The Anticipated Change in Oxygen Consumption
The Anticipated Change in Oxygen Consumption
1. For which of the following urgent obstetric conditions would it be considered
most appropriate to perform neuraxial anesthesia?
A. Placenta previa
B. Preterm footling breech
C. Uterine rupture with hemodynamic compromise
D. Severe obstetric hemorrhage
E. Profound fetal bradycardia
2. Which of the following symptoms is not consistent with a postdural puncture
A. Improves with lying flat, worsened by sitting or standing
B. Neck stiffness
D. Bifrontal distribution
E. Scalp tenderness
3. 23. What is the anticipated change in oxygen consumption during a normal
second stage of labor?
B. Increased by 20%
C. Increased by 50%
D. Increased by 70%
E. Increased by 100%
4. You are participating in the care of a complex obstetric patient who has a
history of severe pulmonary arterial hypertension and is undergoing induction
of labor. She is a G3P2 at 37 weeks with 2 prior vaginal deliveries and has had
progressive dyspnea over the last month, and a multidisciplinary discussion with
her cardiologist, maternal fetal medicine specialist, and anesthesia team took
place before her admission. She has an epidural in place and is now fully dilated
and beginning to push. During which phase of labor and delivery is the cardiac
output the greatest?
A. At the beginning of the first stage of labor (onset of contractions, cervical
dilation <5 cm)
B. At the end of the first stage of labor (full cervical dilation)
C. At the end of the second stage of labor (immediate postpartum period)
D. At the end of 24 hours after delivery
E. At the end of 72 hours after delivery
5. A 23-year-old G1P0 woman with an uncomplicated pregnancy is now beginning
the second stage of labor. Which of the following changes in respiratory
physiology would be expected for this patient compared with prepregnancy?
A. Decreased tidal volume and increased respiratory rate
B. Increased tidal volume and increased minute ventilation
C. Decreased tidal volume and increased minute ventilation
D. Increased tidal volume and decreased respiratory rate
E. Increased tidal volume and decreased minute ventilation
6. Which of the following statements regarding the effect of combined spinal
epidural (CSE) anesthesia on progress of labor is most correct?
A. CSE anesthesia techniques accelerate the progress of the second stage of labor.
B. CSE anesthesia techniques increase the rate of instrumental vaginal delivery.
C. Early placement CSE anesthesia increases the risk of cesarean delivery when
compared with later placement.
D. CSE anesthesia has no greater effect on the progress of labor than epidural
E. CSE has been shown to increase the risk of requiring a cesarean delivery
compared with epidural anesthesia alone.
7. A 31-year-old G2P0 woman with an epidural in place for labor analgesia has
been actively pushing for the last 2 hours and 15 minutes. Her partner inquires
whether this is a concerning duration of time. What would be considered a
prolonged second stage of labor in this patient?
A. Second stage lasting more than 1 hour with neuraxial anesthesia
B. Second stage lasting more than 1 hour without neuraxial anesthesia
C. Second stage lasting more than 2 hours with neuraxial anesthesia
D. Second stage lasting more than 3 hours with neuraxial anesthesia
E. Second stage lasting more than 4 hours with neuraxial anesthesia
28. Which of the following is not a strong indication for cesarean delivery?
A. Previous Pfannenstiel incision cesarean delivery
B. Placenta previa
C. Breech presentation
D. Prolapsed umbilical cord
E. Prior myomectomy
9. 29. For which of the following conditions would general anesthesia be
considered the preferred technique for a cesarean delivery?
A. High body mass index (BMI)/obesity
B. History of malignant hyperthermia
C. Severe psychiatric disorder
D. History of pulmonary disease
E. History of difficult intubation10. Which of the following pregnancy-related changes is least likely to contribute
to airway complications during intubation?
A. Presence of a Mallampati class III or IV airway
B. Friable oral mucosa
C. Increased metabolic need and oxygen consumption
D. Decreased lower esophageal sphincter tone
E. Decreased duration of paralysis following succinylcholine administration
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