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physiotherapy 2.3 > IPS/MED 2.4 > Flashcards

IPS/MED 2.4 Flashcards

1
Q

What is chronic pain according to Loeser and Melzack?

A

Chronic is less the duration of pain, rather the inability of the body to get back to homeostasis

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2
Q

What is the primary gain of pain according to Freud?

A

Primary Gain (Intrapersonal)
- Infantile unconscious conflict that is the main cause of disease
- E.g. alcoholic not aware of problems because he/she drinks it away

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3
Q

What is the secondary gain of pain according to Freud?

A

Secondary Gain (Interpersonal)
- Someone holds on to disease because of alleged or real benefits
- E.g. social benefits, insurance money etc.

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4
Q

What is the tertiary gain of pain according to Freud?

A

Tertiary Gain
- Social gains that a person gets because of someone else’s sickness
- E.g. Wife feeling good for caring for alcoholic husband

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5
Q

What are common problems that develop when pain behavior is supported?

A
  • Dramatisation
  • Disuse
  • Drug abuse
  • Dependency
  • Disability
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6
Q

What is pain according to the neuromatrix?

A

Pain is not a passive registration of the brain, but more an active collection of subjective experiences

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7
Q

What is the first dimension of the neuromatrix regarding pain?

A
  • Awareness of pain
  • Brain stem, thalamus, somatosensory cortex
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8
Q

What is the second dimension of pain according to the neuromatrix?

A
  • Integration and processing
  • Insular cortex, anterior cingulate cortex, prefrontal areas
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9
Q

What is the third dimension of pain regarding the neuromatrix?

A
  • Emotional component
  • Connection with limbic system → amygdala
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10
Q

Persists after injury has healed and results from significant functional and structural changes in nervous system

What is meant here?

A

Chronic pain

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11
Q

What type of memory is chronic pain?

A

Nociceptive memory

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12
Q

What functions in chronic pain do the primary and secondary cortices have?

A

→ Lateral pain pathway
→ Responsible for sensory dimension of pain

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13
Q

What function does the anterior cingulate cortex have in pain?

A

→ Medial pain pathway
→ Important for pain affection

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14
Q
  1. Accept that you have persistent pain…. And then begin to move on
  2. Get involved - building a support team
  3. Pacing
  4. Learn to prioritise and plan out your days
  5. Setting Goals/Action Plans
  6. Being patient with yourself
  7. Learn relaxation skills
  8. Stretching & Exercise
  9. Keep a diary and track your progress
  10. Have a set-back plan
  11. Team Work
  12. Keeping it up…putting into daily practice the tools from 1-11

What is described here?q

A

The pain toolkit

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15
Q

What is peripheral sensitization?

A
  • Increased response and lowered threshold level of nociceptive neurons in periphery
    → To stimuli in their receptive field
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16
Q

What is central sensitisation?

A

Increased response of nociceptive neurons in CNS to normal afferent input or even by afferent input
→ Below threshold level

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17
Q

What are components of successful chronic pain education and therapy?

A
  1. Pain education
  2. Cognitive behavioral therapy (graded exposure and graded activities)
  3. Therapy based on acceptance
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18
Q

What are the 3 phases of graded exposure?

A
  1. Cognitive behavioral phase
    - Analyzing the pain
    - Is there catastrophizing or kinesiophobia?
    - Use TSK or PHODA
  2. Education phase
    - Use fear avoidance model to explain pain behavior
    - Motivate patient to participate in treatment that might provoke fear
  3. Exposure treatment phase
    - Gradual exposure to activities that provoke fear and pain
    - Gradual increase of activity level
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19
Q

What is the overall goal in graded activity?

A

Increase activity level despite pain!!

Time contingent instead of pain contingent

Extinction of pain behaviour → Positive reinforcement of healthy behavior

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20
Q

What are bottlenecks of care in the transition from child to adult?

A

Psychosocial factors

Taking control and responsibility for oneself

Gaps of knowledge

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21
Q

What is Virchow‘s Triade?

A

Venous stasis

Hyper co-agulability

Blood vessel damage

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22
Q

What are cardiovascular effects of immobility?

A

Virchow‘s Triade

Initially increased venous return, intracranial pressure, HR and SV

Later orthostatic hypertension and stasis

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23
Q

What is the ABCDE screening for skin cancer?

A

Asymmetry

Border

Colour

Diameter

Evolving

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24
Q

What are the 4 steps of breast cancer treatment ?

A
  1. Shrink the tumour with chemotherapy
  2. Remove the solid tumour with surgery
  3. Radiation therapy after surgery
  4. Chemotherapy as precaution after surgery in case a few cancer cells have broken away to lymph node or adjacent tissue
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25
Q

What are the 5 standard treatment options for cancer?

A

Local:
1. Surgery
2. Radiation

Systemic:
3. Hormone therapy
4. Chemotherapy
5. Targeted therapy

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26
Q

How does hormone therapy work?

A

Exogenous administration of hormones leads to manipulation of endocrine system

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27
Q

What is targeted therapy in cancer?

A
  • Type of chemotherapy
  • Target cancer cell‘s inner mechanisms and doesn’t harm a lot of healthy cells
  • E.g. blocking chemical signaling, changing proteins, stopping vascularisation
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28
Q

What is curative or primary surgery in cancer treatment?

A

To remove cancer/tumour

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29
Q

What is debulking surgery in cancer?

A

Removal of cancer but not entirely because of damage to or delicate surrounding tissue

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30
Q

What is supportive surgery in cancer treatment?

A

Port-a-Cath implantation for infusions

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31
Q

What is a single gene trait?

A

Change in 1 gene with reproductive cells

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32
Q

What is a chromosomal defect?

A

DNA fragments are displaced or lost

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33
Q

Inherited tendency to develop genetic disorders following exposure to environmental factors is called?

A

Multifactorial

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34
Q

How many single gene disorders are known?

A

6000

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35
Q

If both parents carry an autosomal recessive gene and have 4 kids how would they be affected by it?

A

1 healthy child, 2 carrier children and 1 sick child

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36
Q

If one parent is sick an autosomal dominant gene and the other one is healthy (no dominant or recessive gene) how would their 4 kids be affected?

A

2 kids affected, 2 kids healthy

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37
Q

What type of autosomal disease is Huntington’s disease?

A

Autosomal recessive

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38
Q

Which disease is an example of x-bound inheritance?

A

Duchenne‘s muscular dystrophy

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39
Q

How many people of the world‘s population suffer from multifactorial genetic disorders?

A

10%

40
Q

Which episode of embryonic development is most critical?

A

first 2 months → Most critical time because of basic and rapid development

41
Q

What happens if there is severe exposure to negative environmental factors in the first 2 weeks of embryonic development?

A

Often death

42
Q

Which prenatal screening tool can be used to screen for high risk maternal infections?

A

TORCH

Toxoplasmosis
Other
Rubella
Cytomegalovirus
Herpes

43
Q

What can alcohol use during pregnancy lead to in the embryo?

A

Fetal alcohol syndrome

44
Q

How can cocaine use influence the embryo and baby?

A

→ Premature birth
→ High risk of further illnesses
→ Sudden infant death syndrome

45
Q

How does smoking effluence development of the infant?

A

Low birth weight

High risk of still birth

46
Q

Which parts of the brain lead to biological developments in adolescence?

A

Hypothalamus and pituitary gland

47
Q

What does the release of gonads lead?

A

Development of secondary sex organs

48
Q

What are common characteristics of Cushing‘s disease?

A

Obesity

Acne

Fatigue

High BP

Increased thirst

Depression

Anxiety

Increased incidence of infection

49
Q

Bigorexia is what type of disorder?`

A

Eating disorder

The Adonis complex

50
Q

What are the 3 types of scoliosis?

A

Structural scoliosis

Degenerative scoliosis

Functional scoliosis

51
Q

Joint swelling or discomfort lasting more than 6 weeks in children is an indicator for what?

A

Juvenile RA

52
Q

How many patients have full remission of juvenile RA?

A

50%

53
Q

What is osteomyelitis and which area is mainly affected?

A
  • Infection of bone
  • Complication after fracture or other trauma
  • Common causative organism is Staphylococcus aureus
  • Most common site of infection in adolescents is the metaphysis
54
Q

What are the 2 types of acne?

A
  • Type 1: Comedones, often called whiteheads or blackheads
    → Noninflammatory
  • Type 2: Involves a severe inflammatory response and infection
55
Q

What is the Klinefelter syndrome?

A

Chromosomal disorder

affects males owing to the presence of an additional X chromosome (XXY instead of XY)

56
Q

What is the Turner syndrome?

A

Chromosomal disorder

→ monosomy X in which one X chromosome is missing

→ affects sexual development in females and causes other abnormalities as well

57
Q

What is presbyopia?

A

Change in vision of elderly

Lense gets stiffer and vision declines

58
Q

What effect might DNA changes have on memory in elderly?

A

reduce expression of genes involved in learning and memory

59
Q

What effect do changes in dopamine have in elderly?

A

Loss of dopamine responsible for increased rigidity

Problems with cognitive flexibility

60
Q

WHat effects do changes in serotonin have in elderly?

A
  • Decreased levels can cause insomnia or depression
61
Q

What effects can changes in glutamate have in elderly?

A

Decreased levels in aging

Neurotransmitter used to transfer signals

62
Q

Which organs and areas are involved in stress response?

A
  • Hypothalamus
  • Pituitary Gland
  • Sympathetic nervous system
  • Adrenal medulla
  • Adrenal cortex
63
Q

Which effects does a stress response have on the body?

A
  • Increased HR and BP
  • Bronchodilation and increased ventilation
  • Increased blood glucose levels
  • Increased arousal of CNS
  • Decreased inflammatory and immune responses
64
Q

What are potential stress-related diseases?

A
  • Elevation of BP and arrhythmias can lead to heart damage
  • Chronic infections due to low immune response
  • Cancer due to low immune response
65
Q

What are the 5 stages of anxiety?

A
  1. Anxiety
  2. Abnormal Anxiety
  3. Panic Attacks
  4. Anxiety Disorder
  5. Hypochondria
66
Q

What does the 4KDL questionnaire assess?

A
  • Helps to map out mental complaints in clients
  • Provides insight into complaints by taking four domains into account:
  • Depression
  • Distress
  • Anxiety
  • Somatisation
67
Q

Which type of therapy is most promising in hypochondria?

A

Cognitive behavioral therapy

68
Q

What are somatisation disorders?

A
  • Accumulation of many disorders in different domains
  • Severe limitation in social, occupational functioning
69
Q

What needs to be given to diagnose a somatisation disorder?

A

Each of the following have to be met to be diagnosed:
- 4 pain symptoms
- 2 gastrointestinal symptoms
- 1 sexual symptom
- 1 pseudoneurological symptom

70
Q

Which symptoms may occur in PTSD?

A
  • Revisiting or reliving the event
  • Avoidance of certain activities and lack of emotional response
  • Dissociative state in which person is non-responsive
71
Q

When are opioids mainly used?

A

Post-surgery, cancer, chronic pain

72
Q

Sleepiness
- Bowel and bladder retention
- Nausea
- Vomiting
- Reduction in sports and exercise performance

These are common side effects of which drug?

A

Opiods

73
Q

Opioids can lead to which states of mind?

A
  • Euphoric
  • Despised
  • Dazed
  • Confused
74
Q

What are psychotropic drugs and what types are there?

A

Target specific locations in CNS

Fight mental illness

  1. Hypnotics
  2. Anxiolytics
  3. Antipsychotics
  4. Antidepressants
75
Q

What are hypnotics used for?

A

Remedies for sleep -> sleeping deeper

76
Q

What are anxiolytics used for?

A

Relaxing, soothing and anxiety reducing

77
Q

What are antipsychotics used for?

A

Means against delusions and hallucinations

78
Q

What are antidepressants used for?

A

Mood enhancement

79
Q

What are the 2 main effects of antipsychotics?

A

Hypokinesia
- Reduced ability to move
- Pseudoparkinsonsim

Hyperkinesia
- Tardive dyskinesia
- Rhythmic movements of tongue, neck and jaw

80
Q

What are potential effects of hypnotics?

A
  • Skills and alertness decrease → more accidents
  • Alcohol and drug enhancing effect
  • Sedative and muscle relaxation → risk of falling
81
Q
  • Hyperreflexia
  • Myoclonus
  • Stiffness
  • Hyperthermia
  • Diaphoresis
  • Thermal changes

These are side effects of which type of drugs?

A

Antidepressants

82
Q

How are stress and anxiety often treated?

A
  • Cognitive behavioral therapy
  • Often in combination with psychotropic drugs
83
Q

What are SSRIs?

A
  • Specific serotonin re-uptake inhibitor
  • Inhibits serotonin re-uptake into neurons
  • Effect shows after 1-2 weeks
  • Frequent side effects in 1-10%
84
Q
  • Initial increase in anxiety
  • Gastrointestinal disorders at start of treatment
  • Sleep disorders
  • Headache
  • Joint pain
  • Sexual dysfunction

These are common side effects of which drug?

A

SSRI

85
Q

What are TCAs?

A
  • Tricyclic antidepressants
  • Inhibits re-uptake of noradrenaline and especially serotonin
  • Notifiable after 1 week
  • Alpha1-adrenolytic, anticholinergic, antihistamine properties
  • Frequent side effects in 1-10%
86
Q
  • Dry mouth
  • Constipation
  • Cognitive dysfunction and confusion in elderly
  • Potential weight gain

These are common side effects of which drug?

A

TCA

87
Q

What are the 4 different types of addiction?

A
  • Substance addiction
  • Behavioral addiction
  • Mental addiction
  • Physical addiction
88
Q

What are effects of alcohol abuse?

A
  • Liver cirrhosis
    → Liver is overloaded, can no longer keep up its blood cleaning function
  • Toxicity
    → Especially in blood brain barrier
  • Affect on neurotransmitters and receptors
    → Loss of coordination and sensation
  • Vasodilation
    → BP eventually rises
  • Binge drinking
    → Strong fluctuations in BP
  • Vitamine and nutrition deficiency
89
Q

What is a problem drinker?

A

Long history of drinking
→ Problems in daily life, work or health
→ 10% of Dutch people between 16-69
→ 1.1 million people

90
Q

What is an alcoholic?

A

→ Need for alcohol
→ Wants to but can‘t stop
→ Keeps using alcohol despite damage
→ 0.7% of Dutch people between 18-64
→ 83000 people

91
Q

What is the CAGE questionnaire?

A
  • 4 item questionnaire that can indicate potential problems with alcohol abuse
  • 2 or more „yes“ may indicate problem
92
Q

What causes neurological problems in alcoholics?

A

vitamin B1 shortage leading to poly neuropathy

93
Q

What is Wernicke‘s encephalopathy?

A

→ Necrosis with inflammatory response in the brains followed by atrophy

Result of alcohol abuse

94
Q

Korsakoff‘s syndrome is a result of?

A

Alcohol abuse

95
Q

How does alcohol abuse effect the brain?

A
  • Spikes in dopamine and reward system of the brain
  • Brain adapts → more alcohol is needed
  • Effects on:
    → Self-control (frontal cortex)
    → Motor control (cerebellum)
    → Memory (hippocampus)

physiotherapy 2.3 (9 decks)

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