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Emergency Medicine > Pain Management > Flashcards

Pain Management Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

What is allodynia

A

Pain experienced in response to a stimulus not normally painful

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2
Q

What is hyperalgesia

A

Heightened pain response from something that is painful

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3
Q

What is hyperpathia

A

Sensation of painful numbness

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4
Q

What is neuropathic pain

A

Pain arising as a direct consequence of a lesion or somatosensory system

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5
Q

Symptoms of neuropathic pain

A

Spontaneous, paroxysmal, burning, shooting, sharp, numb, allodynia, hyperalgesia, hyperpathia

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6
Q

Pain tool used to assess chronic pain

A

McGill pain questionnaire

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7
Q

Pain tool used to assess pain in delirium, cognitive impairment or dementia

A

Bolton pain assessment tool

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8
Q

What is at the bottom of the analgesic pyramid

A

Simple analgesics such as NSAIDs and paracetemol

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9
Q

What is in the middle of the analgesic pyramid

A

Weak opioids such as codeine, tramadol

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10
Q

What is at the top of the analgesic pyramid

A

Strong opioids such as morphine

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11
Q

What does paracetemol do

A

Analgesic and antipyretic, unknown mechanism of action

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12
Q

Dose of paracetemol given to adults

A

1g / 6 hours - but if <50kg then max 60mg/kg/day

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13
Q

Contraindications of paracetemol

A

Allergy, hepatic failure

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14
Q

Dose of paracetemol given to children

A

20mg/kg loading dose
10-15mg/kg up to max 90mg/kg/day

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15
Q

Examples of NSAIDs

A

Ibuprofen, diclofenac, naproxen - COX-2s

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16
Q

What do NSAIDs do

A

Anti-inflammatory, antipyretic and analgesic

17
Q

Side effects of NSAIDs

A

Platelet dysfunction, mucosal damage, renal impairment and bronchospasm

18
Q

Contraindications of NSAIDs

A

Allergy, asthma, GI upset, coagulopathy, renal impairment, CVS disease

19
Q

Examples of weak opioids

A

Codeine, dihydrocodeine, tramadol

20
Q

Examples of strong opioids

A

Morphine, oxycodone, fentanyl

21
Q

Side effects of opioids

A

Nausea, vomiting, bradycardia, pruritis, constipation, sedation, hallucinations, respiratory distress, tolerance, dependence, addiction

22
Q

Which opioid is fentanyl especially good for

A

Renal impairment

23
Q

What does tramadol do to epileptic patients

A

Lowers the seizure threshold

24
Q

Which weak opioid is used first line and why

A

Dihydrocodeine as codeine can be metabolised differently in a small group of patients

25
Q

Risk factors for chronic pain

A

females, age >45, socio-economic status, lifestyle risk factors, employment, psychological distress, history of trauma or chronic pain, family history

26
Q

Non spinal causes of back pain

A

Aortic aneurysm, renal causes, pancreatisis, psoas abscess

27
Q

Spinal causes of back pain

A

Slipped intervertebral disc, fracture, osteoarthritis, infection, malignancy, cauda equina

Emergency Medicine (17 decks)

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