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Neuropathic Pain Multiple Choice Questions

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Regarding the use of Lidocaine plasters in neuropathic pain: a) Ma ximum number of plasters to be used at a tim e

is3 b) Licensed indi cation is all neuro pathic pain states including PH N c) Each plaster conta ins 5%w/w Lidocain e total ing 140 mg of drug d) Reduction of peripheral inp ut may co unte ract cent ral scnsirizarion e) In mild to mode rate carpal TUn nel synd rome, th e efficacy oflidocaine plasrer is comparable to local an aesth et ic/corticos te roid injectio ns.

Current Concepts in adult CRPS MOT( Ih'/1I onr ,IIIJII'rr m,,} I" (O"rrt. Srlrcl ,II!,h,lI "PP(~,

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In the Uk, for every 100.000 population, the number of people with CRPS is estimated at ap proxi mately: a) 0.5

b) 5 c) 30

d) 60 {x correct] c) 150

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Sweating Hypoaesthesla (x not correct ) Allodynia Hype ralgesia Tremo r

The following treatments for CRPS have been assessed in randomized controlled trials

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b) Intravenous high-dos e ketamlnc (x not co rrect) c) Steroids

d) Bisphosphonates e) Intravenous low-dose keramine

The following mechanisms have been proposed as important in the CRPS pathophysiology (please m ark correct answers) a) h) c) d) e)

Autonomic dysregulation Inflammation Limb ischaemia Autoimmunity Genetics

Local Treatments for Localised Neuropathic Pain MOT( Ih'l1I oneanswer /!J1l} (0"«1 . &1«1 ,til ,hilI ,tpp(~.

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The following systemic agents are also used in topical form for the management of neuropathic pain: a) Gabapt:lltin h) Amirripryline

c) Clonidine d) Baclofcn e) Kctaminc

Regarding PENS therapy: a) PEN S is co ntrai ndica ted in patient s with pacemckers. b) PENS treat men t like im planted neurosrlmularo rs are unsafe in pat ients havin g MRI scans. c) Project io n of A~ fibres into t he lamina 1-2 can cau se hyperalg esia and allod ynl a. d) PENS cannot be used for direct peripheral nerve srirnularion. e) Th e predominant experience with PENS is in po stop erative scar pain.

a) Tadalafi l

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8% Capsaicin patch in neuropathic pain: a) Acts on cu tane o us T RPVI noc ice prors by en han ced stimulatio n, followed by reduction in th eir nu mb ers. h) Can cause system ic side-effect s like hypertens io n and nasopharyngit is. c) Licensed fo r all neu ro path ic pa in including H IV neuropathy and painful d iabetic neurop athy, d) Th e m inimum du ration between pat ch applicatio ns is 3 mont hs e) Panc nrs need preuearml'lJ[ with EMIA prior to C apsaicin patch app licatio n.

The following limb signs count towards the diagnosis of CRPS according to the ' Bud ap est' diagnostic criteria a) b) c) d) e)

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The following statements regarding Radiofrequency Ablation are: a) The re are mechanisms involving descendin g noradrenergic and seroto nin pathways in the mechanism that pro duces anal gesia b) Co nvent io nal RF lesions can cause disru ption of myelin Sheath, thus modifyin g ncurocellular funct ion rather than just the rmal damage. c) Microvascular deco mpression is the t reatm en t of choice for tr igeminal neuralgia in the elderly. d) Co nvent io nal RF is more effect ive than pul sed RF in the ma nagement of trigemin al neuralgia. e) The re is modetate evidence for facet joint neurotomy using radiofrequency techn iques.

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Recent developments in neuropathic pain mechanisms: implications for treatment

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,'.lufr thlm onr III/S/(1(1' ""~Y rorrat . St'ltrt 111/thttt lI!'p(r.

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a) "lhe numb er of patient s nea rly treated for pain relief b) The nu mber of patie nts needed to be nea red befo re o ne patient ach ieves 50% pain relief. c) The numbers of patients needed to be t reated to ob ta in a pos itive analgesic o utcome d) The n um bers nec essary fo r treat me nt in clinical trials c) 1 he n um ber of pat ients needed [Q be [fea red befo re o ne patient ac hieves full analgesia

What is the definidon of neuropathic pain? a) Pain d ue [Q dysfunction of the nervo us sysrem b) Pain of musculoskeletal o rigin c) Pain arising as a di rect conse q unce neuro logical and lo r psycho logical disturbances d) Pain arising as a dir ect cons(:quence of a lesio n o r disease affecting the som atose nsory system e) Pain arising as a direct conse qu nce of visceromotor lesion o r disease

Wh at is ectopic nerve activity? a) The spo m anoous generarion of neural activity i.e. the gene rat io n of action potentials in the absence of a stimu lus b) The elcctrogeneric propert ies of nerve mem branes c) The excitatory respon se of nerves to sensory sti mulation d) The spo nraneous gene ration of noc icepro rs O il nerve endings e) The extrac ellular mechanisms o f nociceptor trafficking in pr imary affcrenrs

What is the de6nition ofNNf in terms of analgesic efficacy?

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Which voltage gated sodium channel's role in pain sign aling has been validated from human genetic studies? a) b) c) d) e)

Voltage gated Voltage gated Voltage gated Voltage gated Voltage gated

sod ium sod ium sod iu m sod iu m sodium

chan nel chan nel channel chan nel chan nel

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1.9 1.7 1.8 1.5

Neuropathic Pain Multiple Choice Questions.

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