Deck 28: Chronic Pain

Question 1

A patient with chronic low back pain due to instability presents to physical therapy with complaint of unilateral knee pain without history of injury to the knee.Tested in sitting the patient has full active range of motion.Tested in standing the patient has limited range of motion and pain response.The most reasonable explanation is

A)malingering response in standing.
B)primary knee pathology present only in standing.
C)fatigue in standing increases pain.
D)abnormal compensatory movement pattern in standing.

Answer 1

D

Question 2

Pre-emptive analgesia is believed useful for what type of pain?

A)Wind-up
B)Neuropathic
C)Phantom-limb
D)Subacute

Answer 2

A

Question 3

Which of the following physical findings is more indicative of a patient with acute pain than chronic pain?

A)Impaired body mechanics
B)Poor aerobic capacity
C)Muscle shortening
D)Joint restriction

Answer 3

D

Question 4

Allodynia is believed to occur due to

A)excessive activation of the substantia gelatinosa.
B)excessive inhibition of the substantia gelatinosa.
C)excessive stimulation of the spinothalamic tract.
D)excessive inhibition of the spinothalamic tract.

Question 5

Which of the following is more indicative of chronic pain than acute pain?

A)Responds to medication
B)Associated with anxiety
C)Adapted autonomic response
D)Onset is well defined

Question 6

Which of the following techniques would be most helpful in working with a patient who insists passive therapy modalities are the only effective means for reducing her low back pain?

A)"I" statements
B)Reference to standards
C)Active listening
D)Reflecting emotion

Question 7

The physical therapist should respond to a patient presenting with scapular pain who does not report a change in pain with palpation,scapular mobilization,or provocation testing by doing which of the following?

A)Treat for scapular dysfunction
B)Treat for scapular dysfunction,then refer for more medical tests
C)Not treat,refer for more medical tests.
D)Not treat,do not refer

Question 8

A patient states that an activity looks like it will be painful because it is similar to another activity he knows to be painful to his current injury.The patient's statement describes which aspect of the biopsychosocial model?

A)Nociception
B)Pain
C)Suffereing
D)Pain behavior

Question 9

A patient with postherpetic neuralgia reports a deep burning sensation in his legs.This sensation is carried along which type of fiber?

A)A-delta
B)A-beta
C)C fibers
D)Gamma

Question 10

A patient with newly diagnosed fibromyalgia is noncompliant with her home exercise program and states that the treatment is not helping because the therapist just doesn't understand how she is feeling.This behavior is indicative of

A)passive-dependent response.
B)overanxious response.
C)hostile response.
D)help rejecting response.

Question 11

The most appropriate pain rating tool for use with children under the age of 7 years is

A)visual analogue scale.
B)FACES scale.
C)verbal rating scale.
D)body diagram.

Question 12

Which of the following physical findings is more indicative of a patient with chronic pain than acute pain?

A)Dermatomal sensory change
B)Intact reflexes
C)Impaired motor control
D)Flexible postural asymmetry

Question 13

A patient with a long history of pain medication use due to dysesthesia from multiple sclerosis presents to physical therapy low back pain.What acuity of pain is the patient experiencing?

A)Acute
B)Subacute
C)Chronic
D)Chronic pain syndrome

Question 14

Presently the most effective treatment for slowing the progression of cronic regional pain syndrome postsurgically is

A)anesthetic block.
B)rhizotomy.
C)narcotic medication.
D)active range of motion.

Question 15

Which of the following is a possible cause of poor performance on a home exercise program for patients with chronic pain but not patients with acute pain?

A)Motor learning difficulty
B)Joint motion limitation
C)Tissue dysfunction
D)Muscle endurance

Question 16

Which of the following is more indicative of acute pain than chronic pain?

A)Affects the individual
B)Involves the social network
C)Onset ill-defined
D)Associated with depression

Question 17

A patient is observed walking to the therapy gym with a grimaced facial expression and antalgic gait pattern.Regardless of the physical examination findings,the physical therapist is observing

A)nociception.
B)pain.
C)suffering.
D)pain behavior.

Question 18

The physical terapist complains to her coworkers that she is "burnt-out" with her caseload of chronic pain patients.She states that she can't stop thinking about her patients at night because they aren't improving as quickly as they want to.The therapist is exhibiting

A)passive-dependent response.
B)overanxious response.
C)hostile response.
D)help-rejecting response.

Question 19

A patient with chronic pain who exhibits considerable fear and anxiety during the patient interview will likely respond best to what type of treatment plan?

A)Standard-based
B)Physician-based
C)Therapist-based
D)Patient-based

Question 20

Considering the gate control theory of pain,the use of transcutaneous electrical nerve stimulation would perform which of the following actions?

A)Counter-irritant stimulus to close the gate
B)Nonirritant stimulus to close the gate
C)Counter-irritant stimulus to open the gate
D)Nonirritant stimulus to open the gate