Analgesia And Pain Management

Question 1

Pain types

Answer 1

Nociceptive
Inflammatory
Neuropathic
Nociplastic

Question 2

Inflammatory mediators released when tissue is damaged

Answer 2

K+
H+
Bradykinin
Histamine
5HT
NO

Question 3

Which pathway produces leukotrienes and prostanoids

Answer 3

Arachidonic pathway

Question 4

Neuropathic pain mechanisms

Answer 4

Altered ion channel expression
Ectopic and spontaneous discharge
Emphatic conduction
Collateral sprouting at Pri afferents
Sprouting of sympathetic neurones at DRG

Question 5

Nociplastic pain mechanisms

Answer 5

Central pain sensitisation
Dysfunctional inhibitory pathways

Question 6

Pain inhibitory pathways

Answer 6

GABA
Opioid
Mono aminergic
Cannabinoid

Question 7

Nociceptive pain

Answer 7

Appropriate physiological detection of painful stimulus

Question 8

Inflammatory pain

Answer 8

Enhanced nociception in the presence of inflammation

Question 9

Neuropathic pain

Answer 9

Pain initiated or caused by a primary lesion/dysfunction in the nervous system

Question 10

Nociplastic pain

Answer 10

Pain arising from altered nociception despite no clear evidence of actual or threatened tissue damage

Question 11

How long does acute pain last

Answer 11

<12 wks

Question 12

How long does chronic pain last >12wks

Question 13

Pain measurement tools

Answer 13

VAS Visual analogue score
VRS verbal rating score
Observer scoring
BPI
Magill pain questionaire
SF36
EQ5D

Question 14

3 steps in pain relief ladder

Answer 14

Non opioid
Weak opioid
Strong opioid

Question 15

Non opioid painkillers

Answer 15

Aspirin
Paracetamol
Ibuprofen
Diclofenac
COX2 inhibitors

Question 16

Weak opioid painkillers

Answer 16

Codeine
Dihydrocodeine
Tramadol

Question 17

Strong opioid painkillers

Answer 17

Morphine
Hydromorphone
Oxycodone
Buprenorphine
Fentanyl
Methadone

Question 18

What symptoms does paracetamol improve

Answer 18

Moderate pain
Pyrexia

Question 19

Main effect of paracetamol overdose

Answer 19

Liver damage

Question 20

Paracetamol administration

Answer 20

Oral
IV
PR

Question 21

What drug class is naproxen

Answer 21

NSAID

Question 22

How does naproxen inhibit prostaglandin

Answer 22

COX1 and 2 inhibition

Question 23

Naproxen adverse effects

Answer 23

GI bleeding
GI ulcers
Renal effects
CVS effect

Question 24

Tramadol and tapentadol administration

Answer 24

Oral
IV
IM

Question 25

Which pathway does Tramadol target

Answer 25

Monoaminergic pathway

Question 26

Tramadol and tapentadol side effects

Answer 26

Nausea Vomiting Dizziness Sweating

Question 27

Opioid MOA

Answer 27

Mimic endogenous analgesic peptides and act on opioid recpetors

Question 28

Endogenous analgesic peptides

Answer 28

Endorphins Dynorphins Enkephalins

Question 29

3 main opioid receptor types

Answer 29

Mu Kappa Delta

Question 30

Which opioid receptor does morphine act on

Answer 30

Mu

Question 31

Morphine administration

Answer 31

IV IM SC oral Epidural Intrathecal IA

Question 32

Morphine side effects

Answer 32

Constipation Nausea Pruritis Drowsiness

Question 33

Medications for neuropathic pain

Answer 33

Anti neuropathic agents Anticonvulsants Antidepressants Topical creams

Question 34

Antineuropathic agents

Answer 34

Pregabalin Gabapentin Carbamazepine Sodium valproate Phenytoin

Question 35

Is THC Or CBD psychoactive

Answer 35

THC

Question 36

What type of molecule are endocannabinoids

Answer 36

Lipids

Question 37

Anaesthetic techniques

Answer 37

Topical application Local infiltration Simple nerve block Plexus block Epidural infusion