T2 L11: Physiology of Pain 2 (AD)

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Questions and Answers

Which type of pain is caused by injury to the nervous system?

  • Chronic pain
  • Acute pain
  • Visceral pain
  • Neuropathic pain (correct)

What is the defining time period for acute pain?

  • 3-6 months
  • More than 12 months
  • 6-12 months
  • Less than 3 months (correct)

What are the underlying mechanisms of acute pain?

  • Direct activation of nerve receptors
  • Receptors responding to tissue injury (correct)
  • Peripheral sensitization
  • Hyperalgesia

Which type of drugs inhibit prostaglandin synthesis and reduce peripheral sensitization?

<p>Nonsteroidal anti-inflammatory drugs (B)</p> Signup and view all the answers

Which type of pain medication is not anti-inflammatory?

<p>Paracetamol (D)</p> Signup and view all the answers

Which receptors can paracetamol activate in the central nervous system?

<p>Cannabinoid receptors (C)</p> Signup and view all the answers

Which cream contains capsaicin?

<p>Capsaicin cream (D)</p> Signup and view all the answers

Where do opioids primarily work to relieve pain?

<p>Central nervous system (C)</p> Signup and view all the answers

Which of the following is NOT a potential cause of neuropathic pain?

<p>Hypoxia following a stroke (B)</p> Signup and view all the answers

What percentage of the population is estimated to be affected by neuropathic pain?

<p>8-10% (D)</p> Signup and view all the answers

Which of the following words is NOT used by patients to describe neuropathic pain?

<p>Numbness (C)</p> Signup and view all the answers

What are the two main peripheral mechanisms involved in neuropathic pain?

<p>Sensitization and increased firing of afferents (C)</p> Signup and view all the answers

Which part of the nervous system do opioids work in to relieve pain?

<p>Peripheral nervous system (B)</p> Signup and view all the answers

What is the mechanism called when blowing or rubbing an injury site reduces pain sensation?

<p>Gate control (D)</p> Signup and view all the answers

Which of the following is a chronic pain condition?

<p>Migraine (D)</p> Signup and view all the answers

What is the difference between nociceptive pain and neuropathic pain?

<p>Nociceptive pain is caused by tissue injury, while neuropathic pain is caused by injury to the nervous system (C)</p> Signup and view all the answers

What is the difference between Hyperalgesia and Lavinia?

<p>Hyperalgesia is the perception of light touch as painful, while Lavinia is a clinical term for neuropathic pain (A)</p> Signup and view all the answers

What is peripheral sensitization?

<p>Changes in the kinetics of ion channels at the peripheral terminals of nociceptors (A)</p> Signup and view all the answers

How is pain characterized in the last lecture?

<p>Noxious, passive, and neuropathic (D)</p> Signup and view all the answers

What is the focus of today's lecture?

<p>The mechanism of hyperalgesia and peripheral sensitization (D)</p> Signup and view all the answers

Which branch of the nervous system can close down the spinal summit pathway?

<p>Collateral branches that snap single inhibitory neurones in the dorsal hall (C)</p> Signup and view all the answers

What happens when the activated collateral branches close down the spinal summit pathway?

<p>The spinal thalamic tracts become depolarized (D)</p> Signup and view all the answers

What is the role of the branches associated with second order neurones?

<p>To release neurotransmitters when something is touched lightly (D)</p> Signup and view all the answers

What happens when AP two fibres are activated?

<p>The second order neurones become activated (D)</p> Signup and view all the answers

What is the result of a sensitized nervous system?

<p>Inhibition of the torso column medial meniscus pathway (A)</p> Signup and view all the answers

What do the collateral branches do when they are activated?

<p>Close shut down the spinal summit pathway (A)</p> Signup and view all the answers

What is the mechanism responsible for spontaneous pain described by patients with phantom limb pain?

<p>Spontaneous firing of ion channels in the spinal thalamic tracts (B)</p> Signup and view all the answers

What is the basis of phantom limb pain?

<p>Spontaneous firing of noxious axons in the peripheral nerves (A)</p> Signup and view all the answers

What is central sensitisation?

<p>An increase in the responsiveness of spinal thalamic neurons to second order neurons (B)</p> Signup and view all the answers

What are the consequences of prolonged depolarisation in second order neurons in the dorsal horn?

<p>Activation of NMDA receptors and influx of calcium (A)</p> Signup and view all the answers

Which of the following is a characteristic of clinical pain?

<p>It is associated with damage to tissues (B)</p> Signup and view all the answers

What is the defining time period for chronic pain according to the International Association for the Study of Pain?

<p>3 months (A)</p> Signup and view all the answers

Which of the following is NOT a potential cause of acute pain?

<p>Peripheral sensitization (C)</p> Signup and view all the answers

What is the primary site of action for acute pain treatments?

<p>Peripheral nervous system (PNS) (A)</p> Signup and view all the answers

Which of the following substances can reduce the threshold of heat-activated channels (TRPV1) and contribute to hyperalgesia in acute pain?

<p>Bradykinin (B)</p> Signup and view all the answers

What is the mechanism responsible for the excitation of nociceptors in acute pain?

<p>Direct activation (D)</p> Signup and view all the answers

Which of the following is NOT a characteristic of neuropathic pain?

<p>Lasts for a short duration (C)</p> Signup and view all the answers

Where do opioids primarily work to relieve pain?

<p>Central nervous system (CNS) (B)</p> Signup and view all the answers

What is the result of peripheral sensitization in acute pain?

<p>Hyperalgesia (B)</p> Signup and view all the answers

Which of the following is a characteristic of acute pain?

<p>Normal functioning of nociceptors (B)</p> Signup and view all the answers

Which of the following drugs acts within the central nervous system and inhibits cyclooxygenase enzymes?

<p>Aspirin (B)</p> Signup and view all the answers

Which of the following drugs is a TRPV1 agonist and acts in the periphery by topically applying it to the skin?

<p>Capsaicin (A)</p> Signup and view all the answers

Which of the following drugs prevents nociceptor firing by blocking sodium channels?

<p>Lidocaine (D)</p> Signup and view all the answers

Which of the following drugs is NOT a non-steroidal anti-inflammatory drug (NSAID)?

<p>Paracetamol (C)</p> Signup and view all the answers

Which of the following drugs is an example of an opioid?

<p>Morphine (B)</p> Signup and view all the answers

Which of the following mechanisms is responsible for reducing pain sensation by the simultaneous activation of low threshold mechanoreceptors?

<p>Gate control theory (D)</p> Signup and view all the answers

Which of the following is a common chronic pain condition?

<p>Osteoarthritis (B)</p> Signup and view all the answers

Which of the following is NOT a main peripheral mechanism involved in neuropathic pain?

<p>Central sensitization (B)</p> Signup and view all the answers

Which of the following is a potential cause of neuropathic pain?

<p>Tissue injury (C)</p> Signup and view all the answers

Which of the following is the mechanism responsible for spontaneous pain and phantom limb pain in the damaged tips of regenerating nerve endings?

<p>Intact nociceptor firing (B)</p> Signup and view all the answers

Which of the following is NOT a potential treatment for chronic pain?

<p>Physical therapies (A)</p> Signup and view all the answers

What is the mechanism of action of tricyclic antidepressants in the treatment of chronic pain?

<p>Inhibit reuptake of serotonin and noradrenaline (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic of central sensitization?

<p>Constant firing of axons from the periphery (A)</p> Signup and view all the answers

What is the first-line treatment recommended by NICE guidelines for neuropathic pain?

<p>Amitriptyline (B)</p> Signup and view all the answers

What is the proposed mechanism of action of anticonvulsants in the treatment of chronic pain?

<p>Block calcium and sodium channels (C)</p> Signup and view all the answers

What is the primary focus of chronic pain treatments?

<p>Managing primary condition (C)</p> Signup and view all the answers

Which of the following is NOT a potential cause of central sensitization?

<p>Constant firing of axons from the periphery (B)</p> Signup and view all the answers

What is the primary mechanism of action of tricyclic antidepressants in the treatment of chronic pain?

<p>Inhibit reuptake of serotonin and noradrenaline (D)</p> Signup and view all the answers

Which of the following is NOT a potential treatment for acute pain?

<p>Tricyclic antidepressants (C)</p> Signup and view all the answers

What is the second-line treatment recommended by NICE guidelines for neuropathic pain?

<p>Duloxetine (A)</p> Signup and view all the answers

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