Pre-Op Final Exam Questions &
Answers 2023/2024
acute pain - ANSWER-o Sharp or intense
o Pinpoint the pain to a specific body location
o Typically, responsive to common pain management treatments
o Predictably resolves as tissue heals
o Serves a biological purpose
o Sudden in onset, short in duration
o Presents after noxious stimuli (injury, surgery - tissue damage)
o Lasts hours, days, weeks
breakthrough pain - ANSWER-o acute pain that "breakthroughs" controlled chronic/managed pain
chronic pain - ANSWER-o Achy, dull, stabbing, burning, and icy hot
o Difficulty localizing chronic pain with precision
§ General region of the body
§ Example: lower back or legs
o Unpredictable in course
o Resistant to common pain management
o Serves no apparent biological purpose
o Lasts more than 3-6 months- with or without obvious tissue injury
§ Ex: diabetic neuropathy; phantom limb pain, fibromyalgia
chronic malignant pain - ANSWER-o associated with cancer - rapidly dividing cancer cells invade tissues
persistent pain - ANSWER-acute or chronic pain that stops responding when therapies reach max
dosages
,cutaneous pain - ANSWER-- originating in superficial tissues
somatic pain - ANSWER-- originating deeper in the joints, bones, and muscles
visceral pain - ANSWER-- originating in the organs
neuropathic pain - ANSWER-follows damage or injury to nervous system structures
referred pain - ANSWER-- nerve fibers from normally high-sensory areas (superficial tissues) and
normally low-sensory input (visceral organs) areas all converge at a similar level of the spinal cord
ex: heart attack pain in arm
assessment of pain - ANSWER-- Measuring pain intensity
- Examples of unidimensional assessment tools
- Focused pain assessment
unidemensional pain assessment tool - ANSWER-o Numeric rating scales
o Verbal rating scales
o Visual analog scales
focused pain assessment - ANSWER-o OPQRST-AAA
o Physical examination
OPQRST-AAA - ANSWER-§ O: Onset of pain
§ P: Provocation - movement, turning
§ Q: Quality of pain - descriptors "sharp, stabbing, aching, dull" Use open-ended questions initially
§ R: Region and radiation - ask patients to trace their pain
§ S: Severity of pain - compare to past events or how activities are limited by pain
, § T: Time and duration - how long it has be going on, how long pain lasts, does the pain change
§ AAA: Aggravating/alleviating factors and associated symptoms
physical examination for pain - ANSWER-§ The most useful of these techniques for bedside clinicians
may be palpation and assessment of range of motion (ROM).
nonopiods - ANSWER-- This classification of pain medications includes three general categories of
medications: salicylates (aspirin), acetaminophen (Tylenol), and NSAIDs.
o strength - low - ibuprofen;
o medium - naproxen (Aleve);
o high - ketorolac (Toradol) or COX2 inhibitors i.e. celecoxib (Celebrex)
Corticosteroids - ANSWER-- naturally occurring steroid hormones produced in the adrenal cortex.
local anesthetic agents - ANSWER-pharmacological substances, either topically applied or injected into
nerves and tissue, that eliminate sensation and pain without the loss of consciousness
topical rubefacients - ANSWER-- topically applied substances that cause local dilation of blood vessels
and reddening of the skin, producing local sensations of coolness and warmth that many people find
soothing. (ex: Icy Hot)
opioids - ANSWER-- among the oldest known substances used for the treatment of acute & chronic pain.
adrenergic agonists - ANSWER-- Clonidine (Catapres) is a direct-acting alpha-2 adrenergic agonist used to
treat high blood pressure.
Tricyclic Antidepressants (TCAs) - ANSWER-- comprise a large class of medications that modulate the
effects of serotonin and the related neurotransmitter norepinephrine in the central nervous system i.e.
amitriptyline (Elavil)
Antiepileptic Drugs (AEDs) - ANSWER-- gabapentin (Neurontin) common for diabetic neuropathy or
phantom limb pain
Answers 2023/2024
acute pain - ANSWER-o Sharp or intense
o Pinpoint the pain to a specific body location
o Typically, responsive to common pain management treatments
o Predictably resolves as tissue heals
o Serves a biological purpose
o Sudden in onset, short in duration
o Presents after noxious stimuli (injury, surgery - tissue damage)
o Lasts hours, days, weeks
breakthrough pain - ANSWER-o acute pain that "breakthroughs" controlled chronic/managed pain
chronic pain - ANSWER-o Achy, dull, stabbing, burning, and icy hot
o Difficulty localizing chronic pain with precision
§ General region of the body
§ Example: lower back or legs
o Unpredictable in course
o Resistant to common pain management
o Serves no apparent biological purpose
o Lasts more than 3-6 months- with or without obvious tissue injury
§ Ex: diabetic neuropathy; phantom limb pain, fibromyalgia
chronic malignant pain - ANSWER-o associated with cancer - rapidly dividing cancer cells invade tissues
persistent pain - ANSWER-acute or chronic pain that stops responding when therapies reach max
dosages
,cutaneous pain - ANSWER-- originating in superficial tissues
somatic pain - ANSWER-- originating deeper in the joints, bones, and muscles
visceral pain - ANSWER-- originating in the organs
neuropathic pain - ANSWER-follows damage or injury to nervous system structures
referred pain - ANSWER-- nerve fibers from normally high-sensory areas (superficial tissues) and
normally low-sensory input (visceral organs) areas all converge at a similar level of the spinal cord
ex: heart attack pain in arm
assessment of pain - ANSWER-- Measuring pain intensity
- Examples of unidimensional assessment tools
- Focused pain assessment
unidemensional pain assessment tool - ANSWER-o Numeric rating scales
o Verbal rating scales
o Visual analog scales
focused pain assessment - ANSWER-o OPQRST-AAA
o Physical examination
OPQRST-AAA - ANSWER-§ O: Onset of pain
§ P: Provocation - movement, turning
§ Q: Quality of pain - descriptors "sharp, stabbing, aching, dull" Use open-ended questions initially
§ R: Region and radiation - ask patients to trace their pain
§ S: Severity of pain - compare to past events or how activities are limited by pain
, § T: Time and duration - how long it has be going on, how long pain lasts, does the pain change
§ AAA: Aggravating/alleviating factors and associated symptoms
physical examination for pain - ANSWER-§ The most useful of these techniques for bedside clinicians
may be palpation and assessment of range of motion (ROM).
nonopiods - ANSWER-- This classification of pain medications includes three general categories of
medications: salicylates (aspirin), acetaminophen (Tylenol), and NSAIDs.
o strength - low - ibuprofen;
o medium - naproxen (Aleve);
o high - ketorolac (Toradol) or COX2 inhibitors i.e. celecoxib (Celebrex)
Corticosteroids - ANSWER-- naturally occurring steroid hormones produced in the adrenal cortex.
local anesthetic agents - ANSWER-pharmacological substances, either topically applied or injected into
nerves and tissue, that eliminate sensation and pain without the loss of consciousness
topical rubefacients - ANSWER-- topically applied substances that cause local dilation of blood vessels
and reddening of the skin, producing local sensations of coolness and warmth that many people find
soothing. (ex: Icy Hot)
opioids - ANSWER-- among the oldest known substances used for the treatment of acute & chronic pain.
adrenergic agonists - ANSWER-- Clonidine (Catapres) is a direct-acting alpha-2 adrenergic agonist used to
treat high blood pressure.
Tricyclic Antidepressants (TCAs) - ANSWER-- comprise a large class of medications that modulate the
effects of serotonin and the related neurotransmitter norepinephrine in the central nervous system i.e.
amitriptyline (Elavil)
Antiepileptic Drugs (AEDs) - ANSWER-- gabapentin (Neurontin) common for diabetic neuropathy or
phantom limb pain
