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Neuro 3 > Pain Clinical Correlates > Flashcards

Pain Clinical Correlates Flashcards

1
Q

Pain

A

Unpleasant sensory and emotional experience associated with actual or potentia l tissue damage

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2
Q

Acute pain

A

Hurt=harm…avoidance decreases damage

Clear path

Fixed end point, immobilization, meds

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3
Q

Chronic pain

A

Hurt does not = harm and fear avoidance cycel

Multifactorial

No end point, immobilization owrse, meds beware

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4
Q

Tx of actue and chronic

A

Acute - aggressive, coping skills secondary, intensive hospital, physio evolving

Chronic - step wise, coping skills important, outpatient only, physio established

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5
Q

Mech/noci pain

A

Sharp, dull, ache

Tissue destruction, inflammationan, somatic pain, visceral pain

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6
Q

Neuropathyuic pain

A

Bruning, stinging, pins and needles

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7
Q

Allodynia, dysethenia, hyperalgesia

A

Non painful sensation now painful
Abnormal sensation
Increases ensitivity to pain

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8
Q

Fibers types

A

Mecahno - Abeta - fast

Pain - adelta-fast
C - slow

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9
Q

Pain pathway

A

Can be excitatory or inhibitory

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10
Q

Anexiety and depression

A

Lateral pathway - helps ID location, type intensity

Medial - helps drive attnetion and salience to the pain

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11
Q

Gate control theroy

A

Can only handle so much stimulus so if you stimulate Abeta fibers, less capacity to send pain

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12
Q

TENS

A

Transcutaneous electricla nerve stimuloation

Based on Gate theory

For Chronic MSK pain normally

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13
Q

Opioid indication

A

Acute, traumatic, post op, cancer, palliative

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14
Q

What should especially not be prescribed with opioids

A

Benzos

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15
Q

Opioid receptors

A

Mu - most analgesia and bad things
Kappa - some analgesia, dysphoric effects

Delta - no analgesia

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16
Q

Fentanyl onset of action

A

2-5 minutes

Better than morphine or hydromorphone

17
Q

Naloxone with SE

A

Shorter half life than opioid

Confusion, dizzy, N/V
Arrythmias
Seizures
Negative pressure pulooanry edema

18
Q

Complex regional pain syndrome

A

Hyperaesthesia or allodynia
Temperatuee or skin color asymmetry
Sweating, swelling or atrophy

19
Q

2 types of CRPS

A

RSD - absence of definable injury…noxoius event iwht sponatneous pain and hyperalgesia

Casalgia - Similar course with burning and allodynia…need specific nerve injury

20
Q

Tx of CRPS

A

All physical therapy related

21
Q

Sympathetic blockade success

A

Horner syndrome
Temp increase
Increased blood flow

22
Q

Trigeminal nerualgia and causes

A

Sudden stabbing pain or more constant buring pain that is severe to soft touch

Myelin destruction (BV or MS)
Compression from tumor or AVM
23
Q

Main drug for TN and stuff about it

A

Carbamazepine (Na channel blocker)

Diagnositc for TN

Also for tonic-clonic seizures and bipolar disorder

Stabilizes inactivsated V gated channel

Side effects of SJS, toxic epidermal necrolysis, bone marrow suppression

24
Q

Diabetic peripheral neuroapthy

A

Diagnose with PE, NOT EMG

25
Q

Pregablin

A

Alpha 2 delta subunit calcium channel blocker

More potent and quikcer onset than gabapentin

For diabetic and fibromyalgia

Dizziness, sleepiness, swelling

26
Q

Gabapentin

A

Less potent and longer titration period than pregablin

27
Q

Fibromyalgia and tx

A

Physical, mental, and social components
More in women
Widespread pain/abnormal pain processing

Duloxetine/milnacripran/pregablin

28
Q

Duloxetine

A

SNRI serotinin-NE reuptake inhibitor
Favors serotnin over NE

Suicidal thoughts a risk when initating tx in adolescents

29
Q

TCAs

A

Inhibit serotinin and NE as well as partial Na channel blockade

30
Q

Acute Mechanical LBP

A

Most gets better
Ice, rest, heat
NSAIDs,
PT

31
Q

Mechanical back pian tx.

A

Duloxetine or injections

32
Q

Thalamic pain syndrome

A

Dejerine-Roussy syndrome

After thalamic stroke

Try everything

33
Q

Intrathecal drugs

A

Morphine and baclofen (for spasticity)

Ziconotide (Ca hcnanel blocker)

Neuro 3 (31 decks)

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