Order Pain Surdery Discussion Assignment

Order Pain Surdery Discussion Assignment
Order Pain Surdery Discussion Assignment
1. A 55-year-old male with known ischemic heart
disease develops a crushing chest pain which
radiates into his neck and left arm. The phenomenon of referred pain is best explained
by which one of the following mechanisms?
a. Pain transmission along a given afferent
nerve is transferred to another afferent
pathway due to ephaptic transmission
b. Lateral inhibition of secondary afferent
fibers by a single primary afferent
c. Convergence of primary afferent fibers
from a specific part of the body onto
second-order neurons that normally
receive primary afferents from a different
body part
d. Disruption of dorsal root ganglia
e. The blockade of substance P and glutamate in the dorsal horn
2. The descending pathway for central control
of nociception is best described as involving
which one of the following structures?
a. Anterior cingulate cortex fibers that synapse directly on dorsal horn neurons
b. Periaqueductal gray fibers that synapse
nucleus raphe magnus neurons, which in
turn synapse on dorsal horn neurons
c. Thalamic neurons that synapse upon red
nucleus neurons, which in turn synapse
upon dorsal horn cells
d. Hypothalamic fibers that synapse upon
neurons of the nucleus solitarius that then
synapse upon neurons of the dorsal horn
e. Thalamic fibers that synapse upon inhibitory interneurons in the dorsal horn
3. Which one of the following is not a potential
site for ulnar nerve entrapment?
a. Arcade of Struthers
b. Heads of the flexor carpi ulnaris
c. Intermuscular septum
d. Osbourne’s fascia
e. Sublimis arch
Order Pain Surdery Discussion Assignment
4. A 43-year-old woman is referred with a 2-
year history of sharp, shooting pains radiating into the right side of her jaw. Each attack
lasts for a few seconds but they seem to merge
together so it can seem like several minutes of
pain. After this she may be pain free for several hours. It is often triggered by eating/
drinking, brushing her teeth, touching her
face, and talking. She denies any tearing,
eye/eyelid changes or nasal congestion/rhinorrhea. There is no other past medical or
family history. Neurological examination is
normal and MRI head was unremarkable.
Which one of the following is most appropriate first line therapy?
a. Baclofen
b. Carbamazepine
c. Gabapentin
d. Lamotrigine
e. Pimozide
5. A 22-year-old female presents to her GP with
a 3-month history of sharp, stabbing jaw pain
and blurred vision on the right side. She is
about to sit her examinations and is finding
it difficult to study because of her symptoms.
Which one of the following would you wish
to exclude as a priority?
a. Tolosa-Hunt syndrome
b. Multiple sclerosis
c. Intracranial tumor
d. Classical trigeminal neuralgia
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