Pain Mgt/Analgesia Flashcards
How does visceral pain occur?
Visceral pain occurs due to damage to, or distention or inflammation of, an abdominal, pelvic, or thoracic organ.
Which of the following statements regarding visceral pain is correct?
A. Acute pain is visceral, chronic pain is somatic
B. A femoral fracture causes visceral pain
C. Visceral pain is easier to identify than somatic pain
D. Gastric dilation/volvulus causes visceral pain
E. Visceral and somatic pain are transmitted by the same pathways
D. Gastric dilation/volvulus causes visceral pain
Where along the pain pathway do N-methyl-D-aspartate (NDMA) antagonists exert thier effects?
Spinal Cord
How long do analgesic effects of butorphanol typically last?
45 minutes
What drug reverses the effects of dexmedetomidine?
Atipamezole
What species is most prone to hyperthermia after administration of hydromorphone?
Cats
How do opioids elicit hyperthermia?
By altering the thermoregulatory set point in the hypothalamus, which responds to the environment to control the body temperature.
When is preemptive Analgesia administered?
Before tissue damage or surgical insult.
Which of the following patients would benefit most from the use of preemptive Analgesia?
A. Germain shepherd with osteosarcoma of the humerus
B. Dog presented for ovariohysterectomy
C. Cat for an amputation following hit by car
D. Beagle with a fractured dew claw
E. Horse with chronic laminitis
B. Dog presented for ovariohysterectomy
Which of the following patients is most likely to develop central sensitization of the pain response (wind-up)?
A. Dew claw removal in a puppy
B. Feline castration
C. Dog with fractures following hit by car
D. Flank laceration in a horse
E. Tear duct flushing in a brachycephalic dog
C. Dog with fractures following hit by car
What narcotic drug can be absorbed transmucosally in cats?
Buprenorphine
Which of the following parameters may be used to distinguish pain from dysphoria in a postoperative patient?
A. Raised 3rd eyelids
B. Decreased spO2
C. Elevated heart rate
D. Inconsolable vocalization
E. Increased body temperature
C. Elevated heart rate
What is dysphoria?
A state of profound unease or dissatisfaction accompanied by anxiety or agitation.
Dexmedetomidine belongs to which class of analgesics?
Alpha-2 agonist
Which veterinary species is particularly sensitive to possible overdosing with lidocaine when performing local anesthesia?
Goats, sheep and cats
What are the signs of toxicity from sodium-channel blockers?
Muscle fasciculations/nystagmus, seizures/conclusion, hypotension, cardiac and respiratory collapse, and death.
Which of the following most correctly describes physiologic pain?
A. Occurs when homeostasis is disturbed, as when disease is present
B. Originates from damage to peripheral nerves or the central nervous system
C. Results from a long-lasting trauma and tissue damage
D. A protective response to an actual or potentially damaging insult
E. Developing from the spinal roots
D. A protective response to an actual of potentially damaging insult
Which opioid can be associated with hyperthermia in cats when used for pain management?
Hydromorphone
Which opioid choice provides a good long-duration Analgesia for mild to moderate pain in cats and can be given IM, SQ, and transmucosally?
Buprenorphine
Which analgesic can be used either for a local nerve block or as a constant rate infusion (CRI)?
A. Carprofen
B. Bupivacain
C. Lidocaine
D. Ketamine
E. Buprenorphine
C. Lidocaine
How long can local anesthesia with bupivacaine last?
6-8 hours
Which of the following is the most commonly used nonsteroidal anti-inflammatory (NSAID) for musculoskeletal pain in horses?
A. Meloxicam
B. Butorphanol
C. Phenlybutazone
D. Firocoxib
E. Fetanyl
C. Phenylbutazone
Which simultaneous analgesic drug combination should be avoided in dogs and cats?
Meloxicam and dexamethasone
NSAID’s and Corticosteroids should never be used concurrently in dogs and cats, who are at a higher risk of GI ulceration.
Which of the following correctly describes the phenomenon of hyperalgesia?
A. Protective response to an actual or potentially damaging insult.
B.Exaggerated reaction to a normally painful stimulus
C. Increased analgesic effects seen when treating a patient in pain
D. Stimuli that are not normally painful produce a pain response
E. Absence of response to a typically painful stimuli
B.Exaggerated reaction to a normally painful stimulus
Which of the following patients is most likely to develop central sensitization of the pain response?
A. Feline castration with intratesticular lidocaine anesthesia
B. Acute superficial corneal ulceration in a horse
C. Dew claw removal in a puppy receiving a local anesthetic block
D. Flank laceration in a horse
E. Dog hit by car with fractures and no analgesia for 1 week.
E. Dog hit by car with fractures and no analgesia for 1 week.
Which stress hormone, released when an animal is in pain, may result in reduced wound healing?
Cortisol
What is the anticipated duration of analgesia in cats when using Methadone?
2-8 hours depending on the method of administration
What is the best approach to manage pain for a cat who will undergo ovariohysterectomy?
Utilize a preemptive, multimodal, and follow-up analgesia plan
How long is an average, healthy dog or cat expected to require analgesia after a simple, elective soft tissue procedure, such as an ovariohysterectomy?
Three to four days
Which term correctly identifies pain that exists in the absence of disease?
Maladaptive
Maladaptive pain is a response that is heightened beyond that needed to protect the patient from injury
Which of the following patients is most likely to be suffering from neuropathic pain?
A. Cat with abcess
B. Daschund with intervertebral disc disease
C. Canine or equine castration
D. Ovariohysterectomy in a cat
E. Neonate dew claw removal
B. Daschund with intervertebral disc disease
What correctly describes multimodal analgesia?
Using two or more classes of drugs to address pain perception
What is Noctica?
A sterile suspension of liposomes containing Bupivacaine.
What describes nociceptors?
Specialized receptors for painful and noxious stimuli.
They transduce painful stimuli into electrical signals for transmission to the spinal cord and brain.
The vet says she wants to do an abaxial sesamoid nerve block on a horse’s forelimb. Where might you expect her to inject lidocaine?
Medial and lateral aspects of limb at the palmar fetlock.
Noiceception is correctly defined as?
A physiologic process that results in perception of pain
How much time is needed for topical anesthetics to be effective?
20-30 minutes
What would be used to assess acute pain in a dog after an ovariohysterectomy?
The Glasgow Composite Pain Scale
This is a behavior based composite scale recommended to assess acute pain in cats and dogs.
Which opioid is more potent than morphine, given most often via CRI, or administered via transdermal patch?
Fentanyl
What correctly describes the phenomenon of allodynia?
Stimuli that are not normally painful, produce a pain response.
Wind-up phenomenon refers to what?
Heightened pain response.
How can we mitigate the “sting” associated with injection in awake patients when using local blocking agents (e.g., lidocaine, Bupivacaine)?
Add sodium bicarbonate at 0.1 mL per 10 mL of blocking agent.
Which of the following is a possible sign of pain in dogs?
A. Normal gait in order to hide injury
B. Snoring while sleeping
C. Upright head carriage
D. Curiosity about surroundings
E. Guarding the affected body part
E. Guarding the affected body part
What are signs of local anesthetic toxicity?
Seizures, coma, vomiting, and cardiovascular collapse.
A horse is presented for routine lameness examination. What correctly describes how the vet will determine the grade of lameness (American Association of Equine Practitioners grade 0-5)?
Walk and trot on hard and soft ground, in hand and on lunge
Which class of drugs ends with the suffix ‘-caine’ in the name?
Local anesthetics
What is the most commonly used oral dose of meloxicam for acute or chronic pain in cats?
0.1 mg/kg once
Which is an example of preemptive analgesia?
A. Giving an NSAID to a dog with a severe chronic ear infection
B. Performing a dental nerve block prior to tooth extraction
C. Dosing a sedative after surgery so the patient is less likely to move and evoke pain
D. Administering an epidural to a cat with a fractured femur
E. Giving an opioid to a dog that has been bitten by a venomous snake
B. Performing a dental nerve block prior to tooth extraction
