NCS Pain Management

Question 1

true or false: cutaneous receptors respond to many various times of stimulation ie mechanical, chemical, thermal

Answer 1

false - only one
mechanical, hot or cold

Question 2

true or false: persistent pain is a result of peripheral sensitization

Answer 2

false - central sensitization

Question 3

persistent pain is a result of
a. local tissue damage
b. peripheral sensitization
c. central sensitization

Answer 3

c. central sensitization

Question 4

which of the following changes is not seen in central sensitization
a. change in brain areas stimulated
b. increased stimulation of wide dynamic rage neurons in dorsal horn
c. decreased threshold for stimulation
d. symptoms at area of injury only

Answer 4

d. symptoms at area of injury only

Question 5

which of the following changes is not seen in central sensitization
a. change in brain areas stimulated
b. stimulation of wide dynamic rage neurons with high threshold pain neurons in dorsal horn
c. decreased threshold for stimulation
d. symptoms at area of injury only
e. all of the above occur with central sensitization

Answer 5

e. all of the above occur with central sensitization

Question 6

true or false: there are no anatomical changes seen on brain imaging in persons with persistent pain

Answer 6

false - there is cortical reorganization in the homunculus and increased firing of more brain areas

Question 7

true or false: there are no functional changes seen on brain imaging in persons with persistent pain

Answer 7

false - there is cortical reorganization in the homunculus and increased firing of more brain areas

Question 8

what is the term for cortical reorganization as a result of persistent pain
a. hyperalgesia
b. allodynia
c. centralization
d. smudging

Answer 8

d. smudging

Question 9

true or false: persons with persistent pain will have a heightened 2 point discrimination sense

Answer 9

false - they will have a deficit in tactile acuity

Question 10

what would be an appropriate thing to say to a patient who has persistent pain and has had stimulation to the amygdala
a. its all in your head
b. try to be mindful about your pain
c. think to yourself “those are just my sensitive nerves and I do not need to give that sensation attention”
d. this pain is not in my control

Answer 10

c. think to yourself “those are just my sensitive nerves and I do not need to give that sensation attention”

Question 11

what would be an appropriate thing to say to a patient who has persistent pain and has had stimulation to the amygdala
a. its all in your head
b. try to be mindful about your pain
c. no pain no gain
d. I am in control. movement and pain does not mean harm

Answer 11

d. I am in control. movement and pain does not mean harm

Question 12

your patient presents with chronic neck pain and is hyperaware of their pain. every conversation you have is about their neck pain and they cannot deter their attention away from it. this is an example of
a. hyperalgesia
b. allodynia
c. kinesiophobia
d. pain catastrophizing

Answer 12

d. pain catastrophizing

Question 13

true or false: having pain is a true reflection of health

Answer 13

false

Question 14

which of the following is not a component of the biopsychosocial model
a. nociception
b. pain recognition at cortical level
c. suffering
d. pain behaviors
e. disability

Answer 14

e. disability

Question 15

you are working with a patient with persistent low back pain. they are starting to make good gains and have a day where they feel great and do a lot of activity they have been putting off. the next session they come to you with an exacerbation of their pain. what is the most appropriate thing to say to them
a. you did too much. you shouldn’t have done that
b. Notice when you do not pace yourself correctly and go too hard but that is okay and not creating damage
c. this is a set back and it will take some time to get back to where we were

Answer 15

b. Notice when you do not pace yourself correctly and go too hard but that is okay and not creating damage

Question 16

you are working with a patient who had a bad ankle sprain 3 months ago. they present unable to bear weight on the foot, with allodynia, cool dry skin compared to the unaffected foot, with decreased ROM, and nail changes. what is a likely DDx
a. ankle fracture
b. high ankle sprain
c. CRPS
d. malingering

Answer 16

c. CRPS

Question 17

CRPS is a dysfunction of which lobe of the brain
a. frontal
b. parietal
c. temporal
d. insular

Answer 17

b. parietal

Question 18

what is the order of interventions in graded motor imagery
a. imagery, mirror therapy, laterality
b. mirror therapy, laterality, imagery
c. imagery, laterality, mirror therapy
d. laterality, imagery, mirror therapy

Answer 18

d. laterality, imagery, mirror therapy

Question 19

true or false: graded motor imagery only reduces pain in the short term

Answer 19

false - maintains pain reduction at 6 month follow up

Question 20

true or false: there is not enough evidence to make parameters for mirror therapy

Answer 20

false - 6-10x/d no more than 10min for 2 weeks

Question 21

that is the proper parameters for mirror therapy
a. 6 hours a day 90% waking hours for 2 weeks
b. 6-10x a day, no more than 10-15min, for at least 2 weeks
c. 3x10 reps for 6-8 weeks
d. 30-60min, 3-5x/wk, for 12 weeks

Answer 21

b. 6-10x a day, no more than 10-15min, for at least 2 weeks

Question 22

how long is it appropriate to work on laterality for
a. 2 weeks
b. 2 months
c. 2 hours
d. there is no specified time

Answer 22

a. 2 weeks