Pain

Question 1

an appropriate physiological response to a painful stimulus via an intact nervous system

Answer 1

nociceptive pain

Question 2

an inappropriate response caused by a dysfunction in the nervous system

Answer 2

neuropathic pain

Question 3

what are the symptoms of neuropathic pain? (6)

Answer 3

shooting or burning pain sensations
tingling and numbness
allodynia
hyperalgesia

Question 4

pain produced in response to a stimulus that is normally not painful (such as light touch)

Answer 4

allodynia

Question 5

increase in pain response with lowering of the pain threshold, to a stimulus that is normally painful (such ass pinprick)

Answer 5

hyperalgesia

Question 6

what are the causes of neuropathic pain? (6)

Answer 6

spinal cord injury 
Multiple sclerosis 
Stroke 
Diabetic neuropathy 
post-Herpetic neuralgia 
Trigeminal neuralgia

Question 7

what is the first line treatment of trigeminal neuralgia?

Answer 7

caarbamazepine

Question 8

what are the choices for initial treatment for neuropathic pain? (4)

Answer 8

amitriptyline, duloxetine, gabapentin, pregabalin

Question 9

what is the mode of action of amitriptyline?

Answer 9

tricyclic antidepressant that inhibits neuronal reuptake of noradrenaline and serotonin

Question 10

what is the mode of action of duloxetine?

Answer 10

inhibits reuptake of serotonin and noradrenaline

Question 11

what is the mode of action of gabapentin?

Answer 11

primarily inhibits high-voltage-activated presynaptic Ca2+ channels; designed as GABA analogue

Question 12

what is the mode of action of pregabalin?

Answer 12

primarily inhibits high-voltage-activated presynaptic Ca2+ channels; designed as GABA analogue

Question 13

what are the side-effects of amitriptyline? (6)

Answer 13

constipation, weight gain, dry mouth, mydriasis, sedation and hypotension

Question 14

what are the side-effects of duloxetine? (6)

Answer 14

nauseaa, dry mouth, constipation, somnolence, loss of appetite and hyperhidrosis

Question 15

what are the side-effects of gabapentin? (5)

Answer 15

somnolence, dizzineses, peripheral oedema, weight gain and ataxia

Question 16

what are the side-effeectss of pregabalin? (5)

Answer 16

somnolence, dizzineses, peripheral oedema, weight gain and ataxia

Question 17

A chronic condition that causes neuropathic pain, usually after surgery or minor injury and usually affecting the arm or leg?

Answer 17

complex regional pain

Question 18

what are the signs aand symptoms of complex regional pain? (7)

Answer 18

progresssive disproportionate pain
sweelling
skin changes
motor dysfunctions (tremor or dystonia)

Question 19

how is complex regional pain managed?

Answer 19

physiotherapy and amitriptyline

Question 20

what occurs in 10% of stroke patients?

Answer 20

central post-stroke pain

Question 21

what causes neuropathic pain in central post-stroke pain?

Answer 21

due to thalamic lesions

Question 22

A —–, rapidly improving hemiplegia with initial ——— followed in ——– to ——- by allodynia and dysesthesia

Answer 22

mild
paraesthesia
weeks
months

Question 23

a mild and rapidly improving hemiplegia with initial parassthesiaa followed in weeks to months by

Answer 23

allodynia and dysesthesia

Question 24

what can occur on the paralysed side?

Answer 24

hemi-chorea movements