Local anesthetic systemic toxicity: 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 anesthetic systemic toxicity

Sample item

During a peripheral nerve block, a patient reports metallic taste and tinnitus, then develops a seizure. What is the most appropriate immediate specific therapy in addition to airway and seizure management?

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

The answer and the reasoning

A. Intravenous lipid emulsion

Metallic taste, tinnitus, seizures, and cardiovascular collapse can occur in local anesthetic systemic toxicity. Intravenous lipid emulsion is a key specific treatment alongside immediate resuscitation, airway management, and modified ACLS principles.

Option by option

  • A. Intravenous lipid emulsion (correct)

    Correct. Lipid emulsion is a recognized therapy for severe LAST.

  • B. Oral activated charcoal

    Activated charcoal is not appropriate for an acute intravascular local-anesthetic reaction.

  • C. Intravenous methylene blue

    Methylene blue is used for selected cases of methemoglobinemia.

  • D. High-dose beta blocker

    Beta blockade could worsen cardiovascular collapse in toxicity.

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 A, Intravenous lipid emulsion. Metallic taste, tinnitus, seizures, and cardiovascular collapse can occur in local anesthetic systemic toxicity.

Why is "Oral activated charcoal" not the answer?

Activated charcoal is not appropriate for an acute intravascular local-anesthetic reaction.

Why is "Intravenous methylene blue" not the answer?

Methylene blue is used for selected cases of methemoglobinemia.

Why is "High-dose beta blocker" not the answer?

Beta blockade could worsen cardiovascular collapse in toxicity.

What concept does this question test?

It tests Local anesthetic systemic toxicity in Anaesthesia. Intravenous lipid emulsion is a key specific treatment alongside immediate resuscitation, airway management, and modified ACLS principles.

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 anesthetic systemic toxicity?

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.