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Assessment Of Pain Flashcards

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1
Q

What is the primary aim of a comprehensive pain interview?

A

To facilitate self-care and explore the context and meaning of pain

This includes understanding how and why it hurts, not just what hurts.

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2
Q

List the goals of the pain interview.

A
  • Build trust
  • Gather information
  • Facilitate change
  • Understand the patient’s perspective
  • Elicit pain-specific history
  • Identify coping strategies
  • Identify pain interference with functioning
  • Identify important comorbidities
  • Synthesize the patient’s story in a bio-psycho-social perspective
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3
Q

What does the OPQRSTU mnemonic stand for?

A
  • O - Onset
  • P - Provocative/Palliative
  • Q - Quality/Character
  • R - Region/Radiation
  • S - Severity
  • T - Timing/Treatment
  • U - You/Impact
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4
Q

What are considered ‘red flags’ in pain assessment?

A
  • Bowel/bladder dysfunction
  • Saddle anesthesia
  • Bilateral leg weakness
  • Severe, sudden onset headache
  • Fever, weight loss, night sweats
  • Recent injury
  • History of cancer
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5
Q

True or False: Most abnormal findings on MRI are sources of pain.

A

False

Abnormal findings are often age-appropriate and not sources of pain unless proven otherwise.

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6
Q

What is the significance of the STOP-BANG screening tool?

A

It assesses the risk of obstructive sleep apnea

More than three ‘yes’ responses indicate the presence and need to treat obstructive sleep apnea.

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7
Q

What should be assessed in a patient with chronic pain?

A
  • Activity
  • Analgesia
  • Aberrant drug-related behavior
  • Adverse effects
  • Affect
  • Adjuncts
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8
Q

What is the definition of acute neck pain?

A

Pain present for less than 3 months

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9
Q

What are common risk factors for chronic neck pain?

A
  • Stress at work
  • Previous injuries
  • Litigation
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10
Q

What distinguishes radiating neck pain from referring neck pain?

A

Radiating pain follows dermatomes and has an abnormal neurological exam; referring pain follows myotomes and typically has a normal neurological exam.

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11
Q

What are the physical exam components for musculoskeletal pain assessment?

A
  • Inspection and General Appearance
  • Mental Status
  • Vital Signs
  • Posture and Gait
  • Palpation
  • Range of Motion
  • Neurological Examination
  • Special Tests
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12
Q

What is the prognosis for acute low back pain?

A

Favorable; 80% can expect to recover rapidly

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13
Q

What is the definition of chronic neck pain?

A

Pain present for more than 3 months

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14
Q

Fill in the blank: The _______ is a simple opioid screening tool used in primary care.

A

ORT

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15
Q

What is the purpose of using a multidimensional assessment scale like PEG?

A

To better assess pain intensity in patients with chronic pain

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16
Q

What are the key components to assess when diagnosing fibromyalgia?

A
  • Widespread pain index (WPI)
  • Symptom severity (SS) score
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17
Q

What should be done if neck pain persists despite treatment?

Study These Flashcards
A

Perform an MRI to detect an occult lesion and order an image-guided diagnostic test.

18
Q

What is the role of countertransference in interviewing patients with chronic pain?

Study These Flashcards
A

It can elicit an emotional response and provide insight into the patient’s situation.

19
Q

What is the key focus of a patient-centered interview?

Study These Flashcards
A

Building trust and understanding the patient’s perspective

20
Q

What is the significance of imaging in the absence of red flag signs?

Study These Flashcards
A

Routine imaging may reinforce sick behavior and worsen long-term outcomes.

21
Q

What is the clinical indicator for ordering an X-ray?

Study These Flashcards
A

Severe trauma

22
Q

What does the term ‘myofascial pain’ refer to?

Study These Flashcards
A

Pain originating from muscle and fascia

23
Q

What is the definition of nociceptive pain?

Study These Flashcards
A

Pain caused by damage to body tissue

24
Q

What are common psychiatric comorbidities associated with chronic pain?

Study These Flashcards
A
  • Depression
  • Anxiety
  • ADHD
  • Substance use
  • PTSD
25
What is the first line imaging for suspected stress fractures?
X-ray ## Footnote X-ray is typically the first imaging method used to investigate stress fractures.
26
What imaging methods are used for assessing osteomyelitis?
Bone scan or MRI ## Footnote Bone scans or MRIs are indicated for evaluating suspected cases of osteomyelitis.
27
List some risk factors for infection.
* Invasive medical procedure * Injection * Illicit drug use * Trauma to skin or mucous membrane * Immunosuppression * Diabetes mellitus * Alcoholism ## Footnote These factors increase the likelihood of infection in patients.
28
What are the common symptoms indicating a possible tumor?
* Past history of malignancy * Age greater than 50 * Failure to improve * Weight loss * Pain not relieved by rest ## Footnote These symptoms warrant further investigation for possible tumors.
29
Which imaging is preferred for diagnosing an aortic aneurysm?
Ultrasound ## Footnote Ultrasound is the first line imaging choice when a red flag is present for aortic aneurysms.
30
What are the most common shoulder pain conditions?
* Rotator cuff impingement or tear * Gleno-humeral / sub-acromial bursitis * Gleno-humeral instability * Bicep tendonitis ## Footnote These conditions frequently cause shoulder pain and should be considered during assessment.
31
What physical exam tests are used for shoulder pain assessment?
* Apley scratch test * Neers test * Hawkins test * Drop arm test * Lift off test * O’Brian’s test * Speed’s and Yerguson tests * Apprehension test ## Footnote These tests help identify the source of shoulder pain.
32
True or False: Imaging has high utility in diagnosing shoulder pain.
False ## Footnote Imaging is of limited utility in shoulder pain and should only be used if rehabilitation fails.
33
What is the foundational treatment for hip pain?
Exercise therapy ## Footnote Exercise therapy is crucial for long-term management of hip pain.
34
What are some common causes of hip pain in the elderly?
* Osteoarthritis * Adhesive capsulitis * Avascular necrosis ## Footnote These conditions are prevalent causes of hip pain in older adults.
35
What does the Ottawa Rules specify for knee injury imaging?
* Age > 55 * Tenderness at the head of the fibula * Isolated tenderness of the patella * Inability to flex knee to 90 degrees * Inability to walk 4 weight bearing steps ## Footnote These criteria guide the decision for knee imaging.
36
What is the most common knee condition in patients over 45?
Osteoarthritis ## Footnote Osteoarthritis typically presents with specific symptoms such as morning stiffness and knee crepitus in this age group.
37
Fill in the blank: Pain without physical provocation in the hip may indicate _______.
[rheumatologic, infectious, or cancer] ## Footnote Pain at rest should raise suspicion for serious underlying conditions.
38
What are the three compartments of the knee?
* Tibiofemoral * Patellofemoral * Proximal tibiofibular ## Footnote Understanding these compartments is essential for diagnosing knee pain.
39
What is the recommended management for knee osteoarthritis?
* Maintain or improve function * Encourage activity * General exercise with Physical Therapy * Short-term NSAIDs ## Footnote These strategies are important for managing symptoms and improving mobility.
40
True or False: Opioids are indicated for shoulder pain management.
False ## Footnote High-dose opioids are generally not indicated for the management of shoulder pain.
41
What type of imaging is beneficial for early diagnosis of inflammatory hip conditions?
Hip MRI ## Footnote MRI is particularly useful for diagnosing inflammatory or infectious conditions in the hip joint.

Pain Assessment (1 decks)

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