midterms pain

Question 1

primary afferent nociceptors consists of 3 axons __ __ __

Answer 1

a. primary sensory afferent
b. motor neurons
c. sympathetic post ganglion neurons

Question 2

primary sensory afferent is located in the _____ within the vertebra foramen and branch to spinal cord and to the peripheral nerve to innervate tissues

Answer 2

dorsal root ganglia

Question 3

these fibers respond maximally only to intense (painful stimuli) and produce the subjective experience of pain when they are electrically stimulated; this defines them as primary afferent nociceptors (pain receptors)

Answer 3

A-delta (Ad) and unmyelinated (C) axons

Question 4

these fibers are defined as the primary afferent nociceptors (pain receptors)

Answer 4

A-delta(Ad) and unmyelinated axons

Question 5

what are the largest afferent fibers

Answer 5

A-beta (A B)

Question 6

fibers thata respond maximlly to light touch and or moving stimuli; they are present primarily in nerves that innervate the skin

Answer 6

A-beta (A B)

Question 7

inflammatory mediators that contribute for activating primary afferent nociceptors

Answer 7

bradykinin
nerve growth factor
prostaglandins
leukotrienes

Question 8

any lesion of the peripheral or central noceptic pathways, paradoxically can produce pain

characterized as burning, tingling, or electric shock quality

Answer 8

neuropathic pain

Question 9

treatment of acute pain

Answer 9

aspirin, acetaminophen, NSAID agents

inhibits COX

Question 10

side effects of NSAID

Answer 10

gastric irritation
nephrotoxicity
drug-induced hypersensitivity

Question 11

most potent pain relieving drug

Answer 11

narcotic analgesics

codein
morphine
tramadol
phentanyl

Question 12

route of narcotic analgesic

Answer 12

IV or spinal

Question 13

drugs that have these side effects:

nausea and vomiting
pruritus
constipation
hypotension
respiratory depression

Answer 13

narcotics

Question 14

what is secondary perpetuating factors?

Answer 14

initiated by disease and persist after the disease has resolved

damaged sensory nerves
sympathetic afferent activity
painful reflex contraction (spasm)

Question 15

examples of chronic pain for which there is presently no cure

Answer 15

arthritis
cancer
diabetic neuropathy
chronic daily headache
fibromyalgia

Question 16

useful drugs for the management of chronic pain

Answer 16

tricyclic antidepressants particularly nortriphyllin and desipramine

needs multidisciplinary approach; medication, counseling, PT, nerve block or even surgery

may also need glucocorticoids

Question 17

drugs that have these side effects
orthostatic hypotension, drowsiness, memory impairment, constipation, urinary retention, cardiac conduction delay

Answer 17

tricyclic antidepressants (nortriphyllin and desipramine)

Question 18

drugs to give for these chronic pain

postheratic neuralgia
diabetic neuropathy
tension headache
migraine headache
rheumatoid arthritis
chronic low back pain
cancer
central poststroke pain

Answer 18

tricyclic antidepressants

Question 19

drug for trigeminal neuralgia

Answer 19

carbamazine

Question 20

characterized by electric shock-like pain; brief shooting pain

Answer 20

trigeminal neuralgia

Question 21

medication for patients with malignant disease

Answer 21

chronic opioid medication

Question 22

by giving these drugs, can produce drug induced death which is rapid increasing and second leading cause of death in US

Answer 22

chronic opioid medications

Question 23

common causes of headache for primary headache

Answer 23

69% tension type
16% migraine
2% idiopathic
1% exertional
0.1% cluster

Question 24

common causes of headache for secondary headache

Answer 24

63% systemic infection
4% head injury
1% vascular disorders
<1% subarachnoid hemorrhage
0.1% brain tumor

Question 25

___ usually occurs when peripheral nociceptors are stimulated in response to tissue injury, visceral detention

Answer 25

pain

Question 26

structures pain producing

Answer 26

1. scalp 2. meningeal artery 3. dural sinuses 4. falx cerebri 5. proximal segment of the large pial arteries

Question 27

non producing structures

Answer 27

ventricular ependyma choroid plexus pial veins brain parenchyma

Question 28

classification of daily headache >4H daily

Answer 28

chronic migraine chronic tension type headache hemicrania continua new daily persistent headache

Question 29

classification of daily headache <4 Hdaily

Answer 29

chronic cluster headache chronic paroxysmal hemicrania SUNCT/SUNA hypnic headache

Question 30

classification od daily headache secondary

Answer 30

posttraumatic head injury iatrogenic postinfections inflammatory such as giant cell arteritis, sarcordoitis, behchet's syndrome chronic CNS infection medication-overuse headache

Question 31

new daily persistent headache migranous type

Answer 31

subarachnoid hemorrhage

Question 32

new daily persistent headache featureless (tension-type)

Answer 32

low CSF volume headache raised CSF pressure headache posttraumatic headache chronic meningitis

Question 34

What type of drugs Codein Morphine Tramadol Phentanyl

Answer 34

Narcotic analgesics

Question 35

newer anticolvulsants used for trigeminal neuralgia

Answer 35

gabapentin and pregabalin