placement 1 Pain Clinic

Question 1

CRPS

Answer 1

Complex regional pain syndrome

Question 2

Test to aid in CRPS diagnosis

Answer 2

Budapest criteria
o Signs (OBJ) vs symptoms (SUB)
o Continuing pain, disproportionate to any inciting event
o At least 1 symptoms in ¾ of the categories
o At least 1 signs in 2 or more of the categories
o No other condition better explain the PC

Question 3

UMN vs LMN lesion

Answer 3

Upper: brain and spinal cord
o Babinski, hoffmans
o Increased tone, reflexes, weakness
o Stroke, MS,

Lower: spinal cord -> muscles
o Decreased/normal tone, atrophy, reduced reflexes, weakness
o Peripheral nerve; could be due to central compression

Question 4

What is Spondylosis

Answer 4

Arthritis of the spine

Question 5

Myelopathy

Answer 5

o Compression of the spinal cord
o Likely disc changes, or central spinal stenosis
o Loss of balance and co-ordination, numbness, tingling, weakness, pain, loss of bowel or bladder function, difficulty walking, pain in low back, neck, arm/leg, clumsy gait,
o Symptomatic in a non-specific/non-dermatomal pattern -> mis-diagnose as Fibromyalgia

Question 6

Stenosis

Answer 6

Narrowing of the space containing the spinal cord or where the nerve root exists the cord

/bony changes lead to nerve compression

Due to degen changes

Question 7

AVN

Answer 7

Avascular necrosis
Disruption of blood flow to the head of femur
Femoral head pathology

Question 8

Osteotomy

Answer 8

Bone cutting and reshaping surgery to restore function

Question 9

Arthroplasty

Answer 9

Joint replacement surgery/impant

Question 10

neuropathic meds (8)

Answer 10

Amitriptyline – headache, depression

Pregabalin & gabapentin – epilepsy, headache, anxiety

Morphine – opioid; not as effective when use alone, need combine

Oxycodone - opioid

Codeine – opioid; Often combined with acetaminophen, ibuprofen

Duloxetine – opioid, Depression, bladder problem

Tramadol – opioid; POWERFUL, only for ST

Capsaicin – intense burning sensation initial use

Question 11

arthrodesis

Answer 11

joint fusing surgery

Question 12

Vertigo

Answer 12

A Sx, rather than condition

Question 13

RA - SCREEND’ EM (10)

Answer 13

o Skin changes – psoriasis
o IBS – inflammatory bowel disease
o Family Hx
o Painful red eye
o Early morning stiffness >30 mins
o Nails – pitting, thickening, painless detachment
o Swilling of the fingers
o Inflamed Achilles tendon, plantar fascia, patellar tendon
o Worse w REST, better with mvmt
o Response well to NSAIDs

Question 14

Ways to desensitize the nervous system
(Name a few)

Answer 14

Meditation and mindfulness
Relaxation
Sleep
Diaphragmatic breathing
Exercises
Positive thoughts
Cold plunges
Weighted blankets

= Reduce stress

Question 15

Ways to desensitize the nervous system
(Name a few)

Answer 15

Meditation and mindfulness
Relaxation
Sleep
Diaphragmatic breathing
Exercises
Positive thoughts
Cold plunges
Weighted blankets

= Reduce stress