Lecture 4 (older adults/gender)

Question 1

• Presence of acute pain is roughly the same across life span, but there

Answer 1

is an age-related increase in the prevalence of chronic pain at least until the seventh decade of life
o Limited evidence to suggest a plateau or even a slight reduction in the frequency of pain complaints beyond this age

Question 2

• Recognize potential indicators of pain, such as pain behaviors, in those who are unable to report pain

Answer 2

(e.g., stroke, Alzheimer’s, etc.); observe these behaviors against an est. baseline or during movement

Question 3

• Understand the importance of a comprehensive medical hx and physical exam when assessing older pain patient; know how to perform a

Answer 3

comprehensive musculoskeletal exam including that of joints, soft tissues, and the axial skeleton; know that chronic pain in older adults is often contributed to by more than one diagnosis, so comprehensive assessment should be performed routinely

Question 4

• Increased likelihood of atypical pain due to diminished phys. Reserves and interacting comorbidities; high prevalence of incidental pathology (e.g., radiographic osteoarthritis in the absence of symptoms, etc.); know that the

Answer 4

hx and phys exams should guide acquisition of additional diagnostic studies and tests; pathway may be elusive in some with chronic pain, yet treatable/ should be recognized as a discrete entity

Question 5

• Women typically report more frequent and/or severe pain than men report - All the things re. women:

Answer 5

o Women are at greater risk for several chronic pain disorders: temporomandibular disorder, fibro, migraines, interstitial cystitis, joint pain, IBS, complex regional pain syndrome, trigeminal neuralgia
o Greater risk for autoimmune disorders that have a pain component
o Greater procedural and postoperative pain (some studies reported no sex differences)
o Women report lower pain thresholds and tolerances
o Ratings of suprathreshold stimuli are often higher among women across a wide range of painful stimuli
o Women are more likely to seek pain-related medical care
o Women are more likely to suffer an adverse effect after analgesia

Question 6

Men are at greater risk for

Answer 6

some pain disorders, including cluster headaches and pancreatitis

Question 7

Differences vary with age and are associated with

Answer 7

endogenous or exogenous sex hormone changes (migraines is an example)
o Genetic factors appear to determine some sex differences in pain and analgesia

Question 8

• Multiple psychosocial variables may contribute to sex differences in clinical and experimental pain responses, including (but not limited to) anxiety, abuse history, coping, gender roles, and family history

Answer 8

BOO! Wake up, this shit is boring.

Question 9

• Wo/men presenting with pain complaints may be offered different tests/treatments

Answer 9

o Available evidence does not support sex-specific tailoring of treatments; however, this is a conceivable outcome in the foreseeable future

Question 10

Trans adults and pain

Answer 10

• Trans folk are dx w/ more chronic conditions than cis folk, based on limited evidence
  o True for mh conditions
• Trans adults have higher rates of hypertension, congestive heart failure, coronary artery disease, hyperlipidemia, arthritis, dementia, stroke, chronic kidney disease, and diabetes