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WorksheetsPain Management
Total questions: 29
Worksheet time: 16mins
What procedure is indicated for CRPS Type II of the right upper extremity?
Stellate Ganglion Block
Celiac Plexus Block
Superior Hypogastric Plexus Block
Ganglion Impar Block
What is the landmark utilized for a stellate ganglion block?
Carotid tubercle of the C6 vertebral body
5 to 7 cm lateral to midline at the level of L4-L5 interspace
lateral border of paraspinal muscles around L1
Adam’s tubercle from C6-9
What is an expected complication from a Stellate ganglion block?
Ipsilateral Horner’s syndrome
sexual dysfunction
lower extremity numbness
genitofemoral neuralgia
What is the only FDA approved indication for treatment with hyaluronic acid injections?
Symptomatic knee OA
symptomatic hip OA
SI joint OA
symptomatic shoulder OA
How do Spinal Cord Stimulators provide pain relief?
mu-opioid agonist
Gait control theory
dopamine reuptake inhibition
they don’t but they reimburse well
Which of the following describes an exaggerated pain response from a stimulus that normally elicits pain
Allodynia
Hyperesthesia
Hyperalgesia
Dysesthesia
The conversion of a thermal stimuli to nociceptive electrical impulses is an example of
Transduction
Transmission
Modulation
Perception
A-beta fibers terminate in laminae
I and II
I, III-V
III-V
Which fibers conduct the slowest
A-beta
A-delta
C
Beta
Which fibers transmit sharp pain and light touch
A-beta
A-delta
Beta
C
In fibromyalgia CNS sensitization that leads to "disordered afferent processing" and increased levels of which neurotransmitters?
glutamate
substance P
5-hydroxytryptamine
GABA
Which of the following Opioid receptor types is most likely to cause Respiratory depression when activated?
Mu1
Mu2
Delta
Kappa
What is the receptor selectivity of Naloxone?
Mu - High
Kappa - High
Delta - High
Mu - High
Kappa - Moderate
Delta - Moderate
Mu - Low
Kappa - High
Delta - Low
Mu - Low
Kappa - Low
Delta - High
Which of the following are innervated by the medial branch of the dorsal ramus?
Facet joint
Multifidus
Interspinal ligament
Periosteum of the neural arch
Based on the Modic classifications of degenerative vertebral endplate changes, how would changes to the subchondral marrow on MRI that show up bright on T2 and dark on T1 be classified?
Modic Type 1
Modic Type 2
Modic Type 3
Modic Type 4
The C5-C6 facet joint is innervated by which medial branches?
C4
C5
C6
C7
The L4-L5 facet joint is innervated by which medial branches?
L3
L4
L5
S1
Which of the following opioids is contraindicated in patients with renal failure
Oxycodone
Fentanyl
Morphine
Tramadol
Which of the following opioids is a mixed agonist/antagonist?
Hydromorphone
Meperidine
Butorphanol
Tramadol
What is the most commonly reported side effect with Opioid medications?
Sexual Dysfunction
Respiratory depression
Constipation
Dry Mouth
What is the most common type of HA?
Migraine
Tension
Cluster
TMJ
How do corticosteroids reduce inflammation?
Direct inhibition of Mu 2 and Delta
Indirect inhibition of A beta fibers.
Direct inhibition of C fibers
Direct inhibition of Mu 1 and Kappa receptors.
Which of the following agents used for neurolysis is hypobaric compared to cerebrospinal fluid?
Phenol
Ethanol
Glycerol
Which of these is not a border of the “safe triangle”, infrapedicular approach when performing a transforaminal ESI?
Horizontal Line parallel to the inferior border of the pedicle
Medial edge of the inferior articular process
Lateral edge of the vertebral body
Spinal Nerve root
For a suspicion of facet joint mediated pain, what minimal percentage of pain relief should one have with a two series diagnostic medial branch block, before proceeding with a radiofrequency ablation?
50%
60%
75%
80%
Which of the following is true regarding breast cancer pain?
Prevalence of postmastectomy pain is higher after lumpectomy than mastectomy
Intercostobrachial neuralgia is located at T4-T5 dermatomes
Postmastectomy pain is described as heavy/swollen arm
Acute paclitaxel syndrome is described as neuropathic pain
Which of the following neuroablative techniques for cancer pain is described as a surgical technique selectively destroying neurons in the posterolateral spinal cord?
Cingulotomy
Punctate midline myelotomy
Cordotomy
Dorsal root entry zone lesioning (DREZ)
Which of the following is false regarding irritable bowel syndrome?
Abdominal pain or discomfort for 6 months and at least 3 times per month for the last 3 months without other diagnostic cause
Occurs more frequently in women than men
Age typically >45
Common comorbid fibromyalgia, HA, or chronic fatigue
Which of these anesthetics has the shortest duration of action?
Bupivicaine
Ropivicaine
Lidocaine
Procaine
