Regional anesthesia: interscalene block: 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 · Regional anesthesia: interscalene block

Sample item

After an interscalene brachial plexus block, a patient with severe chronic lung disease becomes more breathless. Which predictable associated effect is the most likely explanation?

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

The answer and the reasoning

B. Ipsilateral phrenic nerve block with hemidiaphragmatic paresis

Interscalene block commonly affects the ipsilateral phrenic nerve and can cause hemidiaphragmatic paresis. This may be clinically important in patients with limited respiratory reserve.

Option by option

  • A. Acute pulmonary embolism caused by the local anesthetic

    Local anesthetic does not inherently cause a pulmonary embolism.

  • B. Ipsilateral phrenic nerve block with hemidiaphragmatic paresis (correct)

    Correct. Phrenic involvement is a recognized and relevant effect of interscalene anesthesia.

  • C. Bilateral recurrent laryngeal nerve paralysis

    Bilateral recurrent laryngeal paralysis is not the expected block effect.

  • D. Profound lower-limb motor block

    The interscalene block targets the upper brachial plexus, not the lower limbs.

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 B, Ipsilateral phrenic nerve block with hemidiaphragmatic paresis. Interscalene block commonly affects the ipsilateral phrenic nerve and can cause hemidiaphragmatic paresis.

Why is "Acute pulmonary embolism caused by the local anesthetic" not the answer?

Local anesthetic does not inherently cause a pulmonary embolism.

Why is "Bilateral recurrent laryngeal nerve paralysis" not the answer?

Bilateral recurrent laryngeal paralysis is not the expected block effect.

Why is "Profound lower-limb motor block" not the answer?

The interscalene block targets the upper brachial plexus, not the lower limbs.

What concept does this question test?

It tests Regional anesthesia: interscalene block in Anaesthesia. This may be clinically important in patients with limited respiratory reserve.

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 Regional anesthesia: interscalene block?

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.