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VET 2050 SP 23 > Pain > Flashcards

Pain Flashcards

1
Q

What are some postures that may signify if a dog is painful?

A

Tail between legs
Arched or hunched back
Twisted body to protect the painful site
Drooped head
Prolonged sitting
Tucked abdomen
Lying in flat, extended position

Student #11 ML
McCurnin 10th ed pg 904

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2
Q

What are some postures that may signify if a cat is painful?

A

Tucked limbs
Arched or hunched head/neck or back
Tucked abdomen
Lying flat
Slumped body
Drooped head

Student #11 ML
McCurnin 10th ed pg 904

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3
Q

What are the 3 phases of nociception?

A

Transduction
Transmission
Modulation

Student #11 ML
McCurnin 10th ed pg 906

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4
Q

What occurs in transduction?

A

Nociceptors convert mechanical, chemical, and thermal energy into electrical impulses

Student #11 ML
McCurnin 10th ed pg 906

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5
Q

What occurs in transmission?

A

When the noxious stimuli exceed the nociceptor’s threshold, a nerve impulse is generated and transmitted along the peripheral nerves to the spinal cord

Student #11 ML
McCurnin 10th ed pg 906

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6
Q

What is it called when a dog that has a chronic ear infection can no longer tolerate normal petting?

A

Allodynia

Student #14 SP
McCurnin 10th ed pg 907

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7
Q

What are ways you can maintain analgesic plane once pain is control is established?

A

Epidurals, CRI, or continued bolus dosing.

Student #14 SP
McCurnin 10th ed pg 908

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8
Q

What drug category is a lot of times the drug choice for chronic pain, for example osteoarthritis?

A

NSAIDS

Student #14 SP
McCurnin 10th ed pg 909

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9
Q

What drug plays an important role in reducing neuropathic pain and central sanitization?

A

Gabapentin

Student #14 SP
McCurnin 10th ed pg 914

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10
Q

What is the location of blocking the infraorbital foramen in a dog?

A

The left and right foramen can be located easily just above the third premolar and about midway up the gum line.

Student #14 SP
McCurnin 10th ed pg 911

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11
Q

Increased cortisol levels and sympathetic nervous system activity accompanying pain may have what undesired effects?

A

Reduced wound healing, suppression of immune function, increased catabolism and metabolic rate, anorexia, ileus, atelectasis, increased HR and blood pressure, irregular heart rhythms, and coagulopathies.

Student #6, AF, McCurnin 10th ed, pg. 905

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12
Q

Central sensitization or the “wind-up phenomenon” occurs when

A

Spinal neurons are subjected to repeating or high Intensity nociceptive impulses, leading to these neurons becoming progressively and increasingly excitable, even after the stimulus is removed.

Student #6, AF, McCurnin 10th ed, pg. 906

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13
Q

What is preemptive analgesia?

A

Providing analgesia before a noxious stimulus occurs.

Student #6, AF, McCurnin 10th ed, pg. 907

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14
Q

What is the duration of action of Hydromorphone?

A

3 to 4 hours

Student #6, AF, McCurnin 10th ed, pg. 912

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15
Q

What physiologic effects can be observed when a patient is experiencing emergence delirium?

A

Tachycardia, hypertension, cardiac arrhythmias, ventilation abnormalities, tachypnea, decreased tidal volume, cortisol release, and GI ileus and ulceration.
Student #6, AF, McCurnin 10th ed, pg. 913

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16
Q

What “rescue” drug is commonly used to counteract emergence delirium by providing both sedation and analgesia?

A

Dexmedetomidine (Dexdomitor)
Student #6, AF, McCurnin 10th ed, pg. 913

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17
Q

What does the Pulmonary system pain cause?

A

Tachypnea, Hypoxemia, Pulmonary edema, Pulmonary hypertension and raspatory acid imbalance.
Student #20
McCurnin 10th ed, pg. 906

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18
Q

What should you monitor when giving opioids?

A

Mentation, BP, RR, and nature
Student #20
McCurnin 10th ed, pg. 909

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19
Q

What should you monitor when you are giving alpha 2 agonists?

A

Femoral pulse rate and quality, HR, and BP
Student #20
McCurnin 10th ed, pg. 909

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20
Q

What nerve block should be used for feline declawing?

A

Circumferential Ring block
Student #20
McCurnin 10th ed, pg. 910

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21
Q

What are good local anesthesia’s?

A

Lidocaine, Bupivacaine and mepivacaine
Student #20
McCurnin 10th ed, pg. 918

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22
Q

Signs of pain in horses and other large animals?

A

Anorexia/lack or interest in food, lethargy, restlessness, pawing, vocalizing, bruxism, reluctance to move, lying down more frequently/longer.
#13 KM
McCurnin 10th ed. pg. 917

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23
Q

What does GI pain look like in large animals?

A

Kicking and/or looking at abdomen, violently rolling, stretched out posture (horses), tucked abdomen (cattle), “dog sitting” (foals).
#13 KM
McCurnin 10th ed. pg. 916

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24
Q

The cornual branch of the zygomaticotemporal nerve and the infratrochlear nerve must be blocked for dehorning procedures in ____ (species) while only the cornual branch needs blocked in ____ (species).

A

Goats, cattle
#13 KM
McCurnin 10th ed. pg. 921

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25
Dysphoria
“Emotional state characterized by anxiety, depression, or unease” #13 KM McCurnin 10th ed. pg. 904
26
Mulitmodal analgesia
Synergistic effects of combining two or more classes of analgesic drugs to alter more than one phase of nociception. #13 KM McCurnin 10th ed. pg. 908
27
What procedures are a local infiltration useful in?
Small mass removal, digit amputation, arterial catheter placement, Thoracocentesis, Abdominocentesis, bone marrow sampling, and many more. Student #8 KH, McCurnin 10th ed. pg. 910
28
Which pure opiod are cats sensitive to, therefore lower doses must be used?
Morphine Student #8 KH, McCurnin 10th ed. pg. 912
29
What is the main advantage of using morphine CRI?
Prevents the peaks and valleys that are typically seen with an opiod bolus dosing. Student #8 KH, McCurnin 10th ed. pg. 913
30
What are the principles of managing pain in large animals?
1. Pre-emptive analgesia 2. Multimodal analgesia 3. Analgesia of a duration that covers the entire painful period- for both acute and chronic pain Student #8 KH, McCurnin 10th ed. pg. 916
31
How is Firocoxib used in equine according to the FDA?
Approved for use up to 14 days to control pain and inflammation associated with equine osteoarthritis. Student #8 KH, McCurnin 10th ed. pg. 918
32
Define nociception.
Is the term used to describe three neuralgic phases of the pain pathway. AJ student # 10 McCurnin 9th edition pg 985
33
What are signs of pain associated with the pulmonary system?
tachypnea, hypoxemia, pulmonary edema, pulmonary hypertension, and respiratory acid-base imbalance AJ student # 10 McCurnin 9th edition pg 984
34
What are signs of pain associated with the metabolic system?
cachexia, increased oxygen demand, and negative nitrogen balance AJ student # 10 McCurnin 9th edition pg 984
35
What does a dog with a pin score of 1 look like?
distracted easily by surrounding, content to slightly unsettled/ restless, mild body tension, and reacts to the affected area being touched. AJ student # 10 McCurnin 9th edition pg 895
36
What does a cat with a pain score of 3 look like?
constantly yowling, growling, or hissing; may bite or chew at the wound, reacts aggressively to palpation and pulls away, and moderate body tension. AJ student # 10 McCurnin 9th edition pg 986
37
What are some vocalization signs of pain in dogs?
Barking, Howling, Moaning, and Whimpering Student #3, S.C McCurnin 10th Edition Page:903
38
What are some vocalization signs of pain in cats?
Crying, Hissing, Spitting, Moaning, Screaming, and Purring Student #3, S.C McCurnin 10th Edition Page:903
39
The hospitalized patient is in unfamiliar surroundings and may be comforted by a favorite ________ or ____________. This is an example of _____________ and ____________ care for treatment of pain.
Blanket, Toy Environmental, Emotional Student #3, S.C McCurnin 10th Edition Page:907
40
What two drugs are used for dental nerve blocks?
Lidocaine and Bupivacaine Student #3, S.C McCurnin 10th Edition Page:910
41
What drug could be added to reduce bleeding by coating the syringe when doing dental nerve blocks?
Epinephrine Student #3, S.C McCurnin 10th Edition Page:910
42
Behavioral changes related to pain?
-Restless, decreased appetite, lack of sleep, resistant to handling, not assuming normal positions. Student #4, BE, Pg 983
43
When should a patient be evaluated for pain?
-Upon admonition and at regular intervals throughout hospitalization. Student #4 BE, Pg 984
44
AAHA pain management standards?
-Pain assessment for every P regardless of complaint, assessment recorded in the medical record, use of preemptive pain management, pain management for anticipated pain level and duration, analgesia for all surgical procedures, reassessment of pain throughout surgery, medical and chronic pain treated, written protocols, client education. Student #4, BE, Pg 986
45
What side effects should be monitored when local anesthetics are administered?
-None, unless given via CRI. Then monitor for nausea, vomiting, neurologic signs, and seizures. Student #4, BE, Pg. 989
46
What side effects should be monitored when NSAIDS are administered?
-GI upset, GI bleeding, renal disturbances Student #4, BE, Pg 989
47
Where does the pain pathway begin?
At the site of tissue damage Student #16 ER McCurnin 10th Edition pg 906
48
What differentiates nociception from pain?
Consciousness Student #16 ER McCurnin 10th Edition pg 906
49
Which receptor in the brain and spinal cord is responsible for providing sedation when opioids are administered?
Kappa Student #16 ER McCurnin 10th Edition pg 911
50
Nonsteroidal anti-inflammatory drugs provide analgesia by modifying which of the following?
Inflammatory Response Student #16 ER McCurnin 10th Edition pg 909
51
What are common side effects seen when using Alpha 2 Agonists?
Bradycardia and vomiting Student #16 ER McCurnin 10th Edition pg 912
52
The wind up phenomenon is a cumulation of which two distinct phases of change in the nervous system?
Hyperalgesia and allodynia Student #2 vc McCurnin 10th ed. pg 906
53
What are the benefits of using three different classes of drugs for analgesia?
Provides better pain control and confers the added benefit of allowing the use of lower doses of individual agents, thereby reducing side effects. Effective anaglesia can also reduce the amount of gasesous anesthetic required for a procedure. Student #2 vc McCurnin 10th ed. pg 908
54
What new NSAID has entered the veterinary market, and what are it's benefits?
Grapiprant (Galliprant, Elanco) Works by targeting different receptors and is proposed to successfully combat inflammation and thus be safer for the GI tract. Student #2 vc McCurnin 10th ed. pg 909
55
What procedures can topical analgesia be helpful for?
Wound suturing, arterial puncture, nasal cannulation, and urinary catheter. Student #2 vc McCurnin 10th ed. pg 910
56
What is a common side effect of opioids, particularly morphine and hydromorphone? When does this side effect most frequently occur?
Emesis Occurs most frequently when an opioid is used as a premedication, rather than as an analgesic in an animal already in pain. Student #2 vc McCurnin 10th ed. pg 911
57
Describe neuropathic pain.
Persistent stabbing, aching, burning, itching, or tingling sensations, with or without an observable cause. Student #17 TAS-R McCurnin 10th ed. pg 906
58
Define hyperalgesia.
Less and less stimulation causes pain. Student #17 TAS-R McCurnin 10th ed. pg 906
59
Adverse effects of local anesthetics in a CRI?
nausea, vomiting, neurologic signs, and seizures. Student #17 TAS-R McCurnin 10th ed. pg 909
60
Side effect of opioids in cats and horses? How to treat?
Excitement. Treat with a sedative. #17 TAS-R McCurnin 10th ed. pg 922
61
Onset time and duration of action for lidocaine?
Onset time: 3-5 minutes. Duration of action: 60-90 minutes. #17 TAS-R McCurnin 10th ed. pg 910
62
Soft tissue procedures require how many days of postoperative analgesia?
Three to four days #18 BKS McCurnin 9th ed. pg. 989
63
Research shows that pretreatment with _______________greatly reduces intraoperative and postoperative pain from procedures on soft tissues and orthopedic procedures.
NSAIDs #18 BKS McCurnin 9th ed. pg. 990
64
How long is the contact time for topical analgesia, such as bupivicaine or lidocaine solutions, to ensure effective analgesia?
20 to 30 minutes #18 BKS McCurnin 9th ed. pg. 991
65
Which opioid is considered the "gold standard" for pure opioid agonists, used to manage severe pain?
Morphine is commonly used to provide maximal analgesia and sedation. All other drugs are compared with morphine in terms of efficacy, duration of action, and cost. #18 BKS McCurnin 9th ed. pg. 993
66
Why might it be more difficult for owners to realize or understand that their farm animals need analgesia?
There are misconceptions about animals and pain, especially when it comes to large animals. One misconception is that "animals don't show they are in pain, so they must not feel pain." Large animals are prey animals and by instinct will hide their pain as much as they can to not appear weak to a predator. #18 BKS McCurnin 9th ed. pg. 997
67
What should you monitor for if your patient has been given a local anesthetic?
Muscle tremors and GI upset #19 MW McCurnin 10th ed. pg. 909
68
What is the difference between an agonist and an antagonist?
agonists stimulate receptors while antagonists partially block the receptors. #19 MW McCurnin 10th ed. pg 911
69
What are two reversals for opioids?
Naloxone and Butorphanol (partial) #19 MW McCurnin 10th ed. pg. 912
70
Why is lidocaine beneficial as a CRI for GDV or other GI disorders?
It is safe and provides excellent systemic analgesia #19 MW McCurnin 10th ed. pg. 913
71
Apha 2 agonists inhibit the release of _________?
Norepinephrine #19 MW McCurnin 10th ed. pg. 912
72
What are nociceptors?
Pain receptors #9 KJ McCurnins 10th ed. pg 906
73
In which cases would severe pain be expected?
Cervical disc herniation, extensive inflammation, medical or surgical fracture repairs, limb amputations, declawing, and ear canal ablation #1, MA McCurnin 10th ed. pg 902
74
In which cases would moderate to mild pain be expected?
Cruciate repair, laparotomy, mass removal, castration, and dental procedures #1, MA McCurnin 10th ed. pg 902
75
What are the 5 basic principles which are used in designing an analgesic protocol and to effectively provide pain management?
1. The best way to treat pain is to prevent it 2. Using drug combinations, which often produces better pain relief compared with single agents 3. Matching analgesic 4. Maintaining analgesic plane once pain control is established 5. Adopting the approach of "Don't quit till the pain quits" #1, MA McCurnin 10th ed. pg 908
76
Why do horses generally receive better analgesic treatment than other large animals?
1. They are more likely to be treated as a "companion animal" 2. Horses generally are performance animals, and pain can affect their performance 3. Horses may become violent and dangerous when in acute pain - especially with GI pain 4. Unlike cattle and pigs, horses don't have an absolute economic value; thus the owners are more likely to spend money on their care #1, MA McCurnin 10th ed. pg 921
77
Which form of analgesic is available, effective, and cheap, but underused?
Local anesthetic drugs #1, MA McCurnin 10th ed. pg 917
78
Locomotion signs for a dog in pain
Reluctance to move Carrying one leg Lameness Unusual gait Unable to walk Chewing painful areas #12, JL McCurnin 10th ed pg.903
79
Temperament signs for cat in pain
Aggressive Biting Scratching Chewing Attacking Escaping Hiding #12 JL McCurnin 10th ed pg.903
80
Allodynia
Nerve fibers that normally carry pleasant or neutral information are recruited and become part of the pain process #12 JL McCurnin 10th ed pg.906
81
Local Infiltration
Injection of lidocaine or bupivacaine into local tissue #12 JL McCurnin 10th ed pg. 910
82
Why are camelids more likely to receive analgesic treatment compared with cattle, sheep, and goats?
Generally, they are constrained neither by an absolute economic value nor by entry into the human food chain #12 JL McCurnin 10th ed pg.923
83
What are common NSAIDs used in equine patients?
Phenylbutazone (Bute) and flunixin meglumine (Banamine) Student #7, HHS McCurnin 10th edition, pg:916
84
Why are few medications given orally to ruminants?
The rumen can inactivate, slow absorption, and alter drugs and the patient's response to the drug. Student #7, HHS McCurnin 10th edition, pg:922
85
What is the most common type of anesthetic drugs used in ruminants?
Local analgesic agents such as lidocaine and bupivacaine used in blocks Student #7, HHS McCurnin 10th edition, pg:923
86
What drug in combination with lidocaine increases its effectiveness?
Epinephrine Student #7, HHS McCurnin 10th edition, pg:910
87
What are some nonpharmacologic options for pain treatment?
Massage, aquatic therapy, acupuncture, thermotherapy, shock wave therapy, laser therapy, and electrical stimulation Student #7, HHS McCurnin 10th edition, pg:914
88
Which NSAIDS are FDA approved for the use in dogs?
Rimadyl (Carprofen), Metacam (meloxicam), Deramaxx (deracoxib), and Onisor (robenicoxib) Student #15, HP McCurnin 9th ed. pg. 990
89
Which drug should never be used in circumferential limb blocks?
Epinephrine Student #15 ,HP McCurnin 9th ed. pg 991
90
What is the onset and duration of action for Marcaine (bupivacaine)?
Marcaine has an onset time of 15 minutes and a duration of action for 6-8 hours Student #15, HP McCurnin 9th ed. pg. 991
91
Fentanyl, morphine, and hydromorphone are examples of _____
Pure opioid agonists Student #15, HP McCurnin 9th ed. pg 993
92
What are two examples of Alpha 2 agonists?
Dexmedetomidine (Dexdormitor) and Xylazine Student #15, HP McCurnin 9th ed. pg 994
93
Is fentanyl a partial or pure opioid agonist?
Pure #9 KJ McCurnins 10th ed. pg. 912
94
Nocita duration of pain relief postop?
72 hours #9 KJ McCurnins 10th ed. pg. 910
95
Is there an NSAID approved for chronic use in cats?
No. But Carprofen is a commonly used off-label NSAID for chronic inflammatory pain in cats. #9 KJ McCurnins 10th ed. pg. 910
96
Does Morphine or hydromorphone cause less adverse effects when compared to each other?
Hydromorphone causes less adverse effects than Morphine. #9 KJ McCurnins 10th ed. pg. 912
97
Why is it thought that an animal is experiencing more severe pain if they are showing obvious signs such as vocalizing?
Animals have the natural instinct to hide pain to avoid seeming vulnerable to predators. So, if an animal is showing obvious signs of pain, it is likely that they are no longer able to hide it because the pain is more severe. #5 SF McCurnin's 9th ed. pg 982-982
98
What are some reasons why it is important to treat/prevent pain?
-Pain causes increased cortisol, which can interfere with wound healing and suppress the immune system -Increased sympathetic tone caused by pain can cause increased catabolism and metabolic rate, anorexia, ileus, and atelectasis -Pain can cause tachycardia, hypertension, arrhythmias, and coagulopathies #5 SF McCurnin's 9th ed. pg 984-985
99
Classic signs of inflammation?
redness, heat, and swelling #5 SF McCurnin's 9th ed. pg 986
100
What is gabapentin used to treat, and what are some common indications for its use?
Gabapentin is used to treat neuropathic pain Some common indications include -chronic degenerative conditions (ex: osteoarthritis, cancer) -dermatologic conditions (lick granuloma, chronic skin or ear infections) -persistent biting, licking, scratching, chewing of body areas -resistance to being touched at unaffected body areas -obvious signs of pain not associated with current inflammation #5 SF McCurnin's 9th ed. pg 996
101
Why should an animal be placed in a quiet, dimly lit place after administering alpha 2 agonists?
Loud noises and bright lights may cause agitation and decrease the effect of the drug. #5 SF McCurnin's 9th ed. pg 994

VET 2050 SP 23 (9 decks)

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