ABA ABA Regional & Neuraxial Anesthesia

Question 1

A post-dural puncture headache (PDPH) is BEST characterized by which feature?

Accepted Answer

Frontal/occipital pain worsened upright and relieved supine

Answer

PDPH is caused by CSF leak through the dural puncture site, causing traction on pain-sensitive intracranial structures when upright; lying flat relieves the traction.

Question 2

The epidural blood patch is considered the DEFINITIVE treatment for PDPH. Its mechanism of action is:

Accepted Answer

Sealing the dural leak with a clot and transiently increasing epidural pressure

Answer

15–20 mL of autologous blood is injected epidurally; it clots over the dural tear and transiently increases epidural pressure, restoring normal CSF dynamics.

Question 3

During spinal anesthesia, a 'total spinal' occurs. The MOST immediate life-threatening consequence is:

Accepted Answer

Apnea and cardiovascular collapse from high cervical blockade

Answer

High spinal block paralyzes intercostal and phrenic nerves and blocks cardiac accelerator fibers (T1-T4), causing apnea, bradycardia, and profound hypotension.

Question 4

Which factor INCREASES the spread of spinal anesthesia?

Accepted Answer

Using hyperbaric solution in Trendelenburg position

Answer

Hyperbaric solutions are denser than CSF and flow with gravity; in Trendelenburg (head-down), hyperbaric local anesthetic migrates cephalad, increasing spread.

Question 5

The recommended interspace for spinal anesthesia in adults to avoid spinal cord injury is:

Accepted Answer

L3-L4 or L4-L5

Answer

The spinal cord ends at L1-L2 in adults (conus medullaris); L3-L4 or L4-L5 interspaces are below the cord terminus, eliminating direct cord injury risk.

(ABA) ASA (American Society of Anesthesiologists) Board Certification Practice Test

(ABA) ASA (American Society of Anesthesiologists) Board Certification Practice Test

ABA ABA Regional & Neuraxial Anesthesia