Chronic pain syndromes: Fibromyalgia Flashcards
What is the biopsychosocial model of pain?
It describes pain as an interaction of biological, psychological, and social factors affecting pain perception and management.
How does the Gate Control Theory of pain work?
It suggests that non-painful input (e.g., touch) closes a “gate” in the spinal cord to block pain signals from reaching the brain.
What are the differences between A-delta and C fibers?
A-delta fibers are myelinated, fast-conducting, and transmit sharp pain, while C fibers are unmyelinated, slow-conducting, and carry dull, burning pain.
How does descending pain modulation work?
Descending pathways from the brainstem release neurotransmitters like serotonin and norepinephrine to inhibit pain signals in the spinal cord.
What is wind-up in pain processing?
It is the progressive increase in pain sensitivity due to repeated stimulation of nociceptors, leading to central sensitization.
What are the key mechanisms of neuropathic pain?
Peripheral sensitization, central sensitization, ectopic nerve firing, and altered pain signal processing.
What are the clinical signs of neuropathic pain?
Spontaneous pain, allodynia, hyperalgesia, dysesthesia, and sensory loss.
How does chronic pain impact the nervous system?
It induces neuroplastic changes, including increased pain sensitivity, altered neurotransmitter levels, and structural brain changes.
What role do glial cells play in chronic pain?
They release pro-inflammatory cytokines that amplify pain signaling and contribute to central sensitization.
Why is multimodal analgesia effective?
It targets different pain pathways simultaneously, enhancing pain relief while minimizing side effects.
What is the role of cannabinoid receptors in pain modulation?
CB1 and CB2 receptors modulate pain by inhibiting neurotransmitter release and reducing inflammation.
What is the difference between tolerance, dependence, and addiction in opioid use?
Tolerance is reduced efficacy over time, dependence is physical withdrawal symptoms, and addiction is compulsive drug-seeking behavior despite harm.
How does cognitive-behavioral therapy (CBT) help with chronic pain?
It addresses maladaptive thoughts and behaviors, reducing pain perception and improving coping strategies.
What are the principles of rational opioid prescribing?
Use the lowest effective dose, regularly reassess efficacy and safety, and monitor for misuse or side effects.
How do voltage-gated sodium channels contribute to pain?
They propagate pain signals along nerves; blocking these channels reduces pain transmission.
What are the WHO pain relief ladder steps?
Step 1: Non-opioids (e.g., paracetamol, NSAIDs), Step 2: Weak opioids (e.g., codeine), Step 3: Strong opioids (e.g., morphine) for moderate to severe pain.
What is breakthrough pain?
Sudden, temporary exacerbation of pain occurring despite ongoing pain management.
What are the pharmacokinetic differences between immediate-release and extended-release opioids?
Immediate-release opioids act quickly for acute pain, while extended-release opioids provide prolonged pain relief for chronic pain.
What is opioid rotation?
Switching from one opioid to another to improve pain control or reduce side effects.
What are the diagnostic criteria for complex regional pain syndrome (CRPS)?
Persistent pain disproportionate to injury, sensory/motor abnormalities, and autonomic dysfunction.
How does pain affect quality of life?
It impairs physical function, emotional well-being, social interactions, and work productivity.
What is the mechanism of action of ketamine in pain management?
It blocks NMDA receptors, reducing central sensitization and chronic pain.
Why is pain assessment important in clinical practice?
It guides treatment decisions, monitors therapy effectiveness, and improves patient outcomes.
What are the key components of a comprehensive pain assessment?
Pain location, intensity, quality, duration, aggravating/relieving factors, and impact on daily life.
What is the placebo effect in pain management?
Pain relief resulting from patient expectations rather than the therapeutic effect of a treatment.
How does chronic pain influence the endocrine system?
It disrupts the hypothalamic-pituitary-adrenal axis, leading to hormonal imbalances and increased stress response.
What are the long-term effects of untreated pain?
Increased risk of depression, anxiety, cardiovascular disease, immune dysfunction, and reduced quality of life.
What is the role of TRPV1 receptors in pain?
They detect noxious heat and capsaicin, mediating thermal pain and inflammation.
on.” “How does pain sensitization affect sensory thresholds?”
It lowers sensory thresholds, making normally non-painful stimuli painful and amplifying pain responses.
