LESI LESI Pharmacology 3

Question 1

Epidural corticosteroids can elevate blood glucose in diabetic patients for approximately how long after injection?

Accepted Answer

1-5 days

Answer

Systemic absorption of epidural corticosteroids typically causes transient blood glucose elevation lasting 1-5 days in diabetic patients, requiring monitoring and possible medication adjustment.

Question 2

What volume of injectate is typically used for an interlaminar lumbar ESI?

Accepted Answer

3-6 mL

Answer

Interlaminar lumbar ESIs typically use 3-6 mL of total injectate (steroid plus diluent) to achieve adequate bilateral epidural spread.

Question 3

Which of the following is a potential systemic side effect of repeated epidural corticosteroid injections?

Accepted Answer

Osteoporosis and vertebral fracture risk

Answer

Repeated systemic corticosteroid exposure from epidural injections can contribute to osteoporosis, increasing vertebral compression fracture risk over time.

Question 4

Why is epinephrine sometimes added as an intravascular injection marker in epidural procedures?

Accepted Answer

To detect intravascular needle placement via transient heart rate increase

Answer

A test dose containing epinephrine (typically 15 mcg) will cause a transient tachycardia (>20 bpm increase) if injected intravascularly, serving as an early warning of vascular misplacement.

Question 5

Which local anesthetic is preferred for LESI in patients with a documented allergy to amide anesthetics?

Accepted Answer

Chloroprocaine (ester anesthetic)

Answer

Chloroprocaine is an ester-class local anesthetic and represents an alternative for patients with true amide local anesthetic allergy, as cross-reactivity between classes is rare.

LESI - Lumbar Epidural Steroid Injection Practice Test

LESI - Lumbar Epidural Steroid Injection Practice Test

LESI LESI Pharmacology 3