Risk Factor For The Development Of Postherpetic Neuralgia

Risk Factor For The Development Of Postherpetic Neuralgia
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Risk Factor For The Development Of Postherpetic Neuralgia
1. Which of the following scenarios is suggestive of complex regional pain
syndrome (CRPS) type II?
A. A patient burns his right foot and develops pain, hyperalgesia, and allodynia in
his right lower leg that continues more than 6 months after his burn. His right foot
is noted to be shiny and without hair.
B. A patient’s right forearm is crushed by a falling object. She reports pain,
hyperalgesia, and allodynia of the forearm more than a year later. Her forearm is
noted to be shiny and without hair.
C. A patient’s left forearm is crushed by a falling object. She reports pain,
hyperalgesia, and allodynia of the forearm more than a year later. Atrophy of the
muscles of the forearm is noted.
D. After surgery, a patient develops numbness over his right lateral thigh. He reports
pain, hyperalgesia, and allodynia of the lateral thigh more than a year later. The
area is noted to be shiny and without hair.
2. What is the greatest risk factor for the development of postherpetic neuralgia
(PHN)?
A. Increasing age
B. Male sex
C. Lack of a prodrome
D. Use of antiviral agents during acute herpes zoster infection
3. All of the following are risk factors for the development of phantom limb pain
EXCEPT which one?
A. Preamputation pain
B. Depression
C. Distal amputation
D. Proximal amputation
4. Which of the following is most characteristic with facetogenic back pain?
A. Pain in the low back that radiates to the ipsilateral posterior thigh
B. Nonradiating pain in the low back
C. Pain in the ipsilateral buttocks
D. Numbness over the lower back
5. A patient with a history of pain in the lower back that radiates to his ipsilateral
thigh presents to a pain clinic for a facet joint injection. Which nerve fibers
innervate the facet joints?
A. Medial branch of the dorsal ramus of spinal nerve
B. Lateral branch of the dorsal ramus of spinal nerve
C. Lateral branch of the posterior cutaneous branch of the dorsal ramus
D. Medial branch of the posterior cutaneous branch of the dorsal ramus
Risk Factor For The Development Of Postherpetic Neuralgia
6. 36. Which of the following would you expect to find in a patient who presents
with pain originating from the sacroiliac joint?
A. Back pain that radiates to the ipsilateral buttocks
B. Back pain accompanied by pain extending down the ipsilateral leg when the
ipsilateral leg is passively raised straight in the air up to 60°
C. Numbness of the anterolateral thigh
D. Back pain accompanied by a leg length discrepancy
7. A patient presents with pain in the left buttock. He reports that he frequently
carries his wallet in the left pocket and that his wallet is quite large.
Furthermore, he sits on the wallet throughout most of the day at a desk job.
You suspect piriformis syndrome and plan to inject a combination of local
anesthetic and steroid. Which anatomic relationship between the piriformis
muscle and the sciatic nerve is most common?
A. The undivided sciatic nerve passes below the piriformis muscle.
B. The divided sciatic nerve passes through and below the piriformis muscle.
C. The divided sciatic nerve passes through and above the piriformis muscle.
D. The undivided nerve passes through the piriformis muscle.
8. A 56-year-old man with a history of hypertension, chronic obstructive
pulmonary disease, and diabetes presents for a lumbar epidural steroid
injection (ESI) for lower-back pain that radiates into his right leg. He receives
an injection of methylprednisone and lidocaine. Which of the following is most
likely to occur after he receives this injection?
A. Arachnoiditis
B. Headache
C. Infection
D. Hyperglycemia
9. Which of the following statements about new, acute onset low-back pain is most
accurate?
A. Bed rest is recommended for up to 1 week.
B. In the absence of “red flag” symptoms, imaging is not indicated in the acute
setting.
C. Opioids are the first-line therapy for this type of pain.
D. A short course of oral steroids may be helpful in treating this pain.
10. A patient presents to you with pain on the left side of her face. She states that
the pain began a month ago and that chewing food is excruciating. She also
notes the sensation of “shooting” pain on the left side of her face. Which of the
following statements about this condition is most likely true?
A. Pain on the left side of the face is more common than the right side.
B. Involvement of the V1 distribution is uncommon.
C. Autonomic symptoms such as tearing or nasal discharge are common.
D. The most common first-line drug is oxycodone.
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