Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DONE CLINICAL > PAIN > Flashcards

PAIN Flashcards

1
Q

Describe ‘Somatic’ Pain

A
  • Well localised and sharp in nature

- Constant and increases with movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe ‘Neuropathic’ Pain

A

Burning or electrical in nature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe ‘Breakthrough’ Pain

A

A transient increase in pain in patient who has stable persistent pain treated with opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is ‘Allodynia’?

A

Pain by a stimulus that does not normally provoke pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Parasthesia?

A

Tingling sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Neuropathic pain is a WHAT disorder?

A

Disorder of the Neurones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Over what time course does acute pain occur?

A

Less than 3 to 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Over what time course does chronic pain occur?

A

More than 3-6 months or persisting beyond course of acute disease or after tissue healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is ‘referred pain’?

A

Pain from organ in body felt in different part of body - e.g swollen liver may cause pain in right shoulder due to inflammation pressing on nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fibromyalgia is what?

A

Chemical/hormone imbalance leading to widespread pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List two groups of drugs commonly used in pain relief in fibromyalgia

A

Antidepressants (Low dose TCAs, SSRIs, SNRIs) and Anticonvulsants (Carbamazepine, valproate, pregabalin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is first line treatment of BTP?

A

Oramorph - Low cost and trusted therapeutic profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Only consider Fentanyl products when…

A

Intolerance of Morphine, patient can’t swallow or rapid onset and short duration of BTP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List four types of rating scare…

A
  • Verbal rating scale
  • Numerical rating scale
  • Visual analogue scale
  • Visual recognition scale
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name the questionnaire that allows patient to show position of pain, rate pain and rate type of pain…

A

McGill pain questionnaire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 5 points for correct use of analgesics?

GENERAL THREE?

A

1) Oral
2) Regular intervals
3) Rx according to intensity as evaluated by scale of intensity of pain
4) Dosing adapted to individual - everyone diff
5) Constant concern for detail - provide patient with programme

Right drug, dose, time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

State the 3 steps of the WHO analgesic ladder

A

1) Para +/- NSAID/ ADJUVANT
2) Step 1 + weak opioid
3) Step 1 + strong opioid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why is it often good to prescribe paracetamol and codeine separately?

A

Allows stepping down to take place easily if needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

List the 3 main side effects from opioids…

A
  • Constipation
  • Nausea and vomiting
  • Respiratory depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the safest COX-2 inhibitor in terms of CV risk?

A

Naproxen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What should be prescribed with Naproxen to minimise GI risks?

A

Omeprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

List THREE things commonly associated with chronic pain that can cause further pain

A
  • Anxiety and depression
  • Loss of sleep
  • Muscle tension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does CPSP stand for?

A

Central ‘post-stroke’ pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is CPSP?

A

Neurological disorder develops when CNS damaged. Brain registers all stimuli as pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is first line treatment for Neuropathic pain (except trigeminal neuralgia)?

A

TCAs (amitriptyline) or Gabapentioids (gabapentin, pregabalin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Is Amitriptyline licensed for neuropathic pain?

A

NO

27
Q

Duloxetine comes under what class of drug? and is used in the treatment of what type of pain?

A

SNRI - Neuropathic pain

28
Q

What should be used in the treatment of localised neuropathic pain if the patient cannot tolerate oral treatments?

A

Capsaicin cream

29
Q

What is first line pain treatment in Trigeminal Neuralgia? and what class of drug does this belong to?

A

Carbamazepine (anti-epileptic)

30
Q

What adjuvant therapy can be used in treatment of bone pain?

A

Bisphosphonates (Pamidronate, clodronate, etidronate)

31
Q

What topical treatments can be used in Post-herpetic neuralgia?

A

Lidocaine, capsaicin creams

32
Q

What must be considered first of all before initiating opioids?

A

Is the patient Opioid naive or Not opioid naive?

33
Q

Immediate release opioids should be given in __ hourly doses

A

4 hourly doses

34
Q

Modified release opioids should be given in __ hourly doses

A

12 hourly doses

35
Q

An opioid naive patient should be started on Morphine __-__mg daily

A

20-30mg daily

36
Q

A patient switching from a weak opioid to a strong opioid should be on a starting dose of __ to __mg daily

A

40-60mg daily

37
Q

BTP doses are rescue doses of immediate release morphine and should be given as _/_th to _/_th of the regular 24 hour dose and repeated as needed

A

1/10th to 1/6th of the 24 hour dose

38
Q

If the patient is using their BTP dose of morphing more than ___ a day then the regular dose of morphine should be reviewed

A

Twice

39
Q

Incremental increases of doses should not exceed __ to __ of the TDD in 24 hours

A

1/3rd to 1/2

40
Q

100mg of Codeine PO is equal to __mg of Morphine PO

A

10mg

41
Q

10mg of PO Morphine is equiv to __mg of IM,IV,SC Morphine

A

5mg

42
Q

Why may a syringe driver be used? 5 reasons

A
  • Persistant nausea and vom
  • Unable to swallow oral
  • Poor GI abs
  • Weakness or unconscious
  • Unstable symptoms e.g pain/nausa
43
Q

Syringe drivers are…

IV, IM, PO, SC

A

SC

44
Q

List 4 sites for syringe driver infusion…

A

1) Upper arm
2) Ant/Post chest wall
3) Abdomen
4) Thigh

45
Q

Tramadol should be used in ____ for acute rescue therapy if needed

A

Those with neuropathic pain

46
Q

Morphine use should be avoided in ___ pain unless advised by a specialist

A

Neuropathic pain

47
Q

What is the maximum dose of paracetamol?

A

1g QDS

48
Q

What is the maximum dose of ibuprofen daily?

A

2.4g daily

49
Q

When starting Fentanyl an alternative analgesic therapy should be continued for at least the first ___ hours until therapeutic levels are achieved

A

12

50
Q

Respiratory depression can be reversed by…

A

Naloxone

51
Q

Anti emetics should be co-prescribed routinely with opioids for the first ___ days

A

4 or 5 days then review need thereafter

52
Q

If a patient is on a regular opioid then they should be prescribed a laxative. Suggest one.

A

Co-danthramer (softener and stimulant)
Lactulose and Senna (softener and stimulant)
Docusate sodium and Senna (softener and stimulant)

Dosage should be titrated to give a comfortable stool

53
Q

What are TENS machines?

A
  • Portable battery powered devices that generate small current to electrodes applied to skin
  • Electrodes placed at painful site or close to course of peripheral nerve innervating the painful area
  • Current passed until parathesia (tingling) felt at site of pain
  • Results in pain relief
54
Q

Describe ‘incident pain’

A
  • Predictable
  • Could be movement based e.g sit up, remove dressing, coughing etc
  • Give when anticipate pain will happen
  • Give a potent opioid to manage
55
Q

What monitoring requirements are needed for those being treated for pain?

A
  • Levels of pain
  • Sleeping patterns
  • Side effects - constipation, sedation, dry mouth etc…
  • Ability to carry out daily activities
  • Mood
56
Q

What is Post Herpetic Neuralgia?

What can be used to treat it?

A

Post-herpetic neuralgia is a persistent nerve pain that occurs at the site of a previous attack of shingles.

  • Topical lidocaine or capsaicin
57
Q

Visceral pain can be described as what?

A
  • Caused by damage to hollow organs and smooth muscle

- Usually referred

58
Q

What is the recommended treatment for fibromyalgia?

A
  • Non pharmacological:
  • Hot pool therapy
  • More or less exercise
  • CBT
  • Massage/relaxation
  • Pharmacological:
  • Analgesics
  • Anti-depressants (TCA)
  • Tramadol? Baclofen muscle spasms?
59
Q

What is trigeminal neuralgia?

What can be used to treat it?
What else can be done?

A
  • Abrupt, busrt severe pain provoked by touching trigger areas on one side of face
  • Carbemazapine can be used to treat it
  • Surgery to decompress 5th cranial nerve (if successful then slowly withdraw anti-epileptics)
60
Q

The analgesic effect of NSAIDs should be seen within ____ whereas the anti-inflammatory effects of NSAIDs may not be seen until around ____ weeks

A

Analgesics: 1 week

Anti-inflammatory: 3 weeks

61
Q

What are two effects of codeine that aren’t related to analgesia?

A
  • Cough suppressant

- Causes constipation

62
Q

When starting fentanyl, an alternative analgesic therapy should be continued fro at least the first __ hours until therapeutic levels are achieved

A

12

63
Q

Why is diamorphine good for parenteral administration?

A
  • It is extremely water soluble so a high dose can be given in a small volume

DONE CLINICAL (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions