Pain Management

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. In 1664, he described what to this day is still called a “pain pathway”:

a) Da Vinci
b) Descartes
c) Hippocrates
d) Pasteur
e) Semmelweis

2. This type of pain can be made much worse by environmental and psychological factors:

a) chronic pain
b) acute pain

3. Arachnoiditis can be caused by:

a) pressure and tension
b) medication and surgery
c) narrowing of the canal surrounding the spinal cord
d) infection or trauma

4. Migraines occur more commonly in _______ and cluster headaches occur more commonly in _______.

a) smokers, alcoholics
b) women, men
c) men, adolescents
d) elderly, females

5. This type of pain occurs after an outbreak of shingles:

a) acute neuropathy
b) central pain syndrome
c) postherpetic neuralgia
d) reflex sympathetic dystrophy

6. The common cause of sciatica is:

a) exertion and strain
b) a herniated disc
c) nerve damage and entrapment
d) obesity and poor posture

7. When blood supply to organs, tissue, or limbs is cut off, it is called:

a) central pain
b) stenosis
c) ischemia
d) thalamic pain

8. Magnetic resonance imaging requires the use of:
  1. needles
  2. radio waves
  3. electrodes
  4. an x-ray machine
  5. magnetic fields

a) 1 and 2
b) 2 and 3
c) 3 and 5
d) 4 only
e) 2 and 5

9. Analgesic is derived from the ancient ________ and means to reduce or stop pain.

a) Greeks
b) Chinese
c) Romans
d) Egyptians

10. These anti-anxiety drugs also act as muscle relaxants:

a) alpha-adrenergic blockers
b) barbiturates
c) narcotics
d) benzodiazepines

11. Biofeedback is used to treat most notably:

a) osteoarthritis
b) cancer pain
c) headache and back pain
d) shingles and herpes simplex
e) sprains and strains

12. Capsaicin is the primary ingredient in pain-relieving creams and is found in:

a) poppy seeds
b) camphor oils
c) lizard saliva
d) chili peppers

13. COX-2 inhibitors may be effective for individuals with:

a) arthritis
b) sciatica
c) burn pain
d) tension headaches

14. Hypnosis has not been approved by the American Medical Association.

a) true
b) false

15. Magnets, worn as a wristwatch or collar, have become increasingly popular:

a) among the elderly
b) but may cause skin irritation
c) with athletes
d) for those with arthritis

16. Ibuprophen should be taken:

a) on an empty stomach
b) with food

17. R.I.C.E. is often prescribed for:

a) erythema and burns
b) fractures
c) acute pain
d) sprains and strains

18. This type of surgery is used for the pain of terminal cancer, which does not respond to other therapies.

a) cordotomy
b) discectomy
c) laminectomy
d) spinal fusion
e) DREZ

19. The most common destination in the brain for pain signals is the:

a) cerebrum
b) thalamus
c) cerebellum
d) brainstem
e) medulla oblongata

20. These are the nerve fibers in the skin, muscle, and other body tissues that carry pain signals to the brain and spinal cord:

a) endorphins
b) peptides
c) nociceptors
d) acetylcholine

21. NSAIDs act against hormones, such as prostaglandins by blocking the enzyme that is required for their synthesis.

a) true
b) false

22. In this type of pain research, the nervous system undergoes tremendous reorganization after injury and “sprouting” occurs:

a) channels
b) tropic factors
c) molecular genetics
d) plasticity
e) neurotransmitters

23. Treatment for phantom pain may include the use of:

a) benzodiazepines
b) anticonvulsants
c) muscle relaxants
d) NSAIDs

24. In this type of nerve block, alcohol, phenol, or glycerol are given intravenously to block pain messages, and are often used to treat cancer pain:

a) local nerve block
b) regional block
c) neurolytic block
d) surgical block

25. The severity of pain increases the risk for suicidal thinking.

a) true
b) false

26. In 2006, the International Headache Society defined chronic migraine headaches as:

a) a pattern of headaches experienced by the patient
b) occurring 15 or more days per month for at least three months

27. Damage to or dysfunction of the central nervous system which includes the brain, brainstem and spinal cord is the definition of:

a) compartment syndrome
b) phantom pain
c) neurogenic pain
d) central pain syndrome

28. You cannot develop shingles unless you have had an earlier exposure to chickenpox.

a) true
b) false

29. The first sign of shingles is often a burning or tingling pain or itch, most commonly located:

a) on one side of the face
b) at the base of the spine
c) on one side of the trunk around the waistline
d) the anterior area of the trunk

30. Shingles is most often treated with:

a) antibiotics
b) antiviral drugs
c) analgesics
d) steroids

31. The Food and Drug Administration approved Zostavax for those ____ _______ and older to prevent _______.

a) 18 months, chickenpox
b) 60 years, shingles
c) 20 years, chickenpox
d) 60 years, neuralgia

32. The Ramsey-Hunt syndrome is an infection from shingles near the:

a) eye
b) ear
c) brain
d) spinal cord

33. If a pregnant woman gets chickenpox between 21 to 5 days before giving birth, her new born can:

a) develop shingles within a few days after birth
b) have a lowered immune system
c) develop more antibodies the first few days of life
d) have chickenpox at birth or develop it within a few days

34. The two types of white blood cells that appear to combat shingles are:

a) T lymphocytes and macrophages
b) basophils and neutrophils
c) eosinophils and killer cells
d) plasma cells and macrophages

35. There are _____ lumbar vertebrae.

a) seven
b) 12
c) five
d) four

36. Men and women are equally affected by low back pain.

a) true
b) false

37. Caucasian women of northern European heritage are at the highest risk of developing this condition:

a) sciatica
b) osteoporosis
c) kyphosis and lordosis
d) fibromylgia

38. This diagnostic technique is used to diagnose and monitor infection, fractures, or disorders in the bone:

a) computerized tomography
b) magnetic resonance imaging
c) evoked potential studies
d) bone scans
e) ultrasound imaging

39. In this type of alternative treatment, the body’s internal tissues are warmed, causing the muscles to relax:

a) ultrasound
b) interventional therapy
c) traction
d) biofeedback
e) transcutaneous electrical nerve stimulation

40. In the 2-year study by NIOSH regarding wearing lumbar supports, it found:

a) wearing lumbar supports while lifting reduced back strain
b) most lumbar supports did not fit properly
c) no evidence that the belts reduced back injury of pain
d) other factors such as ergonomics affected the outcome

41. Myofascial pain is best defined as:
  1. acute
  2. chronic
  3. involving a single muscle or muscle group
  4. post-operative pain that requires opiates

a) 1 and 4
b) 4 only
c) 2 only
d) 2 and 3

42. In the study by Dr. Rowbotham, he found when treating patients with levophanol, a morphine-like opiate for chronic neuropathic pain, the patients developed tolerance and addiction during the course of the drug.

a) true
b) false

43. An acupuncturist places needles in points on the body that lie along pathways known as:

a) meridians
b) dermatones
c) nerve endings
d) pressure points

44. One of the most widely used complimentary medicine practices in the United States is:

a) biofeedback
b) guided imagery
c) chiropractic
d) hypnosis

45. Guided imagery is also called visualization.

a) true
b) false

46. When choosing remedies, look for the National Formulary seal which indicates the herbs were prepared according to standards set by the:

a) Food and Drug Administration
b) United States Pharmacopoeia
c) World Health Organization
d) American Medical Association

47. Magnets for pain usually claim strengths of _______ to ______ gauss.

a) 0.5, 500
b) 100, 10,000
c) 300, 5,000
d) 500, 20,000

48. Magnets may work by ______ the temperature of the area of the body to be treated.

a) increasing
b) decreasing

49. Integrative pain therapy involves healing the whole person and is a comprehensive system of medicine.

a) true
b) false

50. The work of Dean Ornish demonstrated that interventions targeted to stress management, proper diet and nutrition, regular exercise and psychosocial support can not only halt but reverse:

a) hypertension
b) diabetes
c) coronary artery disease
d) cancer pain