Pain and Inflammation

Question 1

What is Pain?

Answer 1

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

Question 2

What are the ways of classifying pain?

Answer 2

Region of the body involved
System with the dysfunction
Duration and pattern of occurence
Intensity and time since onset
Etiology

Question 3

What are the two types of pain?

Answer 3

Nociceptive pain

Pathological Pain

Question 4

What is Nociceptive Pain?

Answer 4

It can be acute or chronic,

due to inflammation

Question 5

What is Pathological Pain?

Answer 5

It is usually chronic

Can be due to damage of nervous tissues or Abnormal Function of systems

Question 6

What are examples of neuropathic pain?

Answer 6

Neuralgia, Phantom Pain, Diabetic Neuropathy

Question 7

What are examples of abnormal function pain?

Answer 7

Irritable Bowel Syndrome, Tension Headache

Question 8

What does the pain cause?

Answer 8

Delay Healing
Decreased appetite
Increased stress
Disrupts sleep
Causes anxiety and depression

Question 9

In diseases with chronic pain such as cancer, trigeminal neuralgia, post herpetic neuralgia, chronic inflammation, What drugs are usually given?

Answer 9

NSAIDS, Opioids

Question 10

What are given to patients with psychogenic pain?

Answer 10

Anti-depressants

Question 11

What are given for Severe Pain such as Post operative pain?

Answer 11

NSAIDS, Opioids

Question 12

What are some chemical mediators of inflammation?

Answer 12

Histamine
Bradikinin and Hydroxyptamine
Prostaglandins/ Prostanoids
Leukotrienes
TNF alpha, IL-1

Question 13

What are the mediator macrophages in Acute inflammation?

Answer 13

Mast Cell products (histamine)
Bradykinin
Lysosomal Components
Complement Lipid Mediators

Question 14

What are teh mediator macrophages in Chronic Inflammation?

Answer 14

T-Lymphocytes and products
Cytokines
Growth Factor's Proteases and ROS
Complement
Lipid Mediators

Question 15

What is the main mediator of Acute inflammation?

Answer 15

Prostaglandin

Question 16

What is the main mediator of Chronic Inflammation?

Answer 16

T-Lymphocytes, Cytokines

Question 17

What are the pre-inflammatory Amine mediators?

Answer 17

Histamine, Bradykinin

Question 18

What are the Anti-inflammatory Amine mediators?

Answer 18

Adrenaline, Noradrenaline

Question 19

What are the Pre-inflammatory Lipid Mediators?

Answer 19

PGE2, PGI2, LTB4, LTC4

Question 20

What are the Anti-inflammatory Lipid Mediators?

Answer 20

PGI2, PGA2, Lipoxins

Question 21

What are the Compliment Pre-inflammatory mediators?

Answer 21

C3a, C5a

Question 22

What are the Compliment Anti-inflammatory mediators?

Answer 22

Clq Receptor

Question 23

What are the Pre-Inflammatory Cyclic Nucleosides?

Answer 23

cGMP

Question 24

What are the Anti-Inflammatory Cyclic Nucleosides?

Answer 24

cAMP

Question 25

What are the Pre-Inflammatory Adhesion Molecules?

Answer 25

E-Selectin, P-Selectin, ICAM1, VCAM1

Question 26

What are the Anti-Inflammatory Adhesion Molecules?

Answer 26

a2b2 Integrin, TSP Receptor, PS receptor

Question 27

What are Pre-inflammatory Cytokines?

Answer 27

TNF, IL-1B, IL-5

Question 28

What are Anti-inflammatory Cytokines?

Answer 28

TGF-B1, IL-10

Question 29

What are Pre-inflammatory Chemokines?

Answer 29

IL-8, GRO/KC, MIP1a (CCL3), MCP1 (CCL2)

Question 30

What are Anti-inflammatory chemokines?

Answer 30

NONE

Question 31

What are Pre-inflammatory Steroid Hormones?

Answer 31

NONE

Question 32

What are Anti-Inflammatory Steroid Hormones?

Answer 32

Glucocorticoids

Question 33

What is the action of COX?

Answer 33

it acts on the Arachidonic Pathway to produce Prostaglandins

Question 34

In normal condition, what are the dominant prostaglandins that are produced for protective purposes?

Answer 34

Prostacyclins such as PGI2, PGE2, Thromboxane

Question 35

In Inflammatory condition, what metabolites are formed in prostaglandin synthesis?

Answer 35

There is exaggeration of PGE2 and prostacyclins

Question 36

What is the function of PGD2?

Answer 36

Vasodilation

Question 37

What is the function of PGE2, EP1?

Answer 37

Bronchoconstriction | GIT smooth muscle contraction

Question 38

What is the function of PGE2, EP2?

Answer 38

Bronchodilation GIT smooth muscle relaxation Vasodilation Pain

Question 39

What is the function of PGE2, EP3?

Answer 39

``` Decreased Gastric Acid Secretion Increased Gastric Mucus Secretion GIT Smooth Muscle Contraction Uterine Contraction Lipolysis Inhibition Increase Autonomic neurotransmitters, pyresis ```

Question 40

What is the function of PGF2A?

Answer 40

Uterine Contraction, Bronchoconstriction, Decreased IOP

Question 41

What is the function of PGI2/ Prostacyclin?

Answer 41

``` Vasodilation Inhibits Platelet Aggregation Bronchodilation Salt Excretion Renal Blood Flow ```

Question 42

What is the function of TXA2?

Answer 42

Vasoconstriction Stimulates platelet aggregation Bronchoconstriction Decrease Renal Blood Flow and Salt Excretion

Question 43

What are the general functions of Prostaglandins?

Answer 43

Constriction and dilation in vascular smooth muscle cells Stimulates and inhibits Platelet aggregation Acts on Parietal Cells in the stomach to inhibit acid secretion Acts on mesangial cells in the glomerulus to increase GFR Induces Labor Decreases Intraocular Pressure Regulates Hormones Controls Cell Growth Regulates Inflammation Sensitizes Spinal Neurons to Pain Regulates Calcium Movement Acts on thermoregulatory center in hypothalamus to produce fever

Question 44

What are the Medical Managements for Inflammation?

Answer 44

NSAIDs, Corticosteroids, Herbal