Epidural anaesthesia: spinal haematoma: 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 · Epidural anaesthesia: spinal haematoma

Sample item

After epidural catheter removal, a patient on LMWH develops severe back pain and progressive leg weakness. What is the most appropriate management?

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

The answer and the reasoning

A. Urgent MRI and neurosurgical decompression, ideally within 8 to 12 hours

Spinal epidural haematoma is a surgical emergency, and neurological recovery depends on decompression within about 8 to 12 hours. Anticoagulation should be stopped and coagulation corrected.

Option by option

  • A. Urgent MRI and neurosurgical decompression, ideally within 8 to 12 hours (correct)

    Correct. Urgent imaging and decompression are needed.

  • B. Increase LMWH dose

    More anticoagulation would worsen the bleed.

  • C. Reassurance and oral analgesia

    Delay causes permanent paraplegia.

  • D. Physiotherapy

    Physiotherapy is inappropriate.

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.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, Urgent MRI and neurosurgical decompression, ideally within 8 to 12 hours. Spinal epidural haematoma is a surgical emergency, and neurological recovery depends on decompression within about 8 to 12 hours.

Why is "Increase LMWH dose" not the answer?

More anticoagulation would worsen the bleed.

Why is "Reassurance and oral analgesia" not the answer?

Delay causes permanent paraplegia.

Why is "Physiotherapy" not the answer?

Physiotherapy is inappropriate.

What concept does this question test?

It tests Epidural anaesthesia: spinal haematoma in Anaesthesia. Anticoagulation should be stopped and coagulation corrected.

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 Epidural anaesthesia: spinal haematoma?

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.