45 | A 59-year-old man with a subarachnoid hemorrhage (SAH) is admitted to the intensive care unit (ICU). His serum sodium is 115 mEq/L, 24 hour urine sodium collection is 350 mmol, and central venous pressure (CVP) is 1 mm Hg. The MOST likely cause of these findings is | Acute tubular necrosis (ATN) | Diabetes insipidus (DI) | Cerebral salt-wasting syndrome (CSWS) | Syndrome of inappropriate antidiuretic hormone (SIADH) | 4 | C | 2 | null | null | null | null | null |
3a53419f-827d-5dc8-b284-6808d8e56985 | Intracranial hypertension is defined as a sustained increase in intracranial pressure (ICP) above | 5 to 10 mm Hg | 15 to 20 mm Hg | 25 to 30 mm Hg | 30 + mm Hg | 4 | B | 1 | null | null | null | null | null |
49425ec5-fef5-5d77-b6e8-8b76ca50c8b8 | Calculate cerebral perfusion pressure (CPP) from the following data: blood pressure (BP) 100/70, heart rate (HR) 65 beats/min, cardiac output 5 L/min, CVP of 5 cm/H2O, and ICP 15 mm Hg | 60 mm Hg | 65 mm Hg | 70 mm Hg | 75 mm Hg | 4 | B | 2 | null | null | null | null | null |
7e1159be-4dba-53b4-bb81-6d9412291a78 | Which of the following statements about cerebrospinal fluid (CSF) in a healthy adult is FALSE? | CSF volume is about 150 mL | CSF pressure is about 10 mm Hg | CSF volume turns over 4 times a day | Specific gravity of CSF is higher than the specific gravity of plasma | 4 | D | 1 | null | null | null | null | null |
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