EDAIC Regional Anesthesia and Pain Management 5

Question 1

Which spinal cord tract is primarily responsible for transmission of nociceptive and temperature signals?

Accepted Answer

Spinothalamic tract (anterolateral system)

Answer

The spinothalamic tract crosses at the level of entry within 1-2 spinal segments and ascends contralaterally in the anterolateral funiculus to transmit pain, temperature, and crude touch to the thalamus.

Question 2

During epidural anesthesia, the 'loss of resistance' technique identifies needle entry into which space?

Accepted Answer

Epidural space

Answer

The epidural space is a negative-pressure potential space containing fat and venous plexuses; resistance to injection through ligamentum flavum gives way to easy injection upon entering this space.

Question 3

Gabapentin and pregabalin produce analgesia in neuropathic pain primarily by binding to which receptor subunit?

Accepted Answer

Alpha-2-delta subunit of voltage-gated calcium channels

Answer

Gabapentinoids bind to the alpha-2-delta-1 subunit of voltage-gated calcium channels on presynaptic neurons, reducing calcium influx and decreasing release of excitatory neurotransmitters like glutamate and substance P.

Question 4

A 45-year-old presents with lancinating pain along the T5 dermatome following herpes zoster infection 6 months ago. What is the most accurate diagnosis?

Accepted Answer

Post-herpetic neuralgia (PHN)

Answer

Post-herpetic neuralgia is defined as pain persisting in the distribution of herpes zoster beyond 90 days after acute infection onset, characterized by lancinating, burning, or allodynic pain.

Question 5

Which landmark defines the level of the conus medullaris in adults and guides safe intrathecal injection?

Accepted Answer

L1-L2 interspace

Answer

In adults, the conus medullaris typically ends at L1-L2; spinal anesthesia is most safely performed at L3-L4 or L4-L5 to avoid direct cord trauma.

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 5