pathophysiology of pain

Question 1

pain receptors

Answer 1

nociceptors

Question 2

types of primary afferent fibres

Answer 2

a delta fibres - myelinated , for fast sharp pain
c fibres - unmyelinated , chronic pain

Question 3

what does primary hyperalgesia describe

Answer 3

increased responsiveness to heat add mechanical stimulus at the site of injury

Question 4

visceral pain ?

Answer 4

pain originating from the internal organs

Question 5

what type of stimuli are associated with visceral pain

Answer 5

distention and ischemia

Question 6

what is chronic pain ?

Answer 6

pain without apparent biological value that persists beyond tissue healing ( >3 months )

Question 7

what is the suggested theory behind the development of chronic pain ?

Answer 7

wind up phenomenon, repetitive stimulation off c fibres ( central sensitization)

Question 8

what is secondary hyperalgesia ?

Answer 8

hypersensitivity to pain in an area that is distant to the primary site of injury

Question 9

what receptors play a role in the maintenance of chronic pain ?

Answer 9

NMDA receptors

Question 10

what are the classifications of chronic pain ?

Answer 10

1- inflammatory pain - tissue is damaged by trauma or infection
2- neuropathic pain - pathology of the nervous
3- dysfunctional pain - poorly localised pain not caused by inflammation or nerve damage

Question 11

what are examples of neuropathic pain

Answer 11

phantom limb
carpal tunnel
peripheral neeuropathy
central neeuropathy

Question 12

examples of dysfunctional pain

Answer 12

fibromyalgia
irritable bowl syndrome

Question 13

7 types of neuropathic pain

Answer 13

lumbar radicular pain
trigeminal neuralgia
post herpetic pain
complex regional pain syndrome
phantom limb
diabetic neuropathy
central pain syndrome

Question 14

what is the CP of neuropathic pain

Answer 14

may be described as tingling, burning ,stabbing or numb sensation
associated with spontaneous pain without any stimulus
may be associated with allodynia or hyperalgesia

Question 15

what is allodynia

Answer 15

the feeling of pain from a non painful stimulus

Question 16

what is the cause of complex regional pain syndrome

Answer 16

usually triggeredd by an injury

Question 17

what are thee different types off complex regional pain syndrome ?

Answer 17

CRPS I
CRPS II

Question 18

old names for CRPS ?

Answer 18

type 1 - reflex sympathetic dystrophy
type 2 - causalgia

Question 19

what is the difference between CRPS type 1 and 2 ?

Answer 19

type 1 - occurs after a minor fracture or injury to a limb without direct nerve injury
type 2 - after injury to a major peripheral nerve

Question 20

what are the presenting symptoms of complex regional pain syndrome ?

Answer 20

continuing pain
allodynia
hyperalgesia
autonomic changes - hyperhydrosis or changes iin temperature
trophic skin changes
motor abnormalities
neglect like syndrome
+ sympathetically maintained pain

Question 21

presentation of trigeminal neuralgia

Answer 21

neuropathic pain affecting the the eye, lips nose scalp or forehead
shooting sharp pain “electric shock like pain”
pain provoked by innoxious stimuli

Question 22

what disease is commonly associated with trigeminal neuralgia ?

Answer 22

multiple sclerosis

Question 23

what is thee cause off trigeminal neuralgia ?

Answer 23

due to microvascular loop compressing on the nerve

Question 24

what tumor is commonly associated with trigeminal neuralgia ?

Answer 24

tumor arachnoid cysts in the
cerebellar cerebellopontine angle

Question 25

when is post herpetic neuralgia diagnosed ?

Answer 25

if the pain persists or arises at least three months after the skin lesions has healed

Question 26

what is the commonest area associated with post herpetic neuralgia ?

Answer 26

thoracic dermatomes and the ophthalmic division of trigeminal nerve exhibiting allodynia and hyperalgesia

Question 27

types of neoplastic plexopathy ?

Answer 27

cervical plexopathy
brachial plexopathy
lumbosacral pleexopathy

Question 28

what is the pain syndrome associated with multiple myeloma

Answer 28

myeloma bone disease

Question 29

which type of breast cancer is associated with the highest level of circulating TGF-B1 levels

Answer 29

HER-2 type

Question 30

example of multidimensional pain scale ?

Answer 30

short form mcgill pain questionnaire