EDAIC Obstetric Anesthesia and Analgesia 2

Question 1

A parturient with severe preeclampsia requires cesarean delivery. Which antihypertensive is CONTRAINDICATED in this setting?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors are contraindicated in pregnancy due to fetal renal toxicity and oligohydramnios.

Question 2

During spinal anesthesia for cesarean section, the patient develops hypotension. What is the FIRST-LINE vasopressor according to current evidence?

Accepted Answer

Phenylephrine

Answer

Phenylephrine is first-line for spinal-induced hypotension in cesarean delivery as it better preserves uteroplacental blood flow and fetal acid-base status.

Question 3

Which feature of the pregnant airway increases the risk of difficult intubation compared to non-pregnant patients?

Accepted Answer

Mucosal edema and friability

Answer

Pregnancy causes airway mucosal edema, engorgement, and friability that worsen Mallampati class and increase bleeding risk during instrumentation.

Question 4

What is the approximate minimum alveolar concentration (MAC) change for volatile anesthetics during pregnancy?

Accepted Answer

Decreased by 25-40%

Answer

MAC is reduced by approximately 25-40% during pregnancy due to elevated progesterone and endorphin levels.

Question 5

A patient at 36 weeks gestation presents with acute pulmonary edema. Which condition is MOST likely if she has no prior cardiac history?

Accepted Answer

Tocolytic-induced pulmonary edema

Answer

Beta-agonist tocolytics (e.g., terbutaline) cause sodium and water retention plus increased cardiac output, leading to pulmonary edema at late preterm gestation.

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC Obstetric Anesthesia and Analgesia 2