EDAIC - European Diploma in Anesthesiology and Intensive Care Obstetric Anesthesia and Analgesia Questions and Answers

Question 1

A parturient presents for an emergency Cesarean section due to fetal distress.
After placement of a spinal anesthetic with hyperbaric bupivacaine and fentanyl, her blood pressure drops from 125/75 mmHg to 70/40 mmHg despite a 500 mL crystalloid co-load.
The fetal heart rate is now 80 bpm.
What is the most appropriate initial pharmacological intervention?

Accepted Answer

Phenylephrine 100 mcg IV

Answer

Ephedrine 10 mg IV

Answer

Adrenaline 10 mcg IV

Answer

Glycopyrrolate 0.2 mg IV

Question 2

Which of the following physiological changes in pregnancy has the most significant clinical implication for the induction of general anesthesia?

Accepted Answer

Decreased functional residual capacity (FRC)

Answer

Increased plasma volume

Answer

Increased glomerular filtration rate (GFR)

Answer

Decreased plasma cholinesterase activity

Question 3

A 32-year-old G1P0 parturient develops a severe headache 24 hours after an uneventful epidural for labor analgesia. The headache is postural, worsening when upright and relieved by lying flat. Which of the following is considered the most definitive treatment for her condition?

Accepted Answer

Epidural blood patch (EBP)

Answer

Intravenous caffeine infusion

Answer

Aggressive oral hydration and simple analgesics

Answer

Oral gabapentin

Question 4

A 28-year-old patient with severe pre-eclampsia is receiving an intravenous infusion of magnesium sulfate for seizure prophylaxis. During her Cesarean section under general anesthesia, she receives a non-depolarizing neuromuscular blocking agent (NMB). What effect should be anticipated regarding the NMB?

Accepted Answer

Potentiation of both onset and duration of action

Answer

A significantly increased dose requirement

Answer

Resistance to its effects, requiring a switch to succinylcholine

Answer

No significant interaction with the neuromuscular blocker

Question 5

Regarding the use of local anesthetics for labor epidural analgesia, which statement best describes a primary advantage of ropivacaine over bupivacaine?

Accepted Answer

It produces less motor block at equipotent analgesic concentrations.

Answer

It has a significantly longer duration of action.

Answer

It is associated with a lower incidence of pruritus.

Answer

It has a much faster onset of sensory blockade.

Question 6

A patient undergoes an emergency Cesarean section for placental abruption. Following delivery, there is significant ongoing hemorrhage due to uterine atony. Initial administration of oxytocin and ergometrine has been ineffective. Which of the following is the most appropriate next-line uterotonic agent to administer?

Accepted Answer

Intramuscular carboprost

Answer

Intravenous vasopressin

Answer

An intravenous infusion of salbutamol

Answer

A bolus of intravenous magnesium sulfate