29.7.2013

Question 0

Pain Afferent fibres

Answer 0

A delta

C

Question 1

Features associated with acute pain

Answer 1

HR
BP
pupils
Plasma cortisol levels 
Limb withdrawal
Abdominal wall rigidity

Question 2

Chemical irritants that cause pain

Answer 2

ATP
histamine
Serotonin
Bradykinin

Question 3

Silent nociceptors

Answer 3

Respond to mechanical stimuli only when sensitised

Question 4

Major neurotransmitter in pain pathway

Answer 4

Glutamate

Question 5

Pain from diaphragm reaches which spinal segments

Answer 5

C3 and C4

Pain referred to neck and shoulder

Question 6

Hypothesis explaining referred pain

Answer 6

Convergence projection hypothesis

Question 7

Cortical structure that mediates emotional response to pain

Answer 7

Insula

Cingulate cortex

Question 8

Placebo effect is mediated by

Answer 8

Opioids

Question 9

Descending opioidergic system

Answer 9

Rostral anterior cingulate cortex
Rostral ventral medulla
Periaqueductal grey

Question 10

Characteristics of neuropathic pain

Answer 10

Tingling
Burning
Electric shock like pain
Triggered by light touch
Sensory deficit is present in area affected

Question 11

Hyperalgesia

Answer 11

Increased pain intensity in response to same noxious stimulus

Question 12

Hyperpathia

Answer 12

Greatly exaggerated pain sensation to innocuous or mild nociceptive stimuli
Characteristic of neuropathic pain

Question 13

Rx of post-herpetic neuralgia with allodynia

Answer 13

5% lidocaine patch

Question 14

CRPS(complex regional pain syndrome)

Answer 14

CRPS 1- reflex sympathetic dystrophy

CRPS 2- post traumatic neuralgia

Question 15

Causalgia

Answer 15

Severe post traumatic neuralgia

Question 16

NSAID that can be given IV

Answer 16

Ketorolac

Question 17

Narcotic analgesic available as Intranasal spray

Answer 17

Butorphanol

Question 18

Adverse effects of NSAIDS

Answer 18

Hypertension
Gastritis
Nephrotoxicity

Question 19

Why NSAIDS are contraindicated for post op pain?

Answer 19

May increase bleeding due to platelet inhibition

Question 20

Advantages of selective COX-2 inhibitors

Answer 20

Less gastric irritation
Don’t affect coagulation
But no protection against nephrotoxicity

Question 21

NSAIDS with cardiovascular risk

Answer 21

All except aspirin

Question 22

Painful conditions that respond to TCA

Answer 22

Postherpetic neuralgia
Diabetic neuropathy
Tension headache
Migrane headache
Rheumatoid arthritis
Chronic low back pain 
Cancer
Post stroke pain

Question 23

Antidepressants with pain relieving effects similar to TCA but without their side effects

Answer 23

Venlafaxine

Duloxetine

Question 24

Anticonvulsants used in pain relief

Answer 24

Phenytoin
Carbamazepine
Gabapentin
Pregabalin