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Pain Final > Final > Flashcards

Final Flashcards

1
Q

Enkephalins, endorphans and opioid receptors target what Laminae of Rexad?

A

2

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2
Q

Non-nociceptive example of WDR neurons

A

Type A beta

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3
Q

What part of modulation causes hyperalgesia?

A

Dorsolateral funiculus

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4
Q

Pt screams an asks for pain medicine when putting on EKG leads is an example of what?

A

allodynia

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5
Q

Manipulation of small intestine would involve what fibers?

A

Type C (0.5-2 m/s)

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6
Q

What NT is involved with an open wound on hand (picture)?

A

glutamate

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7
Q

NT for type C fibers

A

substance P

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8
Q

______ are alogenic substances and made from cyclooxygenase and can cause hyperalgesia

A

Prostaglandins

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9
Q

(picture of burned hand) 1. Where are primary afferent neurons (A Delta and C) cell bodies? 2. Where do fibers descend or ascend? 3. After leaving tract of lissauer, the axon (still primary neurons) enter gray matter (rexad’s laminae I, II, V) of dorsal horn of spinal cord where they synapse with what?

(Actual ? had to do with neurons ascending/descending or crossing tract of lissauer??)

A
  1. dorsal root ganglia of spinal cord
  2. Tract of Lissauer
  3. second-order neurons
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10
Q

Visceral pain is ____ (nociceptive or non-nociceptive)

A

Nociceptive. So is somatic

Non-nociceptive pain: neuropathic, idiopathic, and psychogenic

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11
Q

The three sensory neurons involved in transmission are:

A
  1. Primary (stimulus to rexed laminae I/II/V)
  2. Secondary (nociceptive and WDR, start in rexed laminae I, II, V- cross midline of spinal cord though anterior commissure and ascend anterolateral pathway of the spinothalmic tract to terminate in the lateral thalamus and intralaminar nuclei)
  3. Tertiary (thalamus to cerebral cortex)
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12
Q

Type A delta fibers NT and receptor

A

glutamate and NMDA

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13
Q

NT stimulate peripheral nociceptors causing an influx of ___ ions to enter the nerve fiber membranes (depolarization) and a subsequent efflux of ____ (depolarization). This is a pain impulse.

A

Sodium

Potassium

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14
Q

Third order/tertiary neurons terminate in the

A

cerebral cortex

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15
Q

Another name for descending pathway

A

modulation. Efferent pathway. descends axons from cerebral cortex, hypothalamus, thalamus, periaquaductal gray, nucleus, raphe magnus, and locus ceruleus, via the dorsolateral funiculis, synapse with and suppress pain transmission to the brainstem and spinal cord dorsal horn

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16
Q

Descending (afferent/efferent) fibers have to with modulation

A

efferent

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17
Q

NT released on surgical incision

A

glutamate

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18
Q

Pain is an unpleasant and ____ experience associated with actual or potential tissue damage or described in terms of such damage.

A

emotional

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19
Q

Acute pain may result in…

A

atelectasis

20
Q

Prostaglandins enhance the release of

A

glutamate

21
Q

A 19 y/o boy rates his pain a 3 on 1-10 scale and is anxious and wheezing. BEST analgesic for him…

A

tylenol

22
Q

In the presence of inflammation, the administration of a non-selective cylclooxygenase inhibitor may result in

A

fever

23
Q

Doses for IV orfirmev

A

adult: 1000 mg q6h, 650 mg q4h, MAX 4000 mg/day
peds: 15 mg/kg q6h, 12.5 mg/kg q4h, MAX 75 mg/kg/day

24
Q

NSAIDS produce their therapeutic effects by inhibiting the conversion of arachidonic acid to:

A

prostoglandins

25
Q

centrally, opioid receptors are primarily located in which Rexed’s Lamina?

A

two

26
Q

Which agent should be prescribed with caution in a patient with renal insufficiency?

A

Morphine (has active metabolites)

27
Q

Receptor that remains plugged by Magnesium

A

NMDA

28
Q

T/F: Morphine 3 glucuronide is an active metabolite

A

False. (morphine 6 glucuronide)

29
Q

In chronic pain states, ketamine is beneficial in reducing

A

allodynia

30
Q

Common side effect of alpha 2 agonist

A

decreased heart rate

31
Q

Fentanyl route that has the shortest duration of action

A

epidural

32
Q

T/F: Hydromorphone is a safe choice for patients suffering from renal insufficiency.

A

true (no active metabolites)

33
Q

The upper lockout interval for the majority of PCA prescribed opioids is

A

10 min

34
Q

Which PCA variable is least prescribed?

A

basal rate

35
Q

T/F: Inhibition of alpha 2 adrenoreceptors may result in supraspinal analgesia

A

false

36
Q

T/F: celocoxib (a selective cox 2 inhibitor) should be avoided in patients with asthma

A

True

37
Q

Which receptor is a known sympatholytic?

A

Alpha 2

38
Q

Continuous stimulation of the nociceptor terminal by which NT can lead to chronic pain?

A

glutamate

39
Q

____ plug in NMDA receptors renders them inactive

A

magnesium

40
Q

A systemic effect of exogenous steroid administration is

A

depression

41
Q

T/F: Medications for the treatment of chronic pain should be continue throughout the preoperative period

A

True

42
Q

When prescribing an antidepressant as part of a multimodal approach to chronic pain management one would expect effects to take place in

A

1 week (4-10 days)

43
Q

Methadone has a half life of

A

15-60 hours

44
Q

Epileptics on phenytoin affect the metabolism of

A

methadone

45
Q

A single epidural steroid injection can cause hypothalamic pituitary adrenal axis suppression lasting:

A

5 days- 5 weeks

46
Q

What NT plays the greatest role in “wind-up”

A

glutamate

47
Q

The preventative drug used in the treatment of neuropathic pain blocks the alpha 2 delta subunit of the presynaptic voltage gated calcium channels within the CNS is:

A

pregabalin (lyrica) or gabapentin (neurontin)

Pain Final (1 decks)

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