Exam 1-3 Cumulative Concepts

Question 1

Peripheral nerve stimulation is used for:

Answer 1

neuropathic pain

Question 2

what is considered first-line treatment for cancer pain?

Answer 2

opioids
followed by anticonvulsants and antidepressants

Question 3

Select two descriptors of cancer pain:
A. somatic
B. idiopathic
C. psychological
D. neuropathic

Answer 3

A. somatic
D. neuropathic

Question 4

who would be most at risk for opioid-related respiratory depression?

Answer 4

Prolonged general anesthesia
advanced age (>60)
smoker
abdominal surgery
snoring/OSA

Question 5

most at risk for delayed respiratory complications

Answer 5

OSA

Question 6

TWO risk factors for CPRS type 2:

Answer 6

*type of surgery
*nerve injury
previous trauma
work-related injuries
female sex

Question 7

risk factors for neuropathic pain:

Answer 7

female gender
type of surgery

Question 8

allodynia

Answer 8

previously innocuous thermal or mechanical stimulation (e.g., warm water of a shower or the light touch of a towel) may be perceived as painful following a prior noxious stimulus (e.g., sunburn)

Question 9

number of lamina

Answer 9

10

Question 10

C fibers

Answer 10

slowly conducting
mediate the “second” pain or protopathic pain, which temporally follows epicritic
pain
poorly localized or diffuse
characterized as burning or dull

Question 11

first-line treatment for post-herpetic neuralgia:

Answer 11

Based on efficacy, antidepressants are the first choice for neuropathic pain and post-herpetic neuralgia

Question 12

injury/pain resulting from peripheral and CNS injury

Answer 12

neuropathic pain

Question 13

pain in pleura, internal organs, and pericardium

Answer 13

visceral pain

Question 14

pain caused by noxious stimulation due to injury, disease process, or abnormal function

Answer 14

acute pain

Question 15

dysfunction in one or more nerve root

Answer 15

neuropathic pain

Question 16

do not give celebrex in…

Answer 16

kidney injury

Question 17

spinal anesthesia mediated by what receptors?

Answer 17

mu-2

Question 17

elderly people and NSAIDs:

Answer 17

lowest dose for shortest duration

Question 18

corticosteroids inhibit…

Answer 18

prostaglandins

Question 19

MOA of tylenol

Answer 19

Reduce prostaglandin synthesis

Question 20

medial spinothalamic tract procedures

Answer 20

emotional pain

Question 21

substance P binds to

Answer 21

NK1

Question 22

released by C fibers and binds to NK-1

Answer 22

substance P

Question 23

phospholipase A2 catalyzes the conversion of what:

Answer 23

arachidonic acid

Question 24

describe central modulation:

Answer 24

Wind up, receptor expansion, hyperexcitability

Question 25

cranial nerves for face pain:

Answer 25

Trigeminal (V)
Facial (VII)
Glossopharyngeal (IX)
Vagus (X)

Question 26

risk factor for postherpetic neuralgia

Answer 26

increased severity of skin lesions

Question 27

which nerve fiber is the slowest

Answer 27

C

Question 28

how are nerve fibers classified?

Answer 28

by velocity and diameter

Question 29

3rd neurons synapse at…

Answer 29

post-cental gyrus

Question 30

A-delta fibers:

Answer 30

fast pain, acute

Question 31

Do not give buprenorphine with…

Answer 31

benzodiazepines

Question 32

two risks of the opioid-tolerant patient:

Answer 32

increased hospital LOS
increased postop pain

Question 33

substance that is released and reduces substance P:

Answer 33

enkephalin

Question 34

silent nociceptors respond to:

Answer 34

inflammation