Lecture 9 Flashcards by Ezrah Isaac Roy

what is a disease

a medical condition with a specific cause or causes and record and recognizable signs and symptons

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what is a syndrome

a collection of signs and symptoms and medical problems that tend to occur together but are not re;ated to a specific identifiable cause

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what are the three types of clinical pain

-acute pain
-cancer pain
-chronic non cancer pain

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types of acute pain

emergency room
post op

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types of non cancer pain

-inflammatory
-neuropathic
idiopathic/functional
-headache

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true or false: presurgical analgesia makes things better

false it does not make it work

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chronic postsurgical pain: most common chronic pain

-amputation 50-85%
-cardiac surgery 30-55%
-thoracotomy 5-65%

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acronym of chronic postsurgical pain

cpsp

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cpsp: cosmetic surgery

21-50%

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cpsp; breast augmentation

13%

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cpsp; vasectomy

15%

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what are the two types of acute to chronic pain transitioning

-you have acute pain and then there is a transition period in which you can either have pathological pain or resolved
-or you have your post op pain , and then there is chronic pain that kinda starts and the post op pain resolves and then the chronic pain goes up

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what is CIPN? and what prevalence

-chemotherapy induced peripheral neuropathy
-30-40% of all patients get that

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what is in a normal joint

-synovial membrane that protects the joint
-the synovial fluid that is between the joints
-joint capsule that is on the outside of the joint

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osteoarthritis is caused by?

thinned cartilage which means the bones rub together

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what is rheumatoid arthritis

-autoimmune disease
-caused by swollen inflamed synovial membrane
-causes bone erosion

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what is the type of rheumatoid arthritis treatment

monoclonal antibodies

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the monoclonal antibodies for rheumatoid arthritis all block…

tnf alpha

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what are the most popular meds for rheumatoid arthritis

-infliximab aka remicade
-adalimumab aka humira
-etanercept aka enbrel

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causes of chronic neuropathic pain

-nerve trauma (stump pain, phantom pain and bone fracture)
-iatrogenic nerve injury aka caused by medical treatment
-nerve compression due to entrapment ex: carpal tunnel
-nerve compression by tumor ex: many cancer pains
-metabolic/ nutritional/ischemic ex: diabetic neuropathy and sickle cell anemia
-more mpreeeeeeee

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what is the difference between nociceptive and neuropathic pain

-neuropathic is injury to the nerves/nervous system
-nociceptive is the damage to like the surrounding neurons

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true or false: hypersensitivity is common for nociceptive pain

false it is pretty uncommon except for hypersensitivity in the immediate area of an acute injury

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steps of diabetic peripheral neuropathy

-health issue
-capillary damage
-nerve damage and loss of sensation in extremities
-injury dye to loss of sensations
-loss of sensation and circulation problems result in increased risk of infection, ulcers and gangrene

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true or false: shingles are caused by a complication of chicken pox

rtiue
it is the virus that stays there in the drg and stays dormant in where it og got there

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what can cause post herpetic neural gia

shingles

what are the most common causes for phantom limb pain

-type 2 diabetes: 53.2% -perifery arterial disease : 18.3%

which is more common and more severe; upper limb or lower limb phantom limb pain

upper limb at 94%

phantom limb symptoms

pain itch, vibration, temperature movement size, shape, position rings on their finger referred phantom sensation

what is referred phantom sensation

like face touching felt in phantom limb

what is telescoping

phantom limb retracting in their bodies fist clenched and it hurts

what are the 2 causes of phantom limb pain

central and periferal changes

what are central changes in plp

-changes in the brain

what are peripheral changes in plp

in stomp brain changes because of change in stomp

true or false; even in phantom pain, the cortical that is responsible for it, will not take other roles

false; it can

plp interventions

-traditional treatment methods aka drugs and surgery <30% -lidocain blocks, in spinal side, works better near drg, plp eliminated in 50% of cases

what is causing crps type 1

we dunno

what is causing crps 2

classic traumatic neuropathic pain ex: from gunshot

what does crps mean

complex regional pain syndrome

true or false: physiological changes in affected limb affects crps1 and talk examples

true and it is false for crps2 loss of hair nail changes sweating

what are the cardinal signs of crps1

spontaneous pain swelling different skin temperature thermal and mechanical allodynia circumferential in distribution

true or false crps2 does not respond to nerve block but to sympathetic blockers

false that is crps2

what are the cardinal signs of crps2

burning pain mechanical allodynia hyperlagesia follows discrete nerve distribution variable response to sympathetic

true or false; crps2 responds well to nerve blocks

true

what causes crps

we dunno

what is the type of disorder that is fibromyalgia

a nociplastic one

is fibromialgia a form of arthritis

is fibromyalgia a rheumatic condition

yeah

why is fibromyalgia a rheumatoid condition

-a condition that affects the joints and or soft tissues, causing chronic pain -significant pain and fatigue -generally diagnosed by a rheumatologist

why is fibromyalgia not a form of arthritis

-no inflammation or damage to joints, muscles or tissues -does produce pain in soft tissues around joints and in skin, organs throughout the body

which disease causes brain fog

fibromyalgia causes fibro fog

can fibro cause numbness and tingling

yeah

what are the main things that scream fibro

chronic wide body pain and fatigue

what used to be a toll to diagnose fibro

they would [press on tender points since people with fibro have a lower threshold for pain

which disease had the first brain pain imaging

fibro

why did people used to thing that firbo was fake

because mostly women had it it is only when they saw the brain scans that what pain happened in the body coordinated with the brain

which disease causes increased windup and why

fibro -increased ascending transmission=more pain -decreased descending inhibition

which disease causes increased windup and why

fibro -increased ascending transmission=more pain -decreased descending inhibition which disease

which disease causes decreased conditioned pain modulation

fibro

is fibromyalgia a small fiber neuropathy

-if you look at the small fiber density who have it -their nocideptor nerve endings are much less dense -it is as if they have a neuropathy that affects the small fibers

is there overlap between idiopathic pain conditions

true

true or false; some diseases are diagnosed as smth depending on the doctor

true some of them are diagnosed as smth like some people who have ibs also have a form of fibro

what are the types of headache

sinus cluster tension migraine

what is sinus headache

pain is behind browbone and or cheekbone

what is a cluster headache

pain is in and around one eye

what is a tension headache

pain is like a band squeezing the head

what are the symptoms of a migraine

pain nausea visual changes

which is longer a migraine or a headache

migraine

headache and migraine locations

-headache: bilateral -migraine: unilateral

which is most common headaches or migraines

migraines

which has physical aggravation aka when you move it gets worse

migraines

photophobia and phonotobia migraines and headaches

-both for migraine -either for headaches

stages of migraines

-pronodrome which is before the migraine -aura; aka changes in visual perception like flashing light -headache -postdrome; aka migraine hungover

are there any migraine triggers

nah they are all nocebo

do we know the cause of migraine; vasodilation or neuronal

-vasodilation=blood supply is fucked? -neuronal: dura problems which has nerves aka the trigeminal nerve

aura and cortical spreading depression

-spreading wave of cortical hyperexcitability from the back -cortical spreading depression area that trails the wave of cortical hyperexcacitibibility -area of cortical depression has spreaded to the front

the speed of the aura in a migraine matches the speed of ...

cortical spreading depression

what is the % of people who have migraines that have auras

20%

migraine treatments

-over the counter analgesics -acute: triptans and cgrp antagonists -prophylactic: they prevent migraines, cgrp antagonists are a hugeeee slay aka mabs

how do they take migraine meds

they just like take the prophylactic and then if migraine take the acute ones