Therapeutics of Pain Practice Exam

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• Which massage techniques are described as having autonomic effects?
• What distinguishes buprenorphine from full opioid agonists in terms of analgesic ceiling and safety?
• Toe region of the stress–strain curve is characterized by which description?
• Which muscle is a weak/phasic muscle in Upper Cross Syndrome?
• In the described rehabilitation protocol, which is the initial treatment step?
• Which option identifies the spine engine model?
• Which mechanoreceptor is primarily associated with fine touch and texture discrimination in glabrous skin?
• The three parts of Hoffa are?
• How do topical lidocaine patches function and in what clinical scenario are they most appropriately used?
• Rolfing is best described as which concept?
• Which monitoring parameter is particularly important when initiating duloxetine for neuropathic pain?
• What is the initial stage of the cycle of fibrosis?
• What is a lidocaine patch and what is its typical application guideline?
• Which of the following is NOT a type of mechanoreceptor?
• Scar tissue from abdominal surgery can influence distant joints such as the shoulder due to fascial connections. Is this statement true or false?
• Which nonpharmacologic strategy is commonly included in multimodal pain management to improve sleep and mood?
• Aston Patterning emphasizes which concept in its approach?
• What is a PAMORA and when is it used?
• In cancer pain management, what is the role of corticosteroids?
• Active Assisted ROM (AAROM) involves which of the following?
• Traegering approaches include which of the following?
• Which term best describes the final phase where collagen fibers are mature and strong?
• What is the effect of Golgi tendon organ activation on the agonist and antagonist muscles?
• For ibuprofen dosing in children, how often is a typical dose given?
• Name two interventional pain management modalities and typical indications.
• Which of the following is NOT a contraindication to using ketamine as a pain adjuvant?
• Meissner corpuscles are primarily responsible for which sensation?
• Which concept is described as part of thixotropy?
• What does AAROM stand for?
• Which statement differentiates tramadol and tapentadol regarding serotonergic activity?
• Which approach emphasizes habit awareness, habit inhibition, and habit conscious control?
• Myofibroblasts possess which components?
• The yield point is defined as the transition from elastic to ...
• What is a general principle for breakthrough pain management in patients on chronic opioid therapy?
• In pediatric pain management, what is the maximum daily limit for acetaminophen in older children?
• Phases of Tissue Healing in Week 1 are characterized by what?
• What occurs when tissue loading surpasses the yield point?
• Which option describes the Gel-Sol Model?
• What characterizes Weeks 5-10 in tissue healing?
• During the plastic stage of the stress–strain curve, deformation is...
• Upper Cross Syndrome is associated with which spinal posture changes?
• Which technique was developed to help voice projection difficulties due to posture?
• Which of the following is a common adverse effect of opioid therapy and what is a practical first-line management strategy for constipation?
• In Lower Cross Syndrome, which muscle group is tight?
• In cancer pain management, what is the purpose of breakthrough dosing within the WHO ladder framework?
• In the viscoelastic model of tissue, which portion provides immediate, reversible deformation?
• What is the impact of hepatic impairment on acetaminophen and opioid dosing?
• Which morphological change is associated with immobilization of connective tissue?
• Rhythmic oscillations in Traegering do what?
• In cancer pain management, corticosteroids can improve which symptom besides pain?
• Which approach emphasizes 'soft hands' and ergonomics?
• Which statement best describes the role of SNRIs in chronic non-cancer pain?
• Myofibroblasts gain contractile capability from which proteins?
• Merkel's discs are known for detecting which characteristic of touch?
• Hoffa is described as?
• Which of the following is NOT listed as tight/tonic in Upper Cross Syndrome?
• What are the effects of immobilization on muscle?
• Capsaicin provides analgesia by which mechanism, and what is a common initial sensation?
• Lower Cross Syndrome is characterized by which pattern?
• What effect do contract/relax techniques have on the nervous system?
• In the linear (elastic) region of the stress–strain curve, deformation is...
• What does Golgi tendon organ detect?
• What is a key reason for using rapid-onset opioid formulations for breakthrough pain?
• In the cycle of fibrosis, which stage follows macrophage infiltration and activation?
• Which movement-based approach is designed to facilitate the myofascial system through diagonal movement patterns?
• Which method manipulates the proprioceptive system to increase movement awareness?
• How is naloxone used in opioid overdose and what route and dosing considerations maximize safety?
• Neural tension techniques are used to treat which condition?
• Why is methadone considered unique among opioids in practice?
• Gabapentinoids are used for neuropathic pain including postherpetic neuralgia. Which of the following best describes their commonly observed side effects and a renal consideration?
• Hoffa's technique is commonly associated with what outcome?
• Which statement correctly describes the analgesic mechanism of duloxetine in neuropathic pain?
• What is the recommended approach when initiating opioid therapy for acute pain?
• What is the final step in the sequence?
• Which tool is recommended to assess opioid risk and monitor prescription history in chronic noncancer pain?
• Which statement best describes rolfing's approach to fascia and posture?
• What percentage of total daily opioid dose is typically used per breakthrough pain episode?
• Effleurage is defined as?
• Which combination would be a red flag for NSAID use in a patient with chronic pain?
• Which statement best describes NSAID considerations in special populations?
• The intrafascial circulation loop application to specific techniques includes which set?
• What do muscle spindles detect?
• What dosing strategy is commonly advocated for chronic noncancer pain opioid therapy?
• What is a typical clinical goal when converting an opioid agent due to poor efficacy or adverse effects?
• Which practice is associated with 'habit conscious control' as a core component?
• Which agent is most commonly used to modulate glutamatergic signaling in adjuvant analgesia?
• The ultimate fail point on a stress–strain curve refers to...
• Which option is NOT listed as part of the intrafascial circulation loop stages?
• What class of drug treats opioid-induced constipation without reversing analgesia?
• A method that borrows Alexander's posture efficiency ideas and emphasizes 'soft hands' is called?
• How does treatment differ between cancer pain and non-cancer chronic pain?
• Which of the following is NOT a major adverse effect that requires monitoring in long-term opioid therapy?
• Which option best describes the Biotensegrity Model?
• Name two common NSAIDs and describe one major risk associated with chronic NSAID use.
• Which agent is a peripherally acting mu-opioid receptor antagonist used for opioid-induced constipation?
• Opioid rotation is considered in which situations, and what initial dose adjustment is typical after rotation?
• What is the per-dose range for ibuprofen in children?
• How do immediate-release and extended-release opioid formulations differ in clinical use?
• What is the general purpose of muscle spindles and Golgi tendon organs?
• Name an SNRI used as an adjuvant analgesic and summarize its analgesic rationale.
• Which patient factor increases the risk of NSAID-related gastrointestinal bleeding?
• How should acetaminophen dosing be adjusted in patients with significant liver impairment or chronic alcohol use?
• Why are myofibroblasts important?
• The mechanical-effect techniques list includes which group?
• Where are muscle spindles located?
• What is the general approach to NSAID use in patients with reduced renal function?
• What is the effect of muscle spindle activity on the agonist and antagonist muscles?
• What hepatic- or QT-related cautions are specifically relevant to methadone dosing?
• What is the typical per-dose range for acetaminophen in children?
• What is an effect of tension during fibroplasia and consolidation?
• What happens to glycosaminoglycans (GAGs) during immobilization?
• Which method aims to help individuals become aware of their own movements by manipulating proprioceptive input?
• The Traegering technique uses which features?
• Opioid-induced hyperalgesia is best described as a paradoxical increase in pain sensitivity that occurs with prolonged opioid exposure. Which management approach is appropriate?
• Which term describes the baseline tension present in resting muscles?
• In cancer-related breakthrough dosing, what is the typical approach to dosing for breakthrough episodes?
• Which is a complete list of the stages of the intrafascial circulation loop?
• What do myofibroblast cells produce?
• Guidelines for opioid prescribing in chronic noncancer pain, what is a key principle?
• During which phase is collagen finally matured into strong fibers?
• Which technique uses diagonal patterns to facilitate the myofascial system?
• Cross friction primarily targets which tissue type?
• Which movement-based technique focuses on posture to aid voice projection?
• Which statement about addiction, physical dependence, and tolerance is most accurate?
• The principle that tension stimulates collagen synthesis is explained by which law?
• In the fibrosis cycle, what occurs after vascular support system increases?
• An example of muscle spindle function is a protective reflex during stretching where the muscle contracts to resist stretch. Which description fits this?
• When is it advisable to start passive range of motion (PROM) and why?
• Myofibroblast cells are best described as a combination of...
• Which statement best describes the role of PAMORAs in opioid-induced constipation?
• Movement-based techniques are used as progression after applying massage techniques and include which of the following?
• In adjuvant analgesia, glutamate signaling is most closely associated with which pain mechanism that NMDA receptor antagonists target?
• Which of the following is an example of dense regular connective tissue?
• What does the Spine Engine Model describe?
• Which of the following is NOT an example of dense regular connective tissue?
• What is the Biotensegrity Model?
• Which statement best describes the Feldenkrais method's approach?
• What do myofibroblast cells do fascia sometimes?
• In Lower Cross Syndrome, which muscle is weak?
• How should you assess and mitigate opioid-related respiratory depression risk in opioid-naïve patients?
• Which best describes the role of the Golgi tendon organ when muscle tension becomes excessive?
• Which statement best describes central sensitization?
• Which is a described aim of AAROM after tissue manipulation?
• Which receptor is the primary mediator of analgesia in most opioid analgesics, and what are the implications of mu receptor activation?
• Myofascial release is described as?
• Which muscle is a weak muscle in Upper Cross Syndrome?
• What major considerations exist when prescribing opioids to patients with co-morbid psychiatric illness?
• What does the Gel-Sol Model describe?
• What phase occurs at Weeks 10 and beyond?
• Massage techniques that have mechanical effects include which set?
• Which term describes the category that includes rolfing and neural tension?
• What is the mechanism of action of capsaicin topical therapy and when should patients expect to see benefits?
• Which statement is true about Upper Cross Syndrome?
• Which sites are influenced by the cross friction technique?
• Which option correctly names the leg carry trunk model?
• Where are Golgi tendon organs located?
• What is the maximum recommended daily dose of acetaminophen in adults and what factors modify this limit?
• Which phase is characterized by mature and strong collagen fibers?
• Phases of Tissue Healing for Weeks 2-4 describe what process?
• In opioid overdose management using naloxone, what monitoring consideration is essential after reversal?
• What does the leg carry trunk model describe?
• Nociceptors detect what?
• Explain the concept of incomplete cross-tolerance and its relevance to opioid rotation.
• What changes occur in connective tissue due to immobilization, and when do they begin?
• An example of rolfing demonstrates that fascia tightness in the abdomen can affect which distant joint movement?
• The trio that makes up Hoffa are included in which set?
• How do clinicians monitor patients on chronic opioid therapy for safety and efficacy?
• Which technique uses diagonal patterns to stimulate the myofascial system?
• The forward head posture example belongs to which technique's focus?
• Which statement best describes rolfing?
• What is a cultivisceral response?
• The prefix noci- means which concept?
• In Traegering, what is the effect of oscillations?
• Cross friction is described as being done mainly on which structures?
• In intrathecal therapy, what is a common safety concern and a basic monitoring parameter?
• Petrissage refers to which technique?
• Which muscle is NOT part of the Lower Cross Syndrome tight muscle group?
• Mechanoreceptors are activated by which type of stimulus?
• During the fibrosis cycle, connective tissue shrinkage occurs after which stage?
• Lower Cross Syndrome pattern describes which of the following?
• Where are myofibroblasts found?
• Extended-release opioid formulations are primarily used for which purpose?
• Which statements correctly describe the three main categories of pain and their mechanisms?
• Which statement best describes the difference between the elastic and viscous portions of a viscoelastic tissue?
• Ruffini endings are primarily associated with which function?
• What is the WHO analgesic ladder and how is it applied in cancer-related pain management?
• During Weeks 2-4, what occurs in tissue healing?
• Which step directly follows normalization of soft tissue?
• What is true about acetaminophen use in hepatic impairment?
• What is a primary reason to begin PROM during Weeks 2-4?
• What step comes after joint mobilization?
• Which muscle is tight in Upper Cross Syndrome?
• Chemoreceptors respond to which type of stimulus?
• Which are the models proposed for fascia to act as force transmitters?
• What are two key adverse effects of tramadol and in which patient populations should caution be heightened?
• Describe a standard pain assessment approach suitable for adults in a clinical setting.
• Which component of viscoelastic tissue is primarily responsible for creep under sustained load?
• What is the result of connective tissue shrinkage?
• Name two anticonvulsants and two antidepressants commonly used as adjuvant analgesics for neuropathic pain.
• Describe two differences between tramadol and tapentadol.
• Pacinian corpuscles are sensitive to which stimulus?
• Which mechanism describes how duloxetine and amitriptyline work as adjuvant analgesics for neuropathic pain?
• Thermal receptors are activated by which stimulus?
• What is opioid-induced constipation (OIC), and why is it a critical consideration in chronic opioid therapy?
• Traegering is categorized as which type of technique?
• Which CNS depressants commonly interact with opioids to increase respiratory depression risk, and what is the recommended approach?