Local and regional anaesthesia: Bezold-Jarisch reflex: 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 · Local and regional anaesthesia: Bezold-Jarisch reflex

Sample item

Fifteen minutes after a spinal block, a young volume-depleted man in the sitting position suddenly becomes severely bradycardic with profound hypotension and loses consciousness. Which reflex is responsible?

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

The answer and the reasoning

D. Bezold-Jarisch reflex

Reduced venous return after sympathetic block leaves an underfilled but vigorously contracting ventricle, which stimulates cardiac mechanoreceptors. The vagal response causes bradycardia, vasodilatation and hypotension. Treatment is atropine, fluids and a vasopressor, with early adrenaline for severe cases.

Option by option

  • A. Bainbridge reflex

    The Bainbridge reflex increases heart rate when atrial stretch rises.

  • B. Cushing reflex

    The Cushing reflex is hypertension with bradycardia due to raised intracranial pressure.

  • C. Hering-Breuer reflex

    The Hering-Breuer reflex terminates inspiration when the lungs are inflated.

  • D. Bezold-Jarisch reflex (correct)

    Correct. The Bezold-Jarisch reflex produces bradycardia and hypotension from an underfilled ventricle.

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 D, Bezold-Jarisch reflex. Reduced venous return after sympathetic block leaves an underfilled but vigorously contracting ventricle, which stimulates cardiac mechanoreceptors.

Why is "Bainbridge reflex" not the answer?

The Bainbridge reflex increases heart rate when atrial stretch rises.

Why is "Cushing reflex" not the answer?

The Cushing reflex is hypertension with bradycardia due to raised intracranial pressure.

Why is "Hering-Breuer reflex" not the answer?

The Hering-Breuer reflex terminates inspiration when the lungs are inflated.

What concept does this question test?

It tests Local and regional anaesthesia: Bezold-Jarisch reflex in Anaesthesia. The vagal response causes bradycardia, vasodilatation and hypotension. Treatment is atropine, fluids and a vasopressor, with early adrenaline for severe cases.

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 Local and regional anaesthesia: Bezold-Jarisch reflex?

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.