EDAIC Regional Anesthesia and Pain Management 3

Question 1

Which ultrasound finding confirms correct needle placement for an adductor canal block?

Accepted Answer

Local anesthetic spread surrounding the saphenous nerve between the sartorius and adductor longus muscles

Answer

The adductor canal contains the saphenous nerve alongside the superficial femoral artery deep to the sartorius muscle; correct placement shows LA spreading around these structures.

Question 2

What is the mechanism of action of ketamine in pain management?

Accepted Answer

NMDA receptor antagonism

Answer

Ketamine is an NMDA receptor antagonist that blocks central sensitization and 'wind-up' phenomena, making it effective for opioid-resistant and neuropathic pain.

Question 3

A patient has a suspected intravascular injection during an epidural test dose with epinephrine. Which response confirms intravascular placement?

Accepted Answer

Heart rate increase >20 bpm within 60 seconds

Answer

The classic epidural test dose uses 3 mL of 1.5% lidocaine with 1:200,000 epinephrine; intravascular injection causes a heart rate increase of >20 bpm within 60 seconds.

Question 4

Which nerve root primarily supplies sensation to the medial aspect of the ankle and foot?

Accepted Answer

L4 via saphenous nerve

Answer

The saphenous nerve (terminal branch of the femoral nerve, L2-L4, predominantly L4) supplies sensation to the medial leg, ankle, and foot.

Question 5

The WHO analgesic ladder for cancer pain recommends which sequence of analgesic approach?

Accepted Answer

Non-opioids → weak opioids → strong opioids, with adjuvants at each step

Answer

The WHO three-step ladder starts with non-opioids (Step 1), adds weak opioids for mild-to-moderate pain (Step 2), and escalates to strong opioids for moderate-to-severe pain (Step 3), with adjuvants at all steps.

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC Regional Anesthesia and Pain Management 3