Exam 1 Study Guide

Question 1

What causes peripheral sensitization?

Answer 1

• result of injury
• peripheral nerves (esp nociceptors) can become sensitized
• have a lower threshold for pain

Question 2

With peripheral sensitization, where is the area of sensitization?

Answer 2

Site of initial injury

Question 3

How does central sensitization occur?

Answer 3

• Low threshold mechanoreceptors plastically adapt

- create new neural pathways directly to pain centers of the brain

Question 4

Because of central sensitization, what happens from innocuous stimuli?

Answer 4

• triggers a pain response by the CNS

- otherwise wouldn’t be considered painful to the average person

Question 5

What are the clinical syndromes where central sensitization is a contributor?

Answer 5

• RA
• OA
• TMD
• FM
• HA

Question 6

Central sensitization: RA

Answer 6

Miscellaneous MSK pain

Question 7

Central sensitization: OA

Answer 7

Neuropathic

Question 8

Central sensitization: TMD

Answer 8

CRPS

Question 9

Central sensitization: FM

Answer 9

Post-surgical pain

Question 10

Central sensitization: HA

Answer 10

• visceral pain

- hypersensitivity

Question 11

What results in the best outcomes with chronic pain pts?

Answer 11

• Pt education about the neurophysiology of pain

- Better than anatomical explanation

Question 12

Main types of pain

Answer 12

• nociceptive
• inflammatory
• neuropathic

Question 13

What are the 5 critical factors for quality pain mgmt?

Answer 13

1. Prompt recognition and tx of pain
2. Include pt and caregiver in pain mgmt planning
3. Provide multimodal therapy
4. Frequently adjust tx as needed (reassess!)
5. Monitor outcomes using national performance instruments

Question 14

WHO analgesic ladder for mgmt of chronic pain (steps)

Answer 14

1. Non-opioids for mild pain (NSAID)
2. Weak opioids for mod pain
3. Strong opioids for mod to severe pain

Question 15

Common side effects of opioids

Answer 15

• constipation
• nausea, vomiting
• delirium
• respiratory depression
• sedation
• allergy
• hyperalgesia/allodynia
• myoclonus
• pruritis