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Sem 2 - Health Assessment > Assessment of Pain (Test 1) > Flashcards

Assessment of Pain (Test 1) Flashcards

1
Q

What is the primary goal of a comprehensive pain interview?

A

To build trust, gather information, facilitate change, and understand the patient’s perspective.

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2
Q

What does the OPQRSTU mnemonic stand for?

A
  • O: Onset
  • P: Provocative/Palliative
  • Q: Quality/Character
  • R: Region/Radiation
  • S: Severity
  • T: Timing/Treatment
  • U: You/Impact
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3
Q

What are some red flags to rule out during a pain assessment?

A
  • Bowel/bladder dysfunction
  • Saddle anesthesia
  • Bilateral leg weakness
  • Severe, sudden onset headache
  • Fever, weight loss, night sweats
  • Recent injury
  • History of cancer
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4
Q

True or False: Most patients with chronic pain come with a positive medical history and expect to be ‘fixed’.

A

False

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5
Q

What is countertransference in the context of interviewing chronic pain patients?

A

An emotional response from the clinician that can provide insight into the patient’s situation and motivations.

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6
Q

What components are included in a clinical exam for musculoskeletal pain?

A
  • Inspection and General Appearance
  • Mental Status
  • Vital Signs
  • Posture and Gait
  • Palpation
  • Range of Motion (active and passive)
  • Neurological Examination
  • Special Tests
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7
Q

What is the significance of performing routine imaging in patients without red flags?

A

It reinforces sick behavior and worsens long-term outcomes.

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8
Q

When should advanced diagnostic imaging like CT or MRI be considered?

A

When referring for interventional or surgical procedures, or if red flag signs and a physical exam suggest a Red Flag condition.

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9
Q

Fill in the blank: A diagnosis of ‘chronic pain’ is simply not enough; it is important to establish a specific pain _______.

A

patho-anatomic diagnosis

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10
Q

What are the two key assessment tools for diagnosing fibromyalgia?

A
  • Widespread Pain Index (WPI)
  • Symptom Severity (SS) Score
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11
Q

What screening tool can be used to assess the risk of obstructive sleep apnea?

A

STOP-BANG screening tool

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12
Q

What is the primary purpose of the 4 (+2) A’s assessment during patient visits?

A

To assess the effectiveness of treatment.

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13
Q

What is the definition of acute neck pain?

A

Pain that is present for less than 3 months.

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14
Q

What is the prognosis for acute neck pain without trauma or red flags?

A

Favorable; 80% can expect to recover rapidly.

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15
Q

What are the characteristics of chronic neck pain?

A

Pain that is present for more than 3 months, with an unknown cause in the absence of trauma.

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16
Q

What differentiates referring neck pain from radiating neck pain?

A

Referring neck pain follows myotomes and usually has a normal neurological exam, while radiating neck pain follows dermatomes and has an abnormal neurological exam.

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17
Q

What is the definition of low back pain?

A

Pain that is present between the tip of the last thoracic spinous process to the tip of the sacro-coccygeal joints.

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18
Q

What are common risk factors for developing chronic low back pain?

A
  • Stress at work
  • Previous injuries
  • Litigation
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19
Q

What are the two types of symptoms associated with Cauda Equina Syndrome?

A
  • Severe, asymmetric pain
  • Saddle anesthesia
20
Q

What is the primary first-line test for suspected fractures?

A

X-ray

21
Q

What is a key characteristic of the pain associated with Conus Medullaris Syndrome?

A

Early and severe bowel, bladder, and sexual dysfunction.

22
Q

What is the first-line test for suspected spinal fracture due to severe trauma?

A

X-ray

23
Q

What activities are associated with stress fractures of the spine?

A

Sporting activity involving spinal extension, rotation, or both

24
Q

What are the preferred tests for suspected spinal infection?

A

1st line: X-ray
2nd line: MRI

25
Q

List two risk factors for infection related to spinal pain.

A
  • Invasive medical procedure
  • Diabetes mellitus
26
Q

What clinical indicators suggest a possible tumor in spinal pain?

A
  • Past history of malignancy
  • Age greater than 50
  • Weight loss
  • Pain not relieved by rest
27
Q

What is the first-line test for suspected aortic aneurysm?

A

Ultrasound

28
Q

True or False: Bed rest is recommended for managing spinal pain.

A

False

29
Q

What is the most common condition causing shoulder pain?

A

Rotator cuff impingement or tear

30
Q

Fill in the blank: The shoulder and pectoral girdle are stabilized by the _______.

A

rotator cuff

31
Q

What tests are used to provoke shoulder pain during examination?

A
  • Apley scratch test
  • Neers test
  • Hawkins test
  • Drop arm test
  • Lift off test
  • O’Brian’s test
  • Speed’s test
  • Yerguson test
  • Apprehension test
32
Q

What are the common conditions causing shoulder pain in the elderly?

A
  • Osteoarthritis
  • Adhesive capsulitis
33
Q

What is the foundational treatment for hip pain?

A

Exercise therapy

34
Q

What are the three compartments of the knee anatomy?

A
  • Tibiofemoral
  • Patellofemoral
  • Proximal tibiofibular
35
Q

What is the most common presentation of knee osteoarthritis in individuals over 45?

A

Morning stiffness, knee crepitus, bony tenderness, bony enlargement, and no palpable warmth

36
Q

What should be assessed during a hip examination?

A
  • Gait
  • Range of motion
  • Reflexes
  • Pulse
37
Q

List two conditions associated with hip pain in younger patients.

A
  • Slipped Capital Femoral Epiphysis (SCFE)
  • Legg-Calve-Perthes Disease (LCP)
38
Q

What imaging is beneficial for early diagnosis of inflammatory or infectious hip conditions?

A

Hip MRIs

39
Q

What are the Ottawa Rules for knee imaging?

A
  • Age > 55
  • Tenderness at the head of the fibula
  • Isolated tenderness of the patella
  • Inability to flex knee to 90 degrees
  • Inability to walk 4 weight-bearing steps
40
Q

What is the recommended first-line treatment for knee osteoarthritis?

A

Physical Therapy and short-term NSAIDs

41
Q

Fill in the blank: Most acute knee injuries are _______.

A

soft tissue injuries

42
Q

What is the imaging of choice for diagnosing a rotator cuff tear?

A

MRI

43
Q

What should be done if shoulder rehabilitation fails?

A

Utilize MRI

44
Q

What is the primary cause of hip pain in the elderly?

A

Hip Osteoarthritis

45
Q

What is the role of image-guided injections in shoulder pain management?

A

Provide temporary relief allowing exercise and patient activation

46
Q

What are the common non-effective therapies for knee pain?

A
  • Visco-supplementation
  • Prolotherapy
  • Acupuncture

Sem 2 - Health Assessment (35 decks)

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