37: Podiatric Disorders and Depression- Mahoney Flashcards
_______ of pts in primary care have clinical depression
13-25%
people who have major depression are more than ___ to have chronic pain when compared to ppl who have no symptoms of depression
twice as likely
chronic back pain is 3-4 times more prevalent with depression than in the general population
current drug of choice for treating both pain and depression
TCAs
amitriptyline
nortriptyline
doxepin
pts with depression and chronic pain relate ________ than those without depression
more pain
pts with chronic pain have increased rates of suicidal ideation, suicide attempts, and successful suicide
if pain decreases mobility or participation in social activities, depression is …
significantly increased
consider this point when recommending extended tx or surgery that require immobilization
compared to pts with no pain, pts with moderate to severe pain had increased _____ metabolism
glucose
bilaterally in prefrontal cortex
white matter properties are indicators for predisposition to chronic back pain, myelin and axons are distorted
a pain disorder related to chronic fatigue syndrome in which pts have physiological malfunction in the interpretation of pain
fibromylagia
prevalence 6.4%, underdiagnosed by physicians
sensation become unpleasant at stimulus intensities that are significantly lower than those observed in healthy controls
_____ volumes of pain-related brain areas are decrease din fibromylagia
gray matter volumes
most common systemic illness associated with heel pain
fibromyalgia
non-inflammatory disease of soft tissue so ther is no joint swelling detected
key locations for fibromyalgia pain
jaw
chest (upper sternum)
somatic symptoms of fibromyalgia
IBS muscle weakness HA pain/cramps in abdomen insomnia depression constipation ** burning pain, welling in extremities
complex regional pain syndrome CRPS I
minor injury
significant impairment of motor function
pain exceed both magnitude and duration the expected clinical course of inciting event
spontaneous pain or allodynia/hyperalgesia occurs that extends far beyond area of injury and pain out of proportion to inciting event
CRPS I
sympathetic n. dysfunction leading to edema, erythema, warmth or coldness to touch
develops after direct n. injury and has sympathetic n. dysfunction
CRPS II
causalgia
pain maintained by sympathetic efferent innervation or by circulating catecholamines that is also out of proportion and not associated with any specific nerve
classic sympathetic changes to skin not seen
SMP sympathtetically maintained pain
