Pain

Question 1

The cell bodies of the primary sensory afferents are located in the?

Answer 1

Dorsal root ganglia within the vertebral foramina

Question 2

What is the largest diameter afferent fiber?

Answer 2

A-beta

Question 3

Afferent fiber that respond maximally to LIGHT touch and or moving stimuli.
They are present primarily in the nerves that innervate the skin.

Answer 3

A-beta

Question 4

Afferent fibers that respond MAXIMALLY ONLY to intense (painful) stimuli and defines them as PRIMARY AFFERENT NOCICEPTORS (PAIN RECEPTORS)

Answer 4

A-delta and C-fiber

Question 5

The small diameter MYELINATED Afferent fibers

Answer 5

A-Delta

Question 6

The UNMYELINATED Afferent fibers

Answer 6

C-fiber / axon

Question 7

Chemical irritants

Answer 7

ATP
SEROTONIN
BRADYKININ
HISTAMINE

Question 8

When intense, repeated or prolonged stimuli are applied to damaged or inflamed tissues, the threshold for activating primary afferent NOCICEPTORS is _____ and the frequency of firing for all stimulus intensities is ______

Answer 8

LOWERED

HIGHER

Question 9

11 amino acid that Causes vasodilation, degranukates masts cells, chemoattractant to leukocytes, and increases production and release of inflammatory mediators

Answer 9

Substance P

Question 10

Crucial for pain sensation in humans wherein disruption causes deficits in pain and temperature discrimination

Answer 10

Spinothalamic tract

Question 11

Mediates the purely sensory aspects of pain, its location, intensify and quality

Answer 11

Somatosensory cortex

Question 12

subserve the affective or unpleasant emotional dimension of pain like fear

Answer 12

Frontal cortex

Question 13

Pain will worsen following administration of an inner substance can increase its perceived intensity

Answer 13

Nocebo effect

Question 14

Greatly exaggerated pain sensation

Answer 14

HYPERPATIA

Question 15

Very lightest moving stimulus evokes exquisite pain

Answer 15

ALLODYNIA

Question 16

Effective for postherpetic neuralgia who have prominent ALLODYNIA

Answer 16

Topical preparation 5% lidocaine

Question 17

Constellation of spontaneous pain and signs of sympathetic dysfunction following injury

Answer 17

Complex regional Pain Syndrome. CRPS

Question 18

Constellation of spontaneous pain and signs of sympathetic dysfunction following injury with identifiable nerve injury

Answer 18

CRPS 2 or post traumatic neuralgia

If severe CAUSALGIA

Question 19

CRPS WITHOUT OBVIOUS NERVE INJURY

Answer 19

RSD - Reflex sympathetic dystrophy

or CRPS type 1

Question 20

Particularly effective for mild to moderate headache and for pain of musculoskeletal origin

Answer 20

Aspirin, acetaminophen and NSAIDS

Question 21

Inhibits cyclooxygenase but do not have anti-inflammatory action

Answer 21

ACETAMINOPHEN

Question 22

Most common used analgesic

Answer 22

COX INHIBITORS (Aspirin, acetaminophen and NSAIDS)

Question 23

With chronic use, most common side effect of Aspirin, acetaminophen and NSAIDS

Answer 23

GASTRIC IRRITATION

Question 24

Gastric irritation is most severe in?

Answer 24

ASPIRIN

Question 25

Irreversibly acelytates platelet cyclooxygenase thereby interferes its coagulation of the blood and may cause gi bleeding

Answer 25

ASPIRIN

Question 26

Chronic use of NSAID causes side effects

Answer 26

Hypertension Nephrotoxicity GI IRRITATION

Question 27

Significant benefit in postoperative pain because they do not affect blood coagulation

Answer 27

COX 2 selective drugs

Question 28

C/I in post op px because they impair platelet mediated blood clotting and thus associated w increased bleeding

Answer 28

Non-selective cox inhibitors

Question 29

Most potent pain relieving drugs currently available with broadest range of efficacy and provide most reliable and effective method for rapid pain relief

Answer 29

OPIODS

Question 30

OPIOD related side effect can be reversed rapidly with narcotic antagonist

Answer 30

NALOXONE

Question 31

OPIOD receptor

Answer 31

U receptor

Question 32

Metabolite of meperidine

Answer 32

Normeperidime

Question 33

At higher doses of meperidine (>1g/d), accumulation of meperidine produce

Answer 33

Hyper-excitability and seizures not reversible by NALOXONE

Question 34

Respiratory depression by OPIODS are common when used with

Answer 34

BENZODIAZEPINES

Question 35

Lock out period of PCA

Answer 35

5-10 minutes

Question 36

Bolus doses Morphine ___ Hydromorphone ___ Fentanyl ____

Answer 36

Morphine ___1mg Hydromorphone ___0.2mg Fentanyl ____ 10 microgram

Question 37

Morphine intrathecally vs IV

Answer 37

Morphine intrathecally: 0.1-0.3mg | Morphine IV : 5-10mg

Question 38

OPIODS intranasal Transdermal Oral mucosa

Answer 38

OPIODS: intranasal -BUTORPHANOL Transdermal PATCHES- FENTANYL AND BUPRENORPHINE Oral mucosa- FENTANYL

Question 39

OPIOD antagonist that is restricted to the intestinal lumen by limited absorption Effective in lowering duration of persistent Ileus following abdominal surgery

Answer 39

ALVIMOPAN OR ENTEREG

Question 40

OPIOD antagonist available in SQ administration and with no penetration into the CNS Relief in OPIOD induced CONSTIPATION

Answer 40

Methylnatrexone (RELLISTOR)