Introduction to Pain and Pain Assessment

Question 1

function of pain

Answer 1

protective
- alerts about a problem
- protects from further injury
- facilitates healing

Question 2

pain pathway 4 steps

Answer 2

transduction, transmission, modulation, perception

Question 3

modulation usually ____ pain but can also _____

Answer 3

usually decreases, can also increase

Question 4

which of the following is false? pain is always
1. subjective
2. learned
3. innate
4. unpleasant
5.emotional

Answer 4

3- congenital insensitivity to pain

Question 5

Allodynia

Answer 5

pain due to something that is not usually painful

Question 6

Analgesia

Answer 6

no pain towards something that is usually painful

Question 7

Hyperalgesia

Answer 7

increased pain from a stimulus that is usually painful

Question 8

Dysesthesia

Answer 8

unpleasant abnormal sensation, whether spontaneous or evoked

Question 9

Noxious stimulus

Answer 9

a stimulus that is damaging or threatens damage to normal tissues

Question 10

Paresthesia

Answer 10

abnormal sensation (that is not unpleasant), whether spontaneous or evoked

Question 11

Sensitization

Answer 11

increased responsiveness of nociceptors to normal input and/ or recruitment of a response to normally subthreshold inputs

Question 12

what is the prevalence of canadians living with chronic pain

Answer 12

20%

Question 13

how does acute pain result in chronic pain

Answer 13

sustained activation leads to sensitization and structural remodelling = CNS neuroplasticity leading to hyperactivity

Question 14

____ pain usually has an identifiable temporal and causal relationship to injury or disease

Answer 14

acute

Question 15

_____ pain no longer serves a physiologic function

Answer 15

chronic

Question 16

_____ pain is physiological protective

Answer 16

acute

Question 17

what is the causal hypothesis

Answer 17

if pre and post op pain is managed well, it should not become chronic pain

Question 18

what is the associative hypothesis

Answer 18

even if pre and post op pain is managed well, if there are multiple factors associated with chronic pain, periop pain may still result in chronic pain

Question 19

what kind of pain is stimulus dependent and adaptive

Answer 19

nociceptive

Question 20

what kind of pain is stimulus dependent and has central/ peripheral amplification

Answer 20

inflammatory

Question 21

what kind of pain is spontaneously and stimulus dependent but has no structural NS lesions or active peripheral inflammation

Answer 21

dysfunctional

Question 22

what 2 types of pain may be persistent

Answer 22

dysfunctional and neuropathic

Question 23

what kind of pain has nervous system lesions or disease + neuroimmune response

Answer 23

neuropathic pain

Question 24

what kind of pain is most likely to be persistent

Answer 24

neuropathic

Question 25

opioid become more/ less useful as the pain becomes more centralized

Answer 25

less

Question 26

which pain are opioids less effective in
1. supraspinal neuropathic pain
2. spinal neuropath pain
3. peripheral neuropathic pain
4. central neuropathic pain
5. neuropathic pain

Answer 26

1

Question 27

how did the opioid crisis come to be

Answer 27

unmet clinical need to treat chronic noncancer pain
emphasis on profit by pharm companies
misleading information about risk of addition
world events

Question 28

what kinds of pain may be treated with opioids

Answer 28

nociceptive- noninflam and inflam, neuropathic peripehral

Question 29

what kinds of pain may be treated with NSAIDs/ acetaminophen

Answer 29

nociceptive- inflam and noninflam

Question 30

what kinds of pain may be treated by TCAs and SNRIs (not +cannabinoids)

Answer 30

noninflam nociceptive

Question 31

what kinds of pain may be treated by immunosuppressant and antiinflammatories

Answer 31

inflammatory nociceptive

Question 32

what kinds of pain can be treated by gabapentin/ pregabalin, TCAs, SNRIs, cannabinoids

Answer 32

peripheral and central neuropathic