THE 10TH ANNUAL ADVANCED INTERVENTIONAL PAIN CONFERENCE and PRACTICAL WORKSHOP, Budapest, Hungary, September 4-9, 2005

Examples of Multiple Choice Questions

1. The femoral nerve originates from which of the following roots?

  1. T 12, L 1, L 2
  2. L 1, L 2, L 3
  3. L 2, L 3, L 4
  4. L 3, L 4, L 5

2. If symptoms persist after appropriate management of acute cervical disc herniation, the next step is to perform

  1. Cervical laminectomy and fusion
  2. A cervical epidural injection
  3. Chemonucleolysis
  4. A cervical facet injection

3. A 45-year-old patient with a history of chronic low back, left hip and left thigh pain who is status post multiple lumbar laminectomy received a differential epidural block of 3% 2-chloroprocaine. Some pain resumed with return of full sensation and motor function in the lower extremities; all pain returned with return of sympathetic function. The pain was transmitted via which fibers?

  1. A alpha
  2. A delta
  3. C
  4. A delta and C

4. Examination of a patient with neck and shoulder pain reveals referred pain in the lateral aspect of the forearm, with weakness and dysfunction of the biceps and brachioradialis, and hypoesthesia in the lateral aspect of the forearm and thumb. The patient most likely has a lesion of which nerve root?

  1. C 4
  2. C 5
  3. C 6
  4. C 7

5. The most appropriate diagnostic nerve block for pain in upper abdominal viscera is

  1. an intercostal block
  2. a lumbar sympathetic block
  3. a celiac plexus block
  4. a hypogastric plexus block

6. Sympathetic innervation to the upper extremity is carried by which fibers of the brachial plexus?

  1. T 1-T 2 preganglionic fibers
  2. T 3-T 5 preganglionic fibers
  3. T 1-T 2 postganglionic fibers
  4. T 3-T 5 postganglionic fibers

7. Intense whiteness of fingers with subsequent blue coloration with coldness and red coloration on rewarming is most likely due to?

  1. Frostbite
  2. Raynaud’s disease
  3. Reflex sympathetic dystrophy
  4. Acute venous thrombosis

8. Indications for lumbar epidural steroid injections include all of the following EXCEPT?

  1. Radicular pain with corresponding sensory change
  2. Radiculopathy due to herniated disc with failed conservative treatment
  3. Acute herpes zoster in the lumbar dermatomes
  4. Postlaminectomy (failed back) syndrome without radiculopathy

9. Which of the following nerve blocks is LEAST helpful in diagnosing sympathetically mediated pelvic pain?

  1. Differential spinal
  2. Pudendal nerve
  3. Superior hypogastric plexus
  4. Differential epidural

10. All of the following statements regarding the anatomy of the superior hypogastric plexus are true EXCEPT?

  1. It lies anterior to L 5 vertebra.
  2. It lies just inferior to the aortic bifurcation.
  3. It lies right of midline.
  4. It branches left and right and descends to form the inferior hypogastric plexus.

11. All of the following are indications for a stellate ganglion block EXCEPT?

  1. Reflex sympathetic dystrophy
  2. Acute herpes zoster (ophthalmic division)
  3. Hyperhidrosis
  4. Pancreatitis

12. Which of the following regional anesthesia techniques is NOT commonly used with children due to its side effects?

  1. Epidural block
  2. Subarachnoid blocd
  3. Caudal block
  4. Brachial plexus block

13. A brachial plexus block is indicated for all of the following conditions EXCEPT

  1. Sympathetic independent pain due to reflex sympathetic dystrophy
  2. Brachial plexalgia
  3. Angina
  4. Raynaud's disease

14. A celiac plexus block is effective in reducing pain originating from all of the following organs EXCEPT?

  1. Pancreas
  2. Transverse portion of the large colon
  3. Gall bladder
  4. Descending portion of the pelvic colon

15. A patient is positioned prone on the fluoroscopic table, the T 1-T 4 spinous processes are identified on the ipsilateral side, and a skin weal is raised 4-5 cm lateral to the spinous process. A spinal needle is directed to the lamina and "walked" laterally until there is loss of resistance. These procedures are consistent with which type of block?

  1. Stellate ganglion
  2. Thoracic sympathetic
  3. Interpleural
  4. Thoracic epidural

16. The brachial plexus is formed by which rami?

  1. C 5-T 1 anterior primary
  2. C 3-T 2 anterior primary
  3. C 5-T 1 anterior and posterior
  4. C 3-T 2 anterior and posterior

17. Cell bodies of preganglionic fibers of the lumbar sympathetic chain arise at which of the following sites?

  1. T 5-T 9
  2. T 11-L 2
  3. L 3-L 5
  4. S 1-S 4

18. A lateral femoral cutaneous block is indicated for which of the following conditions?

  1. Meralgia paresthetica
  2. Femoral neuralgia
  3. Saphenous neuralgia
  4. Groin pain

19. Which of the following statements is true regarding neurolytic concentrations of less than 2% phenol?

  1. They have no effect.
  2. They selectively destroy A-delta and C fibers.
  3. They have a reversible local anesthetic action when applied to nerve bundles.
  4. They destroy nerves but have no effect on blood vessels.

20. Mydriasis, tachypnea, tachycardia, delirium and a modest decrease in pain can be produced by agonists of which receptor type?

  1. Mu
  2. Kappa
  3. Delta
  4. Sigma

21. A diminished triceps jerk indicates a lesion of which nerve root?

  1. C 4
  2. C 5
  3. C 6
  4. C 7

22. To achieve sympathetic denervation of the head and neck, the best site of blocking is the?

  1. Middle cervical ganglion
  2. Superior cervical ganglion
  3. Stellate ganglion
  4. Sphenopalatine ganglion

23. The lesser splanchnic nerve is formed by which of the following sympathetic nerves?

  1. T 5-T 7
  2. T 8-T 9
  3. T 10-T 11
  4. T 12

ANSWERS TO EXAMPLES OF MULTIPLE CHOICE QUESTIONS

  • Correct answer is C
  • Correct answer is B
  • Correct answer is D
  • Correct answer is C
  • Correct answer is C
  • Correct answer is A
  • Correct answer is A
  • Correct answer is D
  • Correct answer is B
  • Correct answer is C
  • Correct answer is D
  • Correct answer is B
  • Correct answer is C
  • Correct answer is D
  • Correct answer is B
  • Correct answer is A
  • Correct answer is B
  • Correct answer is A
  • Correct answer is C
  • Correct answer is D
  • Correct answer is D
  • Correct answer is C
  • Correct answer is C
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