Neurology/Psychiatry Exam #3 (Pain/Addiction)

36 Questions | Total Attempts: 92

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Neurology Quizzes & Trivia

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Questions and Answers
  • 1. 
    The dorsal horn is responsible for the transmission of signals, due to noxious stimuli,  from peripheral nerve to the thalamus via the descending pain pathway.  
    • A. 

      True

    • B. 

      False

  • 2. 
    Which of the following statements about types of chronic pain is FALSE?  
    • A. 

      Chronic back pain is observe only in the case of morphologic changes

    • B. 

      Diabetic neuropathy is the result of vasoconstriction of microvasculature

    • C. 

      Postherpetic neuralgia may last for years

    • D. 

      “Tingling” sensation is the result of neurons that are hypersensitized due to change in sodium receptor concentrations and demyelinated axons.

    • E. 

      All of the above are correct

  • 3. 
    Tricyclic Antidepressants have not shown significant efficacy in controlling chronic back pain.
    • A. 

      True

    • B. 

      False

  • 4. 
    Which of the following statements about gabapentin (Neurontin) are FALSE?
    • A. 

      Common ADE- Dizziness, somnolence

    • B. 

      Onset of action = 2-3 weeks, Trial requires = 3-8 weeks

    • C. 

      Requires renal adjustment

    • D. 

      Titration- Day 1- 300mg at bedtime; Day 2- 300mg BiD; Day 3- 300mg TiD

    • E. 

      All of the above are True

  • 5. 
    Which of the following statements about pregabalin (Lyrica) are FALSE?  
    • A. 

      Maximum doses dependent on indication

    • B. 

      Requires renal adjustment

    • C. 

      Should be used in caution in patients at risk of cardiovascular disease due to potential peripheral edema

    • D. 

      Starting dose - 500mg/day; Titration-Within 1 week

    • E. 

      All of the above are True

  • 6. 
    Proper administration of the lidocaine patch include applying a 5% patch daily, which can be cut to fit the site of administration  
    • A. 

      True

    • B. 

      False

  • 7. 
    It may take up to 1 month to see a noticeable effect of treatment with capsaicin  
    • A. 

      True

    • B. 

      False

  • 8. 
    Of the opioid receptors (mu, kappa, delta), the pharmacologic side effect of constipation based on action on the delta receptor.
    • A. 

      True

    • B. 

      False

  • 9. 
    Which of the following statements regarding morphine is FALSE?  
    • A. 

      Cannot be used in patients with hepatic dysfunction

    • B. 

      Initiation doses: IR - 5mg q4hr, SR/CR - 15 mg q8-12hr, ER - 30 mg qd

    • C. 

      Metabolized to an active metabolite; avoid in renal dysfunction

    • D. 

      Risk of allergic reaction

    • E. 

      Titrated every 2 days until no longer tolerated

    • F. 

      All of the above are True

  • 10. 
    Which of the following statements regarding oxycodone is TRUE?  
    • A. 

      Controlled release formulation can be mixed into small (

    • B. 

      Less histamine release than morphine at initiation

    • C. 

      Requires no change in initial dose in renal dysfunction

    • D. 

      Titration - dose is increased every 1-2 weeks as tolerated

    • E. 

      All of the above are False

  • 11. 
    Oxymorphone should be taken within 30 mins. after a meal (>500cal)  
    • A. 

      True

    • B. 

      False

  • 12. 
    Which of the following statements regarding tramadol is FALSE?
    • A. 

      Epileptogenic risk

    • B. 

      Non-controlled substance

    • C. 

      Reduced risk of respiratory depression

    • D. 

      Titrate up as tolerated

    • E. 

      All of the above are True

  • 13. 
    Tapentadol is a Schedule II medication because it has a higher abuse potential than tramadol
    • A. 

      True

    • B. 

      False

  • 14. 
    Choice of opioid for control of pain is dependent on patient preference, compliance, and superior opioid efficacy
    • A. 

      True

    • B. 

      False

  • 15. 
    Which of the following statements about opioid treatment principles is FALSE?  
    • A. 

      Titration: Daily dose should be increased by 25% at time

    • B. 

      Short acting doses should be 10% of the daily dose given

    • C. 

      Administration of short-acting doses should be PO q4-6 hrs

    • D. 

      Discontinuation: Daily dose taper 10% each week as tolerated (withdrawal)

    • E. 

      All of the above are True

  • 16. 
    Opioid Withdrawal should be treated immediately due to increased risk of severe problems such as seizure, mortality, or death.
    • A. 

      True

    • B. 

      False

  • 17. 
    While Mu opioid receptors are responsible for the common side effects of opiates, Kappa receptors are responsible for the euphoric effects of opioid abuse.  
    • A. 

      True

    • B. 

      False

  • 18. 
    Which of the following statements about clonidine is FALSE?  
    • A. 

      FDA approved for treatment of opioid withdrawal

    • B. 

      As an alpha-2 adrenergic receptor agonist, it suppresses the sympathetic CNS system

    • C. 

      Dosing based on COWS assessment

    • D. 

      Given in combination with other medication

    • E. 

      All of the above are True

  • 19. 
    Which of the following statements about buprenorphine/naloxone (Suboxone) is FALSE?  
    • A. 

      Buprenorphine is a partial mu receptor agonist and weak kappa receptor agonist

    • B. 

      Buprenorphine is highly protein bound

    • C. 

      Buprenorphine yields an active metabolite via CYP3A4 metabolism

    • D. 

      Dosing of Suboxone is based on most recent opioid dose

    • E. 

      Time to peak effect of Suboxone is 30-60mins.

    • F. 

      All of the above statements are True

  • 20. 
    Subutex (buprenorphine) is not prefered over Suboxone for opiate maintenance expect in pregnant patients
    • A. 

      True

    • B. 

      False

  • 21. 
    Patient must be in withdrawal before administration of first dose of Suboxone.  
    • A. 

      True

    • B. 

      False

  • 22. 
    Which of the follow statements about methadone is FALSE?  
    • A. 

      Dose tapering depends on opiate of abuse from which patient is withdrawing

    • B. 

      Indicated for both treatment of opiate withdrawal and opiate maintenance treatment

    • C. 

      Mechanism of action - Full mu receptor agonist weak NMDA antagonist

    • D. 

      Monitor for QT prolongation via EKG

    • E. 

      All of the above are True

  • 23. 
    Detoxification with methadone may only be performed in a licensed, designated facility except in the case of: Inpatient setting - Can administer methadone for withdrawal if patient scores “severe” on COWS.  
    • A. 

      True

    • B. 

      False

  • 24. 
    Detoxification with methadone may only be performed in a licensed, designated facility except in the case of: Outpatient setting - Physician can prescribe 72 hour of methadone to treat a patient’s opioid withdrawal  
    • A. 

      True

    • B. 

      False

  • 25. 
    The standard for opiate withdrawal in pregnant patients is maintenance treatment with methadone, though buprenorphine shows potential benefit with further studies
    • A. 

      True

    • B. 

      False

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