EFM exam | Questions With 100% Correct Answers | Verified
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Course
EFM certification
Institution
EFM Certification
Hypoxemia - Decreased oxygen in blood
Hypoxia - Not enough oxygen to supply organs
Normal fetal PO2 - 15-25 mmhm
What factors can change the maternal HR? - Intrinsic pacemakers (SA & AV node)
Cardiac conduction system
Autonomic regulation... Sympathetic, parasympathetic
Humoral factors (catec...
What factors can change the maternal HR? - ✔✔Intrinsic pacemakers (SA & AV node)
Cardiac conduction system
Autonomic regulation... Sympathetic, parasympathetic
Humoral factors (catecholamines)
Extrinsic factors (medications)
Local factors (Ca, K)
What are the 3 most common causes of decrease cardiac output in the OB patient? - ✔✔Reduced
preload (HypoTN) from
-hypovolemia
-compression of inferior vena cava
-anesthesia
In what area of the placenta does exchange of gases, nutrients, waste, hormones, antibodies &
medications occur? - ✔✔Maternal blood in the intervillous space
and fetal blood in the villous capill aries
These are separated by the blood -blood barrier
Oxygen, CO2, NaCl, lipids, vitamins and some drugs are exchanged by... - ✔✔Simple diffusion
Amino acids, water -soluble vitamins & large ions are transported by... - ✔✔Active transport
What conditions decrease the volume of the blood in the intervillous space? - ✔✔Abruption
Infarction
Thrombosis
Infection
...These can also decrease the surface area of the chorionic villous thus decreasing O2 absorption (less
surface area = less absorption)
Diffusion across the blood -blood barrier is inversely proportional to _ - ✔✔Distance. Greater distance =
less diffusio n
Villous hemorrhage, thrombosis, infarction, deems, fibrosis...can increase distance
What could result from trauma that causes damages chorionic vessels? - ✔✔Maternal -fetal hemorrhage!
Ruptured vasa previa - ✔✔Vasa previa is a placental vessels that cro sses the chorionic membrane and is
close to the cervical os. It can be damaged from just a cervical exam or cervical check!
What 3 shunts/mechanisms direct oxygenated blood to vital organs in the fetus? - ✔✔Ductus venous,
foramen ovale, ductus arteriosus
When fetus is born, what changes are responsible for the fetus's transition to neonate life? -
✔✔Umbilical -placental circulation is eliminated
Clamping of umbilical cord eliminates umbilica. -placental circulation and raises the BP in neonate's aorta
Flow across ductus arteriosus is reversed
Catecholamines release increases BP & HR
Expansion of neonate's lungs occurs
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The fetal circulation is designed to send oxygenated blood primarily to what 3 organs in the fetus? -
✔✔brain, heart, adrenal gland
Which ve ntricle is dominant in the fetal heart? - ✔✔Right ventricle
Because fetal circulation works in parallel rather than in series like adult circulation
Umbilical vein - type of blood it carries & where? - ✔✔Carries oxygenated blood from placenta to fetus
Compression of umbilical vein - ✔✔Can cause acceleration, sometimes before a variable or prolonged
accelerations
Umbilical artery - ✔✔Carries deoxygenated blood from fetus to placenta
CO = HR x SV for a fetus - ✔✔Cardiac output for a fetus is only re lated to their heart rate, not their stroke
volume. a fetus cannot regulate their stroke volume, only their heart rate
Aerobic metabolism - ✔✔O2 > ATP > by products are CO2 & H2O
Hypoxia can lead to what time of metabolism? - ✔✔Anaerobic metabolism... by product = lactic acid
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Sustained hypoxia > sustained anaerobic metabolism with by product of lactic acid leads to _ -
✔✔Metabolic acidosis
Metabolic acidosis - ✔✔Accumulation of lactic acid in the body (Low pH)
The body then tries to use buffer bases (bi carbonate) to help increase the pH to a more basic/neutral
level
Eventually the buffering capacity is exceeded and the pH is low and cannot be raised to a normal level
Sustained metabolic acidosis leads to _ - ✔✔Metabolic acidemia
When the body cannot rai se the pH to a normal level with buffering bases, sustained low pH
What will sustained hypoxia & metabolic acidosis lead to? - ✔✔Loss of peripheral vascular smooth
muscle contraction, which decreases peripheral vascular resistance
>>>>> Leads to Fetal Hyp otension
>>>>>>>>>>Hypoxic injuries to fetal heart & brain
Distinguish between metabolic & respiratory academia - ✔✔Metabolic acidemia is ^ lactic acid
Respiratory academia is ^ CO2
Causes of respiratory acidemia - ✔✔increased CO2
cord compression/true knot
-can develop rapidly and can correct rapidly
Intermittent Auscultation done with 4 devices - ✔✔Stethoscope
Fetoscope
Doppler US
TVUS - Transvaginal US
Stethoscope for IA - ✔✔Dome on maternal abdomen over fetal back Powered by TCPDF (www.tcpdf.org)
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