Pain Flashcards

1
Q

What is allodynia?

A

pain due to stimulus that does not normally provoke pain

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2
Q

What is analgesia?

A

absence of pain in response to stimulus which would normally be painful

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3
Q

What is hyperalgesia?

A

Inc pain from stimulus that normally provokes pain

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4
Q

What is hypoalgesia?

A

Diminished pain in response to normally painful stimulus

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5
Q

What is neuropathic pain?

A

Pain caused by lesion or disease of somatosensory NS

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6
Q

What is neuropathy?

A

Disturbance of function or pathological change in a nerve

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7
Q

What is nociceptor?

A

High threshold sensory receptor of peripheral somatosensory NS capable transducing and encoding noxious stimuli

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8
Q

What is nociceptive pain?

A

pain that arises from actual or threatened damage to non-neuronal tissue and is due to activation of nociceptors

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9
Q

What is a pain threshold?

A

minimum intensity of a stimulus that is perceived as painful

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10
Q

What is pain tolerance level?

A

Max intensity of a pain-producing stimulus that a subject is willing to accept in a given situation

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11
Q

What is paresthesia?

A

Abnormal sensation, whether spontaneous or evoked

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12
Q

What are the three elements/pathways of pain?

A

nociception (detection) = peripheral

Transmission = spinal

Perception (interpretation) = brain

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13
Q

What pain is detected by alpha-delta fibres?

A

Nociceptive pain

High intensity mechanical or heat stimuli
Sharp, transient, pricking pain

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14
Q

What pain is detected by C-fibres?

A

Nociceptive pain

Intense thermal, chemical and mechanical stimuli

Delayed, prolonged aching and burning pain

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15
Q

What amino acids are responsible for fast nociceptive pain transmission?

A

Glutamate

Aspartate

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16
Q

What neuropeptides produce a slow, prolonged effect?

A

Substance P

Calcitonin-gene release peptide (CRGP)

17
Q

What neurotransmitters/AA causes acute pain stimulus?

A

Release of glutamate or aspartate

18
Q

What neurotransmitters/AA causes maintained/intense stimulus?

A

(hypersensitivity)

Neuropeptides as well as glutamate

Inc NMDA receptor sensitivity

19
Q

What causes nociceptive pain?

A

burns

fractures

appendicitis

myocardial pain

20
Q

What causes neuropathic pain?

A

Peripheral (compression or damage)
- herpetic neuralgia
- trigeminal neuralgia
- diabetic neuropathy

Central
- pathophysiological changes in brain or spinal cord
- nerve plexus avolution
- phantom limb pain, thalamic pain (post stroke)

21
Q

Outline the treatment of neuropathic pain

A

50% reduction in pain = appropriate positive clinically relevant end point

Simple analgesia = paracetamol

Adjuvant therapies = TCAs, SNRI, antiepileptics
- amitryptyline, gabapentin, pregabalin, duloxetine

22
Q

What is breakthrough pain?

A

Pain that occurs between doses of regular pain relief

Intermittent, transitory pain that occurs over the top of chronic pain

May have temporal, precipitating or predictable patterns

23
Q

How is breakthrough pain treated?

A

Give extra (breakthrough) dose of regular analgesic

24
Q

What is incidental pain?

A

Occurs on or is exacerbated by activity (doing something + feeling the pain)

Common post surgery or in patients with metastatic bone pain

25
Q

What analgesics are effective for neuropathic pain?

A

Antidepressants and anti-epileptics (may be effective)

Paracetamol and NSAIDs (less effective)

Opioids may be effective but more ADRs

26
Q

What analgesics are good for nociceptive pain?

A

Paracetamol (most)

Opioids

NSAIDs

27
Q

Discuss the characteristics of acute pain

A

<30 days
Obvious and understandable cause = self-limiting, dec with time as injury heals

Protective in nature, treatment successful

Can involve: anxiety, in autonomic NS (tachycardia, tachypnoea, hypertension, diaphoresis, mydriasis

28
Q

What is chronic pain?

A

Duration of intensity that adversely affects the function or well being of the patient (lasting more than 6 months)

Complication of acute injury where healing process does not occur as expected

No protective function or autonomic NS function

29
Q

What can cause chronic pain?

A

Cancer, degenerative disease (osteoarthritis, rheumatoid arthritis, fibromyalgia)

permanent dysfunction of NS –> nerve trunk injury

Psychological mechanisms

30
Q

What may people with chronic pain experience?

A

Pain as punishment

Depression, anger

Suffer insomnia

Weight loss

Sexual dysfunction

May be unable to cope with normal daily activities

31
Q

How is chronic pain assessed?

A

LINDOCARRF