Spinal anaesthesia: epidural blood patch: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Spinal anaesthesia: epidural blood patch

Sample item

A woman has a severe postural headache 3 days after a dural puncture with a large-bore epidural needle, unrelieved by fluids, caffeine and simple analgesics. What is the definitive treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Epidural blood patch with 15 to 20 mL of autologous blood

A post-dural puncture headache that persists despite conservative treatment is treated by an epidural blood patch. Autologous blood injected into the epidural space seals the dural hole and raises CSF pressure, with relief in most patients. It is contraindicated in the presence of fever or infection.

Option by option

  • A. Intravenous antibiotics

    Antibiotics are not indicated for this headache.

  • B. Repeat lumbar puncture

    A repeat puncture would worsen CSF leakage.

  • C. Epidural blood patch with 15 to 20 mL of autologous blood (correct)

    Correct. A blood patch is the definitive treatment for persistent post-dural puncture headache.

  • D. Strict head-up positioning for a week

    Head-up positioning worsens a postural headache.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Epidural blood patch with 15 to 20 mL of autologous blood. A post-dural puncture headache that persists despite conservative treatment is treated by an epidural blood patch.

Why is "Intravenous antibiotics" not the answer?

Antibiotics are not indicated for this headache.

Why is "Repeat lumbar puncture" not the answer?

A repeat puncture would worsen CSF leakage.

Why is "Strict head-up positioning for a week" not the answer?

Head-up positioning worsens a postural headache.

What concept does this question test?

It tests Spinal anaesthesia: epidural blood patch in Anaesthesia. Autologous blood injected into the epidural space seals the dural hole and raises CSF pressure, with relief in most patients. It is contraindicated in the presence of fever or infection.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spinal anaesthesia: epidural blood patch?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.