Clin Med - Acute Pain

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Questions and Answers

Pain is always a subjective and individual experience.

True (A)

What is the definition of the duration of acute pain?

  • a few minutes to less than six months (correct)
  • less than 3 weeks max
  • less 1 year
  • 3 to 6 months

Acute pain happens suddenly and usually disappears whenever the underlying cause is treated.

True (A)

Types of Acute Pain

<p>Damage to the tissue, muscle, and/or joints that cna lead to well localized pain = Somatic Poorly localized pain that comes from the organs (heart, stomach, gut) = Visceral Atypical pain sensation that is described as numbness, tingling, burning = Neuropathic pain from a stimulus that wouldn’t normally provoke pain = allodynia</p> Signup and view all the answers

somatic and visceral pain fall under the classification of nociceptors

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

What cortex of the brain interprets the location, intensity, and quality of pain sensations and allows individuals to localize and describe their pain experiences?

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

What pain system includes the amygdala and hippocampus process the emotional components of pain?

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

What section of the brain integrates sensory and emotional information and influences pain perception, coping strategies, and decision- making?

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

Chemical Mediators in the Transmission of Pain

<p>Acts on neurons in the spinal cord to amplify pain signals = Substance P An excitatory neurotransmitter that contributes to the amplification and prolongation of pain signals = Glutamate Inhibitory neurotransmitters that activate descending inhibitory pathways = GABA, Glycine, Serotonin, Norepinephrine Provide a mechanism for pain modulation and pain relief = GABA, Glycine, Serotonin, Norepinephrine</p> Signup and view all the answers

Chemical Mediators in the Transmission of Pain

<p>Bind to opioid receptors in the CNS andPNS to induce analgesic effects = Endorphins, Enkephalins, Dynorphins Release can be triggered by physical activity, acupuncture = Endorphins, Enkephalins, Dynorphins Releasedinresponsetotissue injury or inflammation = Prostaglandins, Bradykinin, Histamine, Cytokines Can sensitize nociceptors and amplify pain signals = Prostaglandins, Bradykinin, Histamine, Cytokines</p> Signup and view all the answers

What is the first step in the assessment of acute pain?

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

Pain and nociception are the same thing

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

Nonopioid therapies are at least as effective as opioids for many common types of acute pain

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

Clinicians should maximize the use of nonpharmacologic and nonopioid pharmacologic therapies as appropriate

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

Only consider opioid therapy for acute pain if benefits are anticipated to outweigh risks to the patient

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

What is not an appropriate management of a patient with bug bites, small bruises or sunburns?

<p>Round-the-clock NSAIDs + acetaminophen (alternating) with short term immobilization (D)</p> Signup and view all the answers

A patient that presents with higher level sprains and strains, typical headache or uncomplicated back pain can be managed with all of the following EXCEPT

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

Acetaminophen max daily dose = _______mg

<p>4000</p> Signup and view all the answers

Ibuprofen max daily dose = _____ mg

<p>3200</p> Signup and view all the answers

What is the first line therapy for patients with acute severe pain?

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

You should order an antiemetic when ordering opioids.

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

Some injuries obviously need opioids such as multisystem trauma and high-grade extensive burns.

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

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Study Notes

Acute Pain

  • Acute pain is sudden in onset and usually resolves when the underlying cause is treated
  • Types of acute pain include somatic and visceral pain, both of which fall under the classification of nociceptors

Pain Processing in the Brain

  • The cortex interprets the location, intensity, and quality of pain sensations, allowing individuals to localize and describe their pain experiences
  • The pain system, including the amygdala and hippocampus, processes the emotional components of pain
  • The prefrontal cortex integrates sensory and emotional information, influencing pain perception, coping strategies, and decision-making

Chemical Mediators in Pain Transmission

  • Chemical mediators play a crucial role in the transmission of pain

Assessing and Managing Acute Pain

  • The first step in assessing acute pain is undefined in the text
  • Pain and nociception are not the same thing
  • Nonopioid therapies are at least as effective as opioids for many common types of acute pain
  • Clinicians should maximize the use of nonpharmacologic and nonopioid pharmacologic therapies as appropriate
  • Opioid therapy should only be considered for acute pain if benefits are anticipated to outweigh risks to the patient

Pain Management

  • Bug bites, small bruises, or sunburns should not be managed with opioids
  • Patients with higher-level sprains and strains, typical headaches, or uncomplicated back pain can be managed with:
    • Acetaminophen (max daily dose: 4000mg)
    • Ibuprofen (max daily dose: 2400mg)
  • The first-line therapy for patients with acute severe pain is undefined in the text
  • Antiemetics should be ordered when prescribing opioids
  • Opioids may be necessary for severe injuries, such as multisystem trauma and high-grade extensive burns

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