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Chronic Pain 2010

Chronic Pain 2010. Chronic pain: (A) Has a predictable end (B) Is independent of the original cause of pain (C) Is curable with opioids (D) Rarely becomes a biopsychosocial problem. Answer. (B) Is independent of the original cause of pain.

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Chronic Pain 2010

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  1. Chronic Pain 2010

  2. Chronic pain:(A) Has a predictable end(B) Is independent of the original cause of pain(C) Is curable with opioids(D) Rarely becomes a biopsychosocial problem

  3. Answer • (B) Is independent of the original cause of pain

  4. Which of the following neurotransmitters is associated with the mediation of acute, normal, or adaptive pain?(A) Glutamate (B) Substance P (C) Cholecystokinin(D) Brain-derived neurotrophic factor

  5. Answer • (A) Glutamate

  6. Which of the following physiologic pain types would best be treated with anti-inflammatory agents?(A) Neuropathic (B) Nociceptive (C) Muscular (D) Chronic

  7. Answer • (B) Nociceptive

  8. Lumping • (A) Engaging in high-risk treatments with • noncompliant patients • (B) Feeling obligated to control patient’s pain • (C) Treating acute pain same as chronic pain • (D) Believing chronic pain can be eliminated completely

  9. Answer • (C) Treating acute pain same as chronic pain

  10. Servitude • (A) Engaging in high-risk treatments with • noncompliant patients • (B) Feeling obligated to control patient’s pain • (C) Treating acute pain same as chronic pain • (D) Believing chronic pain can be eliminated completely

  11. Answer • (B) Feeling obligated to control patient’s pain

  12. Perfectionism • (A) Engaging in high-risk treatments with • noncompliant patients • (B) Feeling obligated to control patient’s pain • (C) Treating acute pain same as chronic pain • (D) Believing chronic pain can be eliminated completely

  13. Answer • (D) Believing chronic pain can be eliminated completely

  14. Opioids are the gold standard for treatment of chronic pain.(A) True (B) False

  15. Answer • (B) False

  16. Choose the correct statement about flares of chronic pain.(A) Pain intensity returns to baseline(B) Medication doses should be increased with every episode(C) Flares are a sign of worsening disease(D) Changes in pain quality and physical findings are common with flares

  17. Answer • (A) Pain intensity returns to baseline

  18. Which of the following is a form of noncompliance?(A) Increasing medication doses without authorization(B) Nonparticipation in recommended therapies(C) Illegal drug use(D) All the above

  19. Answer • (D) All the above

  20. The Diagnosis, Intractability, Risk, and Efficacy (DIRE) score assesses which of the following whenconsidering patients for opioid use?(A) Psychologic health(B) Social support(C) Level of motivation to participate in an array of treatments(D) All the above

  21. Answer • (D) All the above

  22. All the following are features of fibromyalgia, except:(A) Unilateral musculoskeletal pain (B) Musculoskeletal pain lasting ≥3 mo (C) Fatigue (D) Mood disturbances

  23. Answer • (A) Unilateral musculoskeletal pain

  24. Pain at which of the following sites is included in the criteria for fibromyalgia by The American College ofRheumatology?(A) Knee (B) Scalp (C) Back of forearm (D) Thumb

  25. Answer • (A) Knee

  26. In patients with fibromyalgia, decreased secretion of _______ can lead to sleep disturbances.(A) Substance P (B) Cortisol (C) Growth hormone (D) Dopamine

  27. Answer • (B) Cortisol

  28. Which of the following nonpharmacologic therapies appears to have greatest efficacy in patients with fibromyalgia?(A) Strength training (B) Low-impact cardiovascular exercise (C) Chiropractic therapyD) Acupuncture

  29. Answer • (B) Low-impact cardiovascular exercise

  30. Which of the following are approved by the Food and Drug Administration (FDA) for the treatment of fibromyalgia?(A) Amitriptyline and duloxetinev (B) Duloxetine and pregabalin (C) Pregabalin and fluoxetine (D) Fluoxetine and citalopram

  31. Answer • Duloxetine and pregabalin

  32. Choose the correct statement about tramadol.(A) 200 times more potent than morphine(B) Side effects include increased risk for seizures(C) Onset of action slow(D) Duration of action long

  33. Which of the following are indicative of a back disorder with nerve root involvement?1. Leg pain that is worse than back pain2.Weakness of ankle and great toe dorsiflexion3. No relief with bed rest4. Unilateral neurologic symptoms in foot A) 1,3 B) 1,2,3 C) 1,2,4 D) 1,2,3,4

  34. Answer • Leg pain that is worse than back pain • Weakness of ankle and great toe dorsiflexion • Unilateral neurologic symptoms in foot • C. 1,2,4

  35.  Patients with spinal stenosis frequently find relief upon sitting or bending forward. A) True B) False

  36. Answer •  A) True

  37. Which of the following is not a justification for ordering radiographic testing? A) Nonspecific low back pain B) Progressive neurologic deficits C) Signs of radiculopathy D) Suspected spinal stenosis

  38. Answer • A) Nonspecific low back pain

  39. All the following medications were shown to be superior to placebo for pain relief in acute low back pain, except: A) Acetaminophen B) Nonsteroidal anti-inflammatory drugs (NSAIDs) C) Skeletal muscle relaxants D) All the above

  40. Answer •  A) Acetaminophen

  41. Which of the following nonpharmacologic therapies was shown to be effective in the treatment of acute low back pain? A) Bed rest B) Superficial heat C) "Back school" program D) None of the above

  42. Answer •  B) Superficial heat

  43. Which of the following symptoms is(are) characteristic of migraine?1. Nausea2. Disability3. Light sensitivity4. Dry mouth A) 1 B) 1,2 C) 1,2,3 D) 1,2,3,4

  44. Answer • Nausea • Disability • Light sensitivity •  C) 1,2,3

  45. Common triggers of migraine include which of the following? A) Environmental allergens B) Excess sleep C) Hormones D) All the above

  46. Answer •  D) All the above

  47. Signs and symptoms of underlying organic disease in the patient with headache include which of the following?1. Systemic symptoms2. Neurologic symptoms3. Sudden onset4. Onset in patient >50 yr of age5. Deviation from previous headache history A) 1,3,5 B) 2,3,4 C) 1,2,4 D) 1,2,3,4,5

  48. Answer • Systemic symptoms • Neurologic symptoms • Sudden onset • Onset in patient >50 yr of age • Deviation from previous headache history • D) 1,2,3,4,5

  49. Chronic tension-type headache is associated with nausea and vomiting. A) True B) False

  50. Answer • B) False

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