CAA CAA Regional & Neuraxial Anesthesia 2

Question 1

The epidural space is most accurately identified using the loss-of-resistance (LOR) technique. What substance should be used for LOR to minimize risk of air embolism?

Accepted Answer

Saline (preservative-free)

Answer

Preservative-free saline is the preferred medium for LOR because air can cause pneumocephalus, patchy blocks, or venous air embolism if injected intravascularly.

Question 2

An epidural test dose typically contains epinephrine to detect:

Accepted Answer

Intravascular injection via a heart rate increase of ≥20 bpm within 60 seconds

Answer

Intravascular injection of the epinephrine marker (typically 15 mcg) causes a transient tachycardia within 30–60 seconds, indicating catheter misplacement into a vein.

Question 3

Epidural analgesia for labor pain is typically targeted to cover which dermatomal levels?

Accepted Answer

T10–L1 (first stage) expanding to S2–S4 (second stage)

Answer

First-stage labor pain is visceral (T10–L1); as delivery approaches, the block is extended caudally to cover S2–S4 for second-stage somatic perineal pain.

Question 4

Which complication is most commonly associated with epidural catheter placement?

Accepted Answer

Unintentional dural puncture (wet tap)

Answer

Unintentional dural puncture occurs in approximately 0.5–2% of epidural placements and is the most common serious complication, often leading to PDPH.

Question 5

Local anesthetic systemic toxicity (LAST) following epidural injection most commonly presents first as:

Accepted Answer

Central nervous system excitation (metallic taste, tinnitus, perioral numbness, seizures)

Answer

CNS excitatory signs (circumoral numbness, tinnitus, metallic taste, agitation, then seizures) typically precede cardiovascular collapse in LAST.

(CAA) Certified Anesthesiologist Assistant Practice Test

(CAA) Certified Anesthesiologist Assistant Practice Test

CAA CAA Regional & Neuraxial Anesthesia 2