CRNA Regional Anesthesia and Nerve Blocks 3

Question 1

What is the first-line treatment for local anesthetic systemic toxicity (LAST) presenting with cardiovascular collapse?

Accepted Answer

20% lipid emulsion (Intralipid) IV

Answer

Epinephrine 1 mg IV bolus

Answer

Sodium bicarbonate IV

Answer

Amiodarone IV

Question 2

Following an epidural top-up dose, a patient develops rapid onset of apnea, unconsciousness, and cardiovascular collapse. What has most likely occurred?

Accepted Answer

Total spinal anesthesia from inadvertent subarachnoid injection

Answer

Anaphylaxis to the local anesthetic preservative

Answer

Air embolism from the epidural injection

Answer

Vasovagal syncope from pain

Question 3

Which brachial plexus approach carries the highest risk of pneumothorax?

Accepted Answer

Supraclavicular

Answer

Interscalene

Answer

Infraclavicular

Answer

Axillary

Question 4

According to ASRA guidelines, what is the minimum time to wait after the last prophylactic dose of LMWH (e.g., enoxaparin 40 mg daily) before performing neuraxial anesthesia?

Accepted Answer

12 hours

Answer

6 hours

Answer

24 hours

Answer

48 hours

Question 5

Ipsilateral Horner syndrome (ptosis, miosis, anhidrosis) following an interscalene block is caused by inadvertent blockade of which structure?

Accepted Answer

Stellate (cervicothoracic) ganglion

Answer

Vagus nerve

Answer

Glossopharyngeal nerve

Answer

Superior laryngeal nerve

Question 6

What is the primary advantage of ultrasound guidance over nerve stimulator technique for peripheral nerve blocks?

Accepted Answer

Provides real-time visualization of needle tip, nerve, and local anesthetic spread

Answer

Eliminates the need for sterile preparation

Answer

Permits use of higher volumes of local anesthetic safely

Answer

Reduces procedure time to under one minute

Question 7

Post-dural puncture headache (PDPH) is best characterized by which clinical feature?

Accepted Answer

Positional headache that worsens upright and improves supine

Answer

Constant occipital headache unaffected by position

Answer

Frontal headache with fever and neck stiffness

Answer

Unilateral headache with pulsating quality and photophobia