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Medical Specialties > Anaesthetics - pain > Flashcards

Anaesthetics - pain Flashcards

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USMLE® Step 1 flashcards
1
Q

What are health benefits to the patient for treating pain?

A

Improved sleep, better appetite
Fewer medical complications ie MI
reduced suffering
Less depression/anxiety

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2
Q

What are benefits to the family of the patient if we treat pain?

A

Improved functioning as a family member (mother/father)

Able to keep working

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3
Q

What are societal benefits to treating the patient’s pain?

A

Lower health costs - shorter hospital stay

Able to contribute to the community

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4
Q

How is pain classified in terms of duration?

A

Acute
Chronic
Acute on Chronic

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5
Q

How is pain classified in terms of cause?

A

Cancer

Non-cancer

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6
Q

How is pain classified in terms of mechanism?

A

Nociceptive

Neuropathic

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7
Q

What is nociceptive pain?

A

Obvious tissue injury or damage - physiological pain

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8
Q

How would nociceptive pain be described?

A

Sharp/dull

Well localised

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9
Q

What is neuropathic pain?

A

Nervous system damage or abnormality

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10
Q

How would neuropathic pain be described?

A

Burning, shooting, numbness, pins and needles

Not well localised

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11
Q

What are pathological mechanisms for neuropathic pain?

A

Increased receptor numbers
Abnormal sensitisation of nerves - peripheral or central
Chemical change in dorsal horn
Loss of normal inhibitory modulation

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12
Q

What are simple analgesics?

A

Paracetamol

NSAIDs

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13
Q

What are examples of mild opioids?

A

Codeine

Dihydrocodeine

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14
Q

What are examples of strong opioids?

A

Morphine
Oxycodone
Fentanyl

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15
Q

How is pain treated at the periphery?

A

Non drug treatments - Rest, ice, compression, elevation
NSAIDs
Local anaesthetics

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16
Q

How is pain treated at the spinal cord?

A

Non drug treatments - Acupuncture, massage, TENS
Local anaesthetic
Opioids
Ketamine

17
Q

How is pain treated at the brain?

A 
Psychological treatment
Paracetamol
Opioids
Amitriptyline
Clonidine
18
Q

What are advantages to paracetamol use?

A

Cheap and safe
Can be given orally, rectally, IV
Good for mild pain or moderate-severe pain if used with other drugs

19
Q

What is the main disadvantage of paracetamol?

A

Liver damage in overdose

20
Q

What are advantages of NSAIDs?

A

Cheap and generally safe

Good for nociceptive pain

21
Q

What are disadvantages of NSAIDs?

A

GI and renal side effects

Bronchospasm in sensitive asthmatics

22
Q

What are advantages of codeine?

A

Cheap and safe

Good for acute nociceptive pain

23
Q

What are disadvantages of codeine?

A

Constipation

Not good for chronic pain

24
Q

What are advantages of tramadol?

A

Less respiratory depression than other opiates
Used with opioids and simple analgesics
Not a controlled drug

25
Q

What is the main disadvantage of tramadol?

A

Nausea and vomiting

26
Q

What are advantages to using morphine?

A

Cheap and generally safe
Can be given orally, IV, IM, SC
Effective if given regularly
Good for severe acute nociceptive pain and chronic cancer pain

27
Q

What are disadvantages of morphine?

A

Constipation
Respiratory depression in high dose
Misunderstandings about addiction
Controlled drug

28
Q

What type of drug is amitriptyline?

A

Tricyclic antidepressant

29
Q

What are advantages to amitriptyline?

A

Cheap and safe in low doses
Good for neuropathic pain
Treats depression and poor sleep

30
Q

What is the main disadvantage of amitriptyline?

A

Anti-cholinergic side effects

31
Q

What is the RAT approach to pain management?

A

Recognise
Assess
Treat

32
Q

How can you recognise patient pain?

A

Ask the patient
Look at the patient - frowning, restricted movement, etc
Ask people who know the patient

33
Q

How is pain assessed?

A

Find out pain score at rest and during movement
Is the patient restricted in movement
Pain classification

34
Q

What should be done after RAT?

A

Reassess patient - Is treatment working and are other treatments needed?

Medical Specialties (23 decks)

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