Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain

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. Fibromyalgia:
1. Affects females after menopause
2. Is a disorder of the central nervous system that affects muscles
3. Causes tenderness at eleven of the eighteen sites
4. Is a chronic, noninflammatory disorder
5. Is a progressive disorder

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

2. According to the Centers for Disease Control and Prevention, 2 percent of the U.S. population has fibromyalgia and the ratio of women to men is 7:1.

a) True
b) False

3. The patient reports lack of energy and non-restorative sleep. These are examples of ________ findings.

a) Objective
b) Subjective

4. Chronic fatigue immunodysfunction is a debilitating condition that causes prolonged severe fatigue, not relieved by rest. It is associated with _____ or more specific symptoms.

a) 2
b) 3
c) 4

5. Chronic fatigue immunodysfunction is classified as a clinical condition rather than a disease because:

a) A direct cause cannot be identified
b) Symptoms vary between individuals
c) Conclusions are based on a practitioner
d) It is not life-threatening

6. Chronic fatigue immunodysfunction is a stand-alone disorder.

a) True
b) False

7. Chronic fatigue immunodysfunction:
1. Has more severe symptoms at the onset
2. Requires treatment of trigger points
3. Often follows a cyclical course
4. Causes a muscle band to tighten

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

8. Chronic myofascial pain:
1. Is a disease that causes sensitivity to touch and muscle weakness
2. Is an autoimmune disease
3. Is a disease at the neuromuscular junction
4. Is a chronic disorder with myofascial trigger points
5. Causes referred pain

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

9. The _______ trigger point is always tender, causes shortening of the muscle, weakness of the muscle and causes patient complaints of referred pain on direct compression.

a) Active
b) Secondary
c) Satellite
d) Latent

10. Hyperirritable trigger points usually are felt as a taut band, restrict motion and cause pain at the end of:

a) Stretching
b) The day
c) Range of motion
d) Long nerves

11. One result of entrapment is:

a) From poor blood flow
b) Paresthetica
c) Neuralgia
d) Chronic edema

12. The primary symptom of ________ is diffuse pain, and the primary symptom of ________ is fatigue.

a) CFID, FM
b) FM, CFID
c) MPS,RSDS

13. Rating pain on a scale of 1-10 with "1" being the least amount of pain is a rating of ________ pain which is subjective.

a) Chronic
b) Acute
c) Mental
d) Physical
e) Descriptive

14. An example of an aggravating and predisposing factor is a change in the barometric pressure.

a) True
b) False

15. This causes an allergic reaction if it is inhaled, swallowed, or comes in contact with the skin:

a) Histamine
b) Allergen
c) Antigen
d) Immunological response

16. This type of arthritis is also called degenerative joint disease and is distinguished by degeneration of cartilage, loss of bone tissue at the margins and changes in the protective synovial membrane:

a) Arthritis
b) Ankylosing spondylitis
c) Rheumatoid arthritis
d) Osteoarthritis
e) Bursitis

17. The most common causes of this condition is repetitive motion and inflammatory forms of arthritis:

a) Carpal tunnel syndrome
b) Complex regional pain syndrome
c) Costochondritis
d) Degenerative disc disease

18. In men, depression is often experienced as:

a) Energy loss and problems concentrating
b) Weight gain or loss and problems sleeping
c) Anger and irritability
d) Thoughts of death and feeling worthless

19. The _______ migraine does not have an aura but presents as a throbbing pain or constant ache when lying still. An attack can last for several hours to several days.

a) Common
b) Classic
c) Hemiplegic
d) Cluster

20. Autoimmune thyroiditis is also known as:

a) Hypothyroidism
b) Thyroid resistance
c) Hashimoto’s thyroiditis
d) A goiter

21. A functional disorder is defined as:

a) The inability to perform a job
b) No sign of disease
c) Periods of remissions and exacerbations
d) Being idiopathic

22. This type of lupus can be life threatening and has no specific test to detect it:

a) Systemic lupus erythematosus
b) Discoid lupus

23. Pain is the primary or initial complaint of multiple sclerosis.

a) True
b) False

24. The primary symptoms of post –polio syndrome are:

a) Painful joints and muscles
b) Sensitivity to cold and heat
c) Sleep disorders and muscle twitching
d) Fatigue and exhaustion

25. Raynaud’s can cause excruciating pain especially:

a) When exposed to cold
b) During re-warming
c) When there is insufficient blood flow
d) If there is nerve entrapment

26. Sjogren’s syndrome:
1. Has a primary phase which occurs with other diseases
2. Is an autoimmune disorder
3. Has early symptoms of a dry nose and throat
4. Affects everyone differently

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

27. _________ dialogue is subjective communication with or without words and intended to share information.

a) External
b) Internal
c) Effective

28. A healthy support system requires you to:

a) Keep a journal
b) State what you need
c) Share common interests
d) Give as well as receive
e) Set goals

29. When an aggravating factor is not addressed you are at risk for:

a) Acute pain
b) A flare
c) Chronic pain
d) Somatic pain

30. Addictive behavior is not a common finding in chronic pain patients.

a) True
b) False

31. Glucosamine chondroitin has the benefits of:

a) Regulating the body’s blood sugar
b) Improving joint health
c) Boosting the immune system
d) Killing harmful organisms in the digestive tract

32. Acupuncture uses strategically inserted needles to:

a) Unblock healing energy
b) Relax specific muscles
c) Improve breathing
d) Monitor brain wave activity

33. Protein and fat lower the glycemic index. However, high glycemic carbohydrates break down into sugar quickly, causing a surge in insulin and fat production.

a) True
b) False

34. This type of exercise can be low, moderate, or high impact. There is an increase in the heart rate and oxygen demand.

a) Isometric
b) Active
c) Anaerobic
d) Aerobic

35. The goal of bodywork is to:

a) Release endorphins
b) Decrease pain and tension
c) Keep all bodyparts in motion with the least amount of stress
d) Restore the body’s natural alignment
e) Promote blood flow

36. _________ medicine is based on five holistic principles:

a) Ayurvedic
b) Chiropractic
c) Naturopathic
d) Osteopathic

37. This type of therapy should not be used if you have had a stroke, head injury or anything that may increase intracranial pressure:

a) Trigger point therapy
b) Tennis ball therapy
c) The MA roller
d) Trigger point injections
e) Physical therapy

38. This is used in place of conventional medicine:

a) Alternative medicine
b) Complementary medicine

39. Comorbidity includes two "diseases" or a "disease" and a symptom cluster.

a) True
b) False

40. Dysthymic disorder:
1. Is full-blown depression of more than six-months
2. Presents with features of paranoia and catatonia
3. Has a high suicide rate
4. May be a chemical imbalance

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

41. Their focus is exclusively on therapy skills and they are often perceived as healers and helpers:

a) Psychiatrists
b) Psychologists
c) Social workers
d) Licensed Professional Counselors

42. The central question of all the great religious traditions pertains to human suffering, the meaning of life and our relationship to the divine.

a) True
b) False

43. This is physical exercise plus meditation:

a) Guided imagery
b) Christian meditation
c) Body scan
d) Progressive muscle relaxation
e) Mindful exercise

44. A tendency of biological systems to maintain stability while continually adjusting to conditions that are optimal for survival is the definition of:

a) A general stress response
b) A holistic approach
c) Homeostasis
d) Adaptation

45. The results of Campbell’s study on "Neuropsychological Deficits Associated with Chronic Fatigue Syndrome," found that 90 percent of patients with CFID have some degree of:

a) Anxiety
b) Forgetfulness
c) Pain
d) Depression
e) brain fog

46. The method of treating the symptom of energy depletion is:

a) To give yourself plenty of time for tasks
b) Prioritizing activities
c) Knowing when to slow down
d) Identifying the underlying cause

47. True priorities involve immediate, intermediate and long-term goals.

a) True
b) False

48. The "until script" as defined by psychiatrist Eric Berne, M.D., states:

a) Get a second opinion
b) Avoid a complete overhaul
c) An unfinished task blocks forward motion
d) Do one thing at a time
e) Begin with a self-taught exercise class

49. The first step when in a "crisis mode" is to say:

a) Why do I feel this way?
b) Who might help me?
c) Look at the big picture.
d) Don’t sweat the small stuff.

50. The Americans with Disabilities Act was signed into law in _______ and regulates hiring practices and accommodations for people with disabilities.

a) 1960
b) 1970
c) 1980
d) 1990

51. Reasonable accommodation may include:
1. Taking a rest break
2. Limited work hours
3. Time off for a broken limb
4. Lowering expectations of the job

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

52. An action or accommodation that requires a significant expense or unfair action by the employer is the definition of:

a) Disability accommodation
b) Undue hardship
c) Compliance with Title 1 and Title 11 of the Technical Assistance Manual

53. The EEOC is an independent agency under the ________ branch of the ______ government with many field offices to enforce the statutes and process charges filed with the EEOC.

a) Judicial, local
b) Executive, state
c) Legislative, regional
d) Administrative, federal

54. When you ask to receive benefits early because your earning capacity has ended due to disability, it is called:

a) Social Security Disability Insurance
b) Supplemental Security Insurance
c) Medicaid
d) Social Security
e) A pension

55. A narrative report of your treatment, tests and prognosis plus a Residual Functional Capacity Assessment will be required from your doctor by:

a) An employer
b) Social Security Insurance
c) Medicaid
d) Social Security Administration

56. Grids are divided into _____ categories which guide the decision as to whether a claimant is disabled or not disabled based on laws for age, education and previous work experience.

a) 3
b) 4
c) 5
d) 6

57. Rate of rejection varies from state to state but the average for 2007 showed 34.1 percent of claims were awarded.

a) True
b) False

58. During this period, the Social Security Administration may request the claimant be examined by one of their doctors:

a) Assessment
b) Reconsideration
c) Hearing
d) Appeals council
e) Federal court review

59. Bill HR 2994 was introduced in 2007 to amend the Public Health Service Act with the intention to:

a) Promote education to the patient or medical proxy
b) Prevent breach of confidentiality
c) Withdraw consent for research or experimentation
d) Improve pain management and quality of life by providing adequate treatment

60. The concept behind Workers’ Compensation is to provide the affected employee, regardless of fault, with enough support to avoid requiring public assistance because of an injury or illness that occurred while on the job. Compensation is the same as the employee’s wages.

a) True
b) False

61. The Consolidated Omnibus Budget Reconciliation Act:
1. Is available as a result of a "qualifying event"
2. Protects you and your dependents from interrupted health insurance coverage
3. Requires you to pay the entire amount of health insurance
4. Protects you with a full and fair plan
5. Has an option for unlimited coverage for life

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

62. The Family and Medical Leave Act applies to all public agencies, all public and private elementary and secondary schools and companies with ______ or more employees. An eligible employee can receive up to ______ weeks of unpaid leave each year.

a) 25, 10
b) 40, 20
c) 50, 12
d) 10, 16

63. The Health Insurance Portability and Accountability Act was originally drafted:
1. As the Kennedy-Kassebaum Bill
2. To allow individuals to carry insurance benefits from job to job
3. For temporary assistance of special provisions
4. By each state to provide rehabilitation
5. As a federal law with minimum standards for health plans

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