Exam 1 Part 3 Flashcards

(98 cards)

1
Q

What is pain?

A

An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

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2
Q

What is acute pain?

A

Typically nociceptive and resolves when tissue heals

Last less than 4 weeks

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3
Q

What is chronic pain?

A

Pain that extends beyond the healing period of an acute pain

at least 3 months

serves no adaptive purpose

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4
Q

What kind of management is warranted for cancer?

A

Aggressive management warranted

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5
Q

What is musculoskeletal pain?

A

Somatic pain/ localized
Throbbing, constant, dull

Responds well to analgesics

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6
Q

How do we prevent pain?

A

Stop COX 1 and COX 2

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7
Q

What is included in the musculoskeletal system?

A

Muscles, tendons, ligaments, cartilage, synovial bursae and bone

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8
Q

What is myalgia?

A

Pain in a muscle or group of muscles

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9
Q

What can result in myalgia?

A

Systemic infection, chronic disorder and medication

Result from medication, exercise, and trauma

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10
Q

What is released from COX 1?

A

Thromboxine -clotting
Prostaglandins in the GI and Kidneys (regulate salt and water, neutralize acids)

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11
Q

What do NSAIDs do?

A

Block COX 2 and COX1

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12
Q

What are the side effects of NSAIDs?

A

Acid reflux
GI problems
Hypertension
GI bleeds/bleeding

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13
Q

What is tendonitis?

A

Inflammation of the tendon (bone to muscle)

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14
Q

What causes tendonitis?

A

Infection
Overuse
Trauma
Aging

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15
Q

What are the common sites of tendonitis?

A

Shoulder
Elbow
Hip
Thumb
Knee
Heel

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16
Q

What is the treatment for tendonitis?

A

NSAIDs
Corticosteroids
Joint rest and immobilization

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17
Q

What is bursitis?

A

Inflammation of bursa, sac filled with synovial fluid located near joints

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18
Q

What causes bursitis?

A

Overuse
Injury
Aging
Infection
Trauma

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19
Q

What are the symptoms of bursitis?

A

Pain is tender and constant

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20
Q

Where are the common sites of bursitis?

A

Shoulder
Elbow
Hip
Thumb
Knee
Heel

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21
Q

What can treat bursitis?

A

NSAIDs
Corticosteroids
Joint rest and immobilization
Cold therapy

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22
Q

What is a sprain?

A

Trauma to joint causes ligament damage

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23
Q

What is the treatment for a sprain?

A

Cold therapy for 24 to 48 hours then heat

elevate and or joint immovilization

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24
Q

What causes a sprain?

A

Hyperextension

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25
What are the signs of sprain?
Swelling Bruising
26
What are the symptoms of Sprain?
Loss of function Numbness
27
What causes a strain?
Overstretching of the muscle
28
What is the treatment for strain?
Joint rest
29
What is osteoarthritis?
Localized disease with cartilage deterioration and formation of new bone at joint surface
30
What are the risk factors for osteoarthritis?
Age Trauma to joints Fracture Infection
31
What are the treatments for osteoarthritis?
APAP, NSAIDS, hyaluronate injections, glucosamine chondroitin, opiod analgesics | No topical on hips
32
What are the signs of Osteoarthritis?
Evidence of joint degeneration Visible deformitis of fingers
33
What are the symptoms of osteoarthritis?
Pain joint tenderness Morning stiffness Limited ROM Crepitus
34
What is rheumatoid arthritis?
Systemic disease with inflammation of synovial tissues Need diagnosis from MD and prescription
35
What are the causes of Rheumatoid arthritis?
Unknown
36
What is the treatment of RA?
Disease modifying antirheumatic drugs NSAIDs, adjunctive corticosteroids
37
What is the difference between RA and OA in morning sickness?
RA over an hour OA less than fifteen minutes
38
What is the difference in inflammation for RA and OA?
RA - present OA- absent or mild
39
What is the difference in swelling for RA and OA?
RA- symmetrical OA- irregular
40
What is RICE?
Rest injured area Ice area during beginning 10-20 min up to 24 hours Compression of injury using elastic support or bandage Elevation of injured area at or above the levell of the heart to decrease swelling
41
What are the dietary supplements for Arthritis?
Glucosamine Chondroitin SAMe Cetyl myristolate
42
What lifestyle changes can help with arthritis?
PT Weight loss
43
What topical analgesic causes cooling sensation?
Camphor Menthol
44
What topical analgesic can cause vasodilation?
Histamine dihydrochloride
45
What topical analgesic causes warming?
Capsaicin Desensitize the area
46
What are other common topical analgesics?
Lidocain Trolamine salicylate Methyl salicylate
47
What does Capsaicin heat producer do/
Produces loss of sensation to pain receptors Has heating sensation
48
How do you use capsaicin for patch?
Apply to affected area 3-4 times a day for up to 8 hours for 7 days
49
How do you use topical capsaicin?
Apply to affected area 3-4 times a day
50
What is capsaicin used for?
Arthritis or chronic joint pain
51
What warning should be given for capsaicin?
Can really irritate the skin
52
What is trolamine salicylate?
works very similar to NSAIDs in that it inhibits COX enzymes
53
What does trolamine do?
Relief of pain of muscular aches, rheumatism, neuralgia, sprains, arthritis on intact skin without systemic side effects
54
How do you use trolamine?
Apply to affected area as needed up to 3-4 times a day
55
What is lidocaine?
Local anesthetic work by blocking the permeability of sodium ions leading to numbing of an affected area
56
How do you use the lidocaine cream?
Apply 2-4 times daily
57
How do you use the lidocaine patch?
Place for up to 12 hours in any 24 hour period
58
What do you not want to use topical products on?
abraded sunburned damaged skin
59
What are the key counseling points for topical agents?
Wash hands after applying to skin and before touching mucous membranes or thin sensitive areas Dont use a tight wrap or heating device
60
What age should you be when using zostrix/capsaicin?
Above 18 years old
61
What age is reccommended for lidocaine?
12 years and above
62
What are the side effects of camphor?
High doses can cause nausea, vomitting, headache, dizziness, convulsions
63
What are the side effects of menthol?
Sensitization may occur
64
What is the major side effect of capsaicin?
Can really irritate skin
65
What is PQRS?
Palliative provoking factor Quality (describe pain) Region Severity
66
What are the exclusions for self care for pain?
Pain above 6 Pain over 10 days Pain last longer than 7 days with topical analgesic Increased intensity or change in characteristics of pain Pelvic or abdominal pain Pain with other systemic symptoms Deformed joints, numbness, suspected fracture Pregnancy Under 2
67
What are primary headaches?
About 90% prevalence - are not associated with underlying illness | Migraine, tension and cluster headaches
68
What are secondary headaches?
Symptomatic from an underlying conditions like trauma, stroke, bacterial or viral infection | Cannot make reccomendation
69
How long to chronic headaches last?
Chronic headaches 15 or more days per month for 3 months | Acute is less than this
70
What are the different types of self treated headaches?
Tension type Migraine Cluster Sinus Alcohol induced
71
What kind of onset is tension headache?
Gradual onset
72
What kind of pain occurs in a tenstion headache?
Bilateral, diffuse pain in the head that may radiate to other areas Tight, pressing or constricting pain Dull pressure that does not throb
73
What causes tension headaches?
Stress Anxiety Depression Emotional conflict
74
How long can tension headaches last?
Minutes to days
75
What is the usual age of onset for migraine headaches?
10-45 years
76
TF: Migraines are more common in men?
False In women than men
77
What are migraines caused by?
Thought to be due to temporary narrowing of some blood vessels, decreasing the brain's supply of blood and oxygen - enlargement of other vessels in an attempt to normalize the brains oxygenation
78
What are the signs of migraines?
Throbbing Pounding Pulsating ache that is usually unilateral ## Footnote Originates as a dull ache at pain onset usually worsens to full intensity that may persist for 6-48 hours
79
What other symptoms come from migraines?
Visual abnormalities Fatigue Phonophobia Photophobia Nausea and vomitting Sweating Chills
80
What foods may cause migraines?
Foods that contain tyramine | Beans Figs Chicken liver Smoked fish Aged cheese Red wine
81
Who has cluster headaches the most?
30-40 year old males
82
What pain is seen with cluster headaches?
Unilateral Concentrated in temporal or orbital region | Sudden onset with no warning 15 min to 3 hours
83
What is a sinus headache caused by?
Infection or blockage of paranasal sinuses causing inflammation of the sinus walls
84
Where is the pain for sinus headaches?
Around the forehead or periorbital area | Pain stops when sinus pressure is relieved
85
What are the preventions for tension headache?
Avoid triggers Reduce stress Get treatment for anxiety depression
86
What are the preventions for migraines?
Avoid triggers Prescription medication
87
What are the preventions of cluster headaches?
Prescription only
88
What are the preventions for sinus headaches?
Avoid allergens
89
What are the treatments for tension headaches?
APAP ASA Caffeine IBU Avoid triggers
90
What is the treatment for sinus headaches?
Combination analgesic and decongestant
91
What are the pharamacologic treatment options for headaches?
Aspirin APAP Ibuprofen Naproxen Caffiene
92
What do combo products for sinus headaches contain?
APAP Diphenhydramine/phenylephrine Guaifenesin ASA Caffeine
93
What do combo products for migraines contain?
APAP ASA Caffeine
94
When do you refer patients for headaches?
Severe head pain Lasting longer 10 days Third trimester Younger than 8 years old History of liver disease Secondary headaches Undiagnosed migraines
95
What is the max dose for ASA?
4 g
96
What is the max dose for APAP?
3 g
97
What is the max dose of IBU?
1.2 g
98
What is the max dose of Naproxen?
660 mg