Pain Assessment (Exam II)- Corndog

Question 1

What is the primary goal of a comprehensive pain interview?

Answer 1

To build trust, gather information, facilitate change, and understand the patient’s perspective.

Question 2

What does the OPQRSTU mnemonic stand for in pain assessment?

Answer 2

• O: Onset
• P: Provocative/Palliative
• Q: Quality/Character
• R: Region/Radiation
• S: Severity
• T: Timing/Treatment
• U: You/Impact

Question 3

What are some common red flags to rule out during a pain assessment?

Answer 3

• Bowel/bladder dysfunction
• Saddle anesthesia
• Bilateral leg weakness
• Severe, sudden onset headache
• Fever, weight loss, night sweats
• Recent injury
• History of cancer

Question 4

What are medical comorbidities that should be identified during a pain assessment?

Answer 4

• Lung and sleep disorders
• Obesity
• Heart disease
• Liver disease
• Kidney disease

Question 5

True or False: A diagnosis of ‘chronic pain’ is sufficient without a specific pain patho-anatomic diagnosis.

Answer 5

False

Question 6

What is the significance of countertransference during patient interviews?

Answer 6

It can elicit emotional responses that provide insight into the patient’s situation and motivations.

Question 7

What are the components of a clinical exam for pain assessment?

Answer 7

• Inspection and General Appearance
• Mental Status
• Vital Signs
• Posture and Gait
• Palpation
• Range of Motion (active and passive)
• Neurological Examination
• Special Tests

Question 8

What should be done if red flag signs and a normal physical exam are present?

Answer 8

Routine imaging should be avoided as it may reinforce sick behavior and worsen long-term outcomes.

Question 9

What does the STOP-BANG screening tool assess?

Answer 9

The presence and need to treat obstructive sleep apnea.

Question 10

What is the definition of acute neck pain?

Answer 10

Pain that is present for less than 3 months.

Question 11

Fill in the blank: Neck pain can refer to the ____ or ____.

Answer 11

[head], [arm]

Question 12

What is the prognosis of acute low back pain without trauma or red flags?

Answer 12

Favorable, with 80% expecting to recover rapidly.

Question 13

What are some key features of Cauda Equina Syndrome?

Answer 13

• Severe symptoms
• Asymmetric symptoms
• Saddle anesthesia
• Weakness to flaccid paralysis

Question 14

What are the two types of neck pain based on duration?

Answer 14

• Acute Neck Pain
• Chronic Neck Pain

Question 15

What is the importance of a physical exam in pain assessment?

Answer 15

To exclude red flags, complement psychosocial assessment, and quantify impairment.

Question 16

What should be the first line investigation for suspected fracture?

Answer 16

X-ray

Question 17

What is the role of imaging in acute low back pain?

Answer 17

Do not image within the first six weeks unless red flags are present.

Question 18

What is the significance of the Widespread Pain Index (WPI) in fibromyalgia assessment?

Answer 18

It helps diagnose and assess the severity of fibromyalgia.

Question 19

True or False: Opioids are indicated for the treatment of neck pain.

Answer 19

False

Question 20

What is a key characteristic of radiating neck pain?

Answer 20

It follows dermatomes and usually has an abnormal neurological exam.

Question 21

What are some factors that can increase the risk for chronic low back pain?

Answer 21

• Stress at work
• Previous injuries
• Litigation

Question 22

What are the four A’s used to assess treatment effectiveness?

Answer 22

• Activity
• Analgesia
• Aberrant drug-related behavior
• Adverse effects

Question 23

What are the symptoms of chronic neck pain?

Answer 23

Pain present for more than 3 months, often with an unknown cause in the absence of trauma.

Question 24

What should be done if neck pain persists despite conservative treatment?

Answer 24

Perform an MRI to detect an occult lesion and order image-guided diagnostic tests.

Question 25

What is the first-line imaging method for diagnosing a stress fracture?

Answer 25

X-ray ## Footnote MRI and bone scans may be used for further evaluation.

Question 26

Name two risk factors for infection related to musculoskeletal issues.

Answer 26

* Invasive medical procedure * Immunosuppression ## Footnote Other factors include injection, illicit drug use, trauma to skin or mucous membrane, and diabetes mellitus.

Question 27

What are the common symptoms indicating the need for imaging when shoulder pain is present?

Answer 27

* Fever * Weight loss * Pain not relieved by rest ## Footnote These symptoms may indicate underlying serious conditions.

Question 28

What is the primary component of the shoulder and pectoral girdle?

Answer 28

Scapula, clavicle, and humerus ## Footnote These bones work together to form the shoulder joint.

Question 29

List three tests used during a shoulder examination.

Answer 29

* Apley scratch test * Neers test * Drop arm test ## Footnote These tests help assess shoulder pain and functionality.

Question 30

True or False: MRI is indicated for all cases of shoulder pain.

Answer 30

False ## Footnote MRI is typically used only if rehabilitation fails or if there is weakness and loss of function.

Question 31

What is the most common cause of hip pain in the elderly?

Answer 31

Hip Osteoarthritis ## Footnote Other conditions may also present but osteoarthritis is the most prevalent.

Question 32

Fill in the blank: The hip joint is a ____ joint consisting of the femoral head and the acetabulum.

Answer 32

ball-and-socket

Question 33

What is the foundational treatment for hip pain?

Answer 33

Exercise therapy ## Footnote Active physical therapy is preferred over passive treatments.

Question 34

What are the three compartments of the knee?

Answer 34

* Tibiofemoral * Patellofemoral * Proximal tibiofibular

Question 35

What type of knee pain often occurs in patients under 45 years of age?

Answer 35

Patellofemoral pain ## Footnote This pain is more prevalent in women and often doesn't require surgical referral.

Question 36

List two common conditions associated with knee pain in older adults.

Answer 36

* Osteoarthritis * Meniscal tear ## Footnote Osteoarthritis presents with morning stiffness and crepitus.

Question 37

What is the purpose of the Ottawa Rules in knee injury assessment?

Answer 37

To determine the need for imaging ## Footnote These rules help identify patients who should receive radiographic evaluation.

Question 38

True or False: High-dose opioids are indicated for treating shoulder pain.

Answer 38

False ## Footnote High-dose opioids are not recommended for shoulder pain management.

Question 39

What is the role of imaging in diagnosing shoulder pain?

Answer 39

Limited utility unless rehabilitation fails ## Footnote MRI may reveal structural issues that are not the source of pain.

Question 40

What is a common treatment method for knee pain associated with bursitis?

Answer 40

Image guided intra-articular steroid injection ## Footnote This can provide temporary relief.

Question 41

Fill in the blank: Avascular Necrosis of the hip is frequently associated with _______.

Answer 41

corticosteroids

Question 42

What condition may cause knee locking during movement?

Answer 42

Meniscal tear ## Footnote This injury is commonly associated with twisting motions.

Question 43

What are the potential causes of referred hip pain?

Answer 43

* Low back * Thigh * Buttocks * Groin

Question 44

What is the recommended management for shoulder pain in the elderly?

Answer 44

Discuss surgery or palliation if functionality is limited ## Footnote Rehabilitation may be less effective in older patients.