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Adams Principles of Neurology > Pain > Flashcards

Pain Flashcards

1
Q

This pain theory asserts that each of the sensations has a distinctive end organ in the skin and each stimulus-specific end organ is connected by its own private pathway to the brain

A

Specificity theory

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2
Q

This pain theory states that the sensation of pain is the result of summation of impulses excited by pressure stimuli applied to the skin

A

Pattern or summation theory

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3
Q

Very fine, unmyelinated, slowly conducting nerve fiber which are polymodal and are most effectively excited by noxious stimuli but can respond to both mechanical, chemical and thermal stimuli.

A

C fibers

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4
Q

T/F: The peripheral afferent pain fibers of both A-delta and C types have their cell bodies in the dorsal root ganglia.

A

True

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5
Q

Neurologically relevant maps of pain projection from the bones, ligaments and adjacent musculoskeletal structures

A

Sclerotomes

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6
Q

T/F: As the ascending fibers cross the cord, they are added to the inner side of the spinothalamic tract so that the longest fibers from the sacral segments come to lie most superficially and fibers from successively more rostral levels occupy progressively deeper positions.

A

True

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7
Q

Most important cause of pain in muscle

A

Ischemia

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8
Q

A process by which inflammation lowers the threshold for perception of pain

A

Sensitization

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9
Q

Referred to as a demonstrable reduction in pain perception associated with an increased reaction to the stimulus once it is perceived

A

Hyperpathia

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10
Q

T/F: For most patients, pain that necessitates medical consultation,is, by definition, severe.

A

True

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11
Q

Non-medical pain treatment in which the patient is instructed to perform movements in the painful arm while watching the same moves made by the unaffected arm.

A

Mirror therapy

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12
Q

Meissner corpuscles

A

touch

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13
Q

Merkel discs

A

pressure

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14
Q

Ruffini plumes

A

warmth and skin stretch

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15
Q

Krause end bulbs

A

cold

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16
Q

Pacinian corpuscles

A

vibration and tickle

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17
Q

Which of the sensory receptors are the most deeply situated?

A

Pacinian corpuscles

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18
Q

The effect of aging is most evident in relation to this sensory function?

A

Vibratory sense

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19
Q

T/F: When the neuropathy is primarily demyelinating rather than axonal, paresthesia is an early feature.

A

True

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20
Q

This is the pathogenesis of headache following seizures and ingestion of alcohol

A

cerebral vasodilatation

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21
Q

How many percent of patients with migraine has its onset before 30 years old?

A

80%

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22
Q

gene associated with 50% of familial hemiplegic migraine?

A

CACNA1A

23
Q

contraindications of ergot drugs and triptans in migraine?

A

coronary artery disease and poorly controlled hypertension

24
Q

inhalation of 100% O2 via mask for 10-15 minutes at the onset may abort this type of headache?

A

Cluster headache

25
Q

Type of subdural hematoma with positional worsening of headache?

A

acute SDH

26
Q

A more sensitive indicator of Temporal arteritis and is particularly helpful when the sedimentation rate is only mildly elevated

A

CRP

27
Q

An intense, generalized, throbbing headache occurring in conjunction with flushing of the face and hands and numbness of the fingers

A

Erythrocyanotic Headache

28
Q

Treatment of choice in occipital neuralgia

A

Carbamazepine, Gabapentin

29
Q

The parts of the back that possess the greatest freedom of movement and hence are most frequently subject to injury.

A

Lumbar, lumbosacral, cervical

30
Q

Refers to the delayed subcutaneous hematoma in the flanks after a fractured transverse process

A

Greg-turner sign

31
Q

Most often involved disc in herniation of lumbar intervertebral discs?

A

L5-S1

32
Q

Most common pathogen of the infection of the vertebral column

A

Staphylococci

33
Q

Most common causes of intraspinal hemorrhage

A

coagulopathy and spinal arteriovenous malformation

34
Q

root most commonly involved in cervical disc herniation

A

seventh (70%)

35
Q

Drug of choice if the frequency of migraine is very frequent

A

Amitryptiline (propranolol if the severity is the prime concern)

36
Q

T/F: A migrainous patient having several attacks per week usually proves to have a combination of headaches.

A

True

37
Q

Pain that arises from the distention of this artery is projected to the back of the eye and temporal area.

A

Middle meningeal artery

38
Q

T/F: Trigeminal and cervical sensory inputs converge on the second order neurons at the C2 level.

A

True

39
Q

How many percent of patients with migraine have its onset before 30 years old?

A

80%

40
Q

Most common gene associated with familial hemiplegic migraine

A

P/Q type calcium channel alpha subunit (CACNA1A)

41
Q

Rate of cortical impairment in migraine

A

2-3mm/min

42
Q

T/F: sumatriptans are best administered just after the aura.

A

True

43
Q

Contraindication in triptans

A

Coronary artery diseaseand poorly controlled hypertension

44
Q

It has been called the alarm clock headache

A

Cluster headache

45
Q

Inhalation of 100% oxygen via mask for 10-15 mins at the onset may abort this attack

A

Cluster headache

46
Q

This is said to be the most common variety of headache

A

Tension headache

47
Q

This is the only type of headache that exhibits the peculiarity of being present throughout the day, day after day, for long periods of time

A

Chronic tension type headache

48
Q

Why is early diagnosis of temporal arteritis important?

A

Threat of blindness from thrombosis of the ophthalmic or posterior ciliary arteries

49
Q

Syndrome characterized with herpes of the external auditory meatus and pinna combined with facial paralysis

A

Ramsay-Hunt Syndrome

50
Q

Focal neurologic symptoms preceding migraine typically lasting lass than an hour

A

Aura

51
Q

Also called alarm clock headache because of nocturnal nature of headache

A

Hypnic Headache

52
Q

A serious preventable complication of untreated pseudotumor cerebri

A

Visual loss

53
Q

T/F: chronic migraine is a new entity defined by migraine headaches on 15 or more days per month for 3 or more months in the absence of medication overuse.

A

True

54
Q

T/F: Propranolol has no value in the treatment of migraine.

A

True

Adams Principles of Neurology (19 decks)

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