EDAIC Obstetric Anesthesia and Analgesia 4

Question 1

Which local anesthetic is ABSOLUTELY CONTRAINDICATED for epidural use in obstetrics due to cardiac toxicity?

Accepted Answer

Bupivacaine 0.75%

Answer

Bupivacaine 0.75% is absolutely contraindicated for epidural use after multiple maternal cardiac arrests; the lower concentrations remain acceptable.

Question 2

What is the Apgar score component affected FIRST by opioid-induced neonatal depression?

Accepted Answer

Respiratory effort

Answer

Respiratory effort is the most sensitive Apgar component to neonatal opioid depression, appearing as slow, irregular, or absent breathing.

Question 3

A patient with known mitral stenosis presents for labor. Which hemodynamic goal is MOST important during labor analgesia?

Accepted Answer

Avoid tachycardia and maintain sinus rhythm

Answer

In mitral stenosis, tachycardia reduces diastolic filling time across the stenotic valve, precipitating pulmonary edema; maintaining sinus rhythm and controlled heart rate is critical.

Question 4

Which drug should be immediately available when performing test dose confirmation of epidural catheter placement?

Accepted Answer

Epinephrine to detect intravascular placement

Answer

Epidural test dose contains epinephrine 15 mcg; intravascular injection causes a transient heart rate increase >20 bpm, confirming misplacement.

Question 5

At what gestational age does the lower esophageal sphincter pressure decrease sufficiently to significantly increase aspiration risk?

Accepted Answer

18-20 weeks

Answer

By 18-20 weeks gestation, progesterone-mediated LES relaxation combined with upward gastric displacement significantly increases aspiration risk, justifying aspiration prophylaxis.

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 4