Question 1

Which treatment is helpful in neuropathic pain but not used for acute pain?&#10;A) Narcotic analgesics&#10;B) Nonsteroidal antiinflammatory drugs and aspirin&#10;C) Anticonvulsants&#10;D) Nonnarcotic analgesics

Accepted Answer

Management of pain associated with neuralgia includes antiseizure medications.Narcotic analgesics are discouraged for long-term therapy.NSAIDs and aspirin are not indicated for treatment of neuropathic pain.Management of neuralgia includes topical and systemic therapies.

Question 2

Most sensory afferent pain fibers enter the spinal cord by way of the ________ nerve roots.&#10;A) anterior&#10;B) posterior&#10;C) C fiber&#10;D) anterolateral

Accepted Answer

Most sensory afferent pain fibers enter the spinal cord by way of the posterior nerve roots.The cell bodies of pain neurons are located in the dorsal root ganglion.Sensory afferent pain fibers do not enter the spinal cord by way of anterior nerve roots.Pain transmitted by C fibers is poorly localized and transmitted slowly.Many neurons originating in lamina I cross the spinal cord to activate neurons in the anterolateral tract.

Question 3

A patient presenting with a severe, pounding headache accompanied by nausea and photophobia is likely experiencing a ________ headache.&#10;A) tension&#10;B) migraine&#10;C) sinus&#10;D) chronic

Accepted Answer

Typical signs of a migraine headache include severe unilateral pounding or throbbing pain that may be accompanied by nausea, vomiting, photophobia, phonophobia, and lacrimation.A severe, pounding headache with nausea and photophobia is likely to be a migraine headache.A sinus headache is not typically associated with nausea and photophobia.Pain is considered chronic when it lasts more than several months beyond the expected healing time.

Question 4

One of the most common causes of acute pain is&#10;A) headache.&#10;B) fibromyalgia.&#10;C) malignancy.&#10;D) trigeminal neuralgia.

Accepted Answer

Headache is one of the most common causes of acute pain, accounting for approximately 13 million visits each year in the Unites States to physician's offices, urgent care clinics, and emergency departments.Fibromyalgia syndrome is a chronic pain syndrome.Cancer pain is a subcategory of chronic pain, although it may be acute.Trigeminal neuralgia is a form of neuropathic pain.

Question 5

The ________ is the level of painful stimulation required to be perceived.&#10;A) perception&#10;B) tolerance&#10;C) expression&#10;D) threshold

Accepted Answer

Pain threshold is the level of painful stimulation required to be perceived and is remarkably similar from one individual to another.Perception includes an awareness and interpretation of the meaning of the sensation.Pain perception is influenced by attention, distraction, anxiety, fear, fatigue, and previous experience and expectations.Pain tolerance is the degree of pain that one is willing to bear before seeking relief.Pain tolerance varies widely among individuals and within the same individual under differing conditions.Pain expression is the way in which the pain experience is communicated to others.Pacing, writhing, jaw clenching, facial grimacing, muscle guarding, crying, moaning, groaning, and verbal descriptions may be used to express pain.

Question 6

Pain is thought of as&#10;A) a subjective experience that is difficult to measure objectively.&#10;B) associated with changes in vital signs reflecting its intensity.&#10;C) experienced in the same way by all individuals.&#10;D) always the result of tissue damage that activates nociceptors.

Accepted Answer

Because pain is a subjective experience, defining and assessing it are difficult.Pain is not always associated with a change in vital signs.Pain is whatever the experiencing person says it is, and may vary according to each individual.Most pain begins in the periphery when free nerve endings called nociceptors are stimulated.

Question 7

Pain that waxes and wanes and is exacerbated by physical exertion is likely related to&#10;A) neuralgia.&#10;B) intermittent claudication.&#10;C) fibromyalgia syndrome.&#10;D) neuropathy.

Accepted Answer

Patients complain of pain that waxes and wanes and that does not follow a dermatomal pattern in fibromyalgia syndrome.The pain tends to be exacerbated by physical exertion.Trigeminal neuralgia is a form of neuropathic pain that can be quite disabling for patients.It is sudden, momentary, but excruciating pains along the second and third divisions of the trigeminal nerve.In the early stages, intermittent claudication is associated with physical activity and alleviated with rest and has a cramping quality.In severe cases, ischemic neuropathy may ensue and cause a more consistent burning, shooting pain in the leg or foot.In pain related to neuropathy, patients complain of burning pain in the distal bilateral lower extremities that is frequently worse at night.

Question 8

Referred pain may be perceived at some distance from the area of tissue injury, but generally felt&#10;A) on the same side of the body.&#10;B) with slightly less intensity.&#10;C) within the same dermatome.&#10;D) within 10 to 15 cm area.

Accepted Answer

Referred pain is perceived in an area other than the site of the injury.It is often felt at some distance from the point of nociceptor activation.Pain is generally referred to other structures in the same sensory dermatome.The brain cannot differentiate the two sources of pain signals and tends to attribute the visceral pain to a body surface location regardless of on which side of the body the injury occurs and on which side of the body the referred pain is felt.Referred pain is not felt with less intensity.Referred pain is not perceived at a distance that is within 10 to 15 cm.

Question 9

The physiologic mechanisms involved in the pain phenomenon are termed&#10;A) nociception.&#10;B) sensitization.&#10;C) neurotransmission.&#10;D) proprioception.

Accepted Answer

The physiologic mechanisms involved in the pain phenomenon are termed nociception.Sensitization is not the physiologic mechanism of pain phenomena.Neurotransmission is not related to the physiologic pain mechanism.The physiologic mechanisms involved in the pain phenomenon are not known as proprioception.

Question 10

It is useful to conceptualize pain physiology according to the four stages because each stage provides an opportunity for&#10;A) education.&#10;B) stimulation.&#10;C) intervention.&#10;D) documentation.

Accepted Answer

It is clinically useful to conceptualize pain physiology according to these four processes, because each stage provides an opportunity for intervention in the pain experience.It is more useful to provide intervention for the patient experiencing pain.Stimulation may actually increase the pain level for the patient.Documentation of findings is appropriate, but taking measures to reduce or stop the pain is more advantageous.

Question 11

Slow pain sensation is transmitted primarily by&#10;A) group Ia afferents.&#10;B) a motor neurons.&#10;C) unmyelinated C fibers.&#10;D) Ad fibers.

Accepted Answer

The answer of Slow pain sensation is transmitted primarily by&#10;A)...

Question 12

The gate control theory of pain transmission predicts that activity in touch receptors will&#10;A) enhance perception of pain.&#10;B) decrease pain signal transmission in the spinal cord.&#10;C) activate opioid receptors in the CNS.&#10;D) increase secretion of substance P in the spinal cord.

Accepted Answer

The answer of The gate control theory of pain transmission...

Question 13

Modulation of pain signals is thought to be mediated by the release of&#10;A) histamine.&#10;B) endorphins.&#10;C) cholecystokinin.&#10;D) glutamine.

Accepted Answer

The answer of Modulation of pain signals is thought to...

Deck 47: Pain