Deck 8: Neuropathic Pain, pain Matrix Dysfunction, and Pain Syndromes

Question 1

What type of sensation can be described as excessive sensitivity to stimuli that is normally mildly painful in uninjured tissue?

A)Dysesthesia
B)Allodynia
C)Paresthesia
D)Secondary hyperalgesia

Answer 1

D
Explanation: Secondary hyperalgesia is excessive sensitivity to stimuli that is normally mildly painful in uninjured tissue.

Question 2

What type of sensation can be described as pain evoked by a stimulus that would not normally cause pain?

A)Dysesthesia
B)Allodynia
C)Paresthesia
D)Secondary hyperalgesia

Answer 2

B
Explanation: Allodynia is pain evoked by a stimulus that would not normally cause pain.For example,the normally nonpainful stimulus of touch produces pain if skin is sunburned.

Question 3

Which of the following may cause residual limb pain?

A)Neuropathy
B)Poorly fitting prosthesis
C)Nerve compression
D)All of the above

Answer 3

D
Explanation: Phantom pain must be differentiated from residual limb pain (i.e.,pain in the part of the limb that still exists)because some causes of residual limb pain can be successfully treated.Residual limb pain is caused peripherally by neuropathy,neuroma (i.e.,a tumor of nerve tissue),a poorly fitting prosthesis,or nerve compression.

Question 4

What syndrome is characterized by severe,spontaneous pain out of proportion to the original injury?

A)Phantom pain
B)CRPS
C)Secondary hyperalgesia
D)All of the above

Question 5

What type of headache is characterized by pain after head injury and abrupt onset?

A)Headache caused by excessive pressure
B)Headache caused by hemorrhage
C)Headache caused by serious intracranial disease
D)ETTH

Question 6

What type of headache is characterized by pain triggered by coughing,sneezing,or straining;vomiting;and worsening when lying down?

A)Headache caused by excessive pressure
B)Headache caused by hemorrhage
C)Headache caused by serious intracranial disease
D)ETTH

Question 7

What type of headache is characterized by progressive worsening over days or weeks,neck stiffness and vomiting,and rash and fever?

A)Headache caused by excessive pressure
B)Headache caused by hemorrhage
C)Headache caused by serious intracranial disease
D)ETTH

Question 8

Migraine symptoms are thought to be related to amplification of nociceptive signals in which pathway?

A)Cranial nerve (CN)VII relay to spinal nucleus of thalamus
B)Spinothalamic pathway
C)Trigeminothalamocortical pathway
D)Fasciculus cuneatus relay to medial lemniscus
E)None of the above

Question 9

Which of the following contribute to chronic low back pain syndrome?

A)Muscle guarding
B)Abnormal movement
C)Disuse syndrome
D)A and B
E)A,B,and C

Question 10

Which of the following are characteristic of CRPS?

A)Effects on the somatosensory,autonomic,and motor systems
B)Muscle guarding,disuse,and abnormal movements
C)None of the above
D)A and B

Question 11

Which mechanisms produce neuropathic pain?

A)Ectopic foci and central sensitization
B)Ephaptic transmission and structural reorganization
C)Ectopic foci and ephaptic transmission
D)All of the above

Question 12

Tinel's sign is associated with which of the following?

A)Avulsion of dorsal roots as a result of trauma
B)Maladaptive structural reorganization with phantom pain
C)Neuropathic syndrome associated with fibromyalgia
D)Ectopic foci associated with peripheral neuropathy
E)All of the above

Question 13

What type of headache is characterized by unilateral location,pulsating quality,severity that interferes with daily activities,and aggravation by routine physical activity?

A)Headache caused by excessive pressure
B)Headache caused by hemorrhage
C)Migraine headache
D)ETTH

Question 14

What causes the pain in post-herpetic neuralgia,diabetic neuropathy,and Guillain-Barré syndrome?

A)Psychological abnormalities
B)Ectopic foci
C)Central nervous system response to small fiber deafferentation
D)Pain matrix dysfunction
E)Reduced activity in pain inhibition areas of the cerebral cortex

Question 15

What type of sensation can be described as a painless abnormal sensation in the absence of nociceptor stimulation?

A)Dysesthesia
B)Allodynia
C)Paresthesia
D)Secondary hyperalgesia

Question 16

What type of sensation can be described as an unpleasant abnormal sensation,whether evoked or spontaneous?

A)Dysesthesia
B)Allodynia
C)Paresthesia
D)Secondary hyperalgesia

Question 17

Neuropathic pain can arise from abnormal neural activity in which of the following?

A)Central nervous system
B)Dorsal horn
C)Peripheral nervous system
D)All of the above
E)None of the above

Question 18

What type of headache is characterized by mild-to-moderate pain,is usually bilateral,and lasts 30 minutes to 7 days but is not aggravated by physical activity and is not associated with nausea or vomiting?

A)Headache caused by excessive pressure
B)Headache caused by hemorrhage
C)Migraine headache
D)Episodic tension-type headache (ETTH)

Question 19

Which of the following characterize the late stage of complex regional pain syndrome?

A)Trauma
B)Red skin,excessive sweating,edema,skin atrophy
C)Lack of any sympathetic activity
D)Muscle atrophy,osteoporosis,arthritic changes
E)Excessive acetylcholine release by postganglionic neurons