Epidemiology of Pain

Question 1

MCC LBP

Answer 1

Discogenic Pain MCC, Facet and SIJ

Question 2

SI joint innervation

Answer 2

Dorsal rami L5-S3

Question 3

Trigeminal neuralgia diagnosis

Answer 3

MRI and MRA

Can be caused by vascular compression by ipsilateral superior cerebellar artery as trigeminal nerve exits pons.

Question 4

Pain scales for children who cannot verbalize pain and adults in ICU

Answer 4

FLACC

Question 5

Pain scale for infants >38 weeks gestation

Answer 5

CRIES (crying, O2 requirement, change in VS, facial expression, sleep state)

Question 6

Pain scale for mild to moderate pain

Answer 6

Objective pain scale (OPS), a 4 point pain score.

Better than numerical rating scale (NRS) for defining mild-mod pain

Question 7

Wong-Baker Pain FACES pain rating scale is for children older than…

Answer 7

3 years old

Question 8

Paroxysmal Hemicrania characteristics

Answer 8

1. Female
2. Photophobia and phonophobia
   3.Severe
3. <30 minutes
   5< Tx indomethacin

Question 9

Hemicrania Continum characteristics

Answer 9

• HA for >3 months
• Daily, continuous, moderate to severe
• Autonomic symptoms
• Unilateral
• Resolution with indomethacin

Question 10

SF (short form) 36 for disability

Answer 10

-8 scales score (vitality, physical functioning, physical role functioning, social role functioning, emotional role functioning, mental health, bodily pain, general health perception.

• The lower the score the more disability
• Score 100 = no disability

Question 11

Neuromodulation of nociception - excitatory vs inhibitory NT

Answer 11

Excitatory:

• Calcitonin G related peptide
• Substance P
• Glutamate, aspartate
• ATP

Inhibitory effects on nociception:

• Acetylcholine
• Norepinephrine
• Serotonin
• Endorphins, Beta endorphins
• Enkephalins
• Somatostatin
• GABA, glycine
• GABA