Domain 9: Pain Management

Pregunta	Respuesta
Kayla Velasquez #7 pg. 329: What is the correct sequence of steps to the pain pathway? A. Transduction, transmission, modulation, perception B. Modulation, transduction, perception, transmission C. Transduction, modulation, transmission, perception D. Transmission, transduction, modulation, perception	A. Transduction, transmission, modulation, perception
Kayla Velasquez #19 pg. 330: Visceral pain is quite common among companion animals. Which of the following is not an example of visceral pain? A. Pancreatitis B. Gastroenteritis C. Bowel ischemia D. Osteosarcoma	D. Osteosarcoma
Kayla Velasquez #29 pg. 331: Which of the following is the most common sign of osteoarthritic pain in cats? A. Hiding from company B. Eating fewer meals C. Reduced frequency of jumping up to high places D. Sleeping all day	C. Reduced frequency of jumping up to high places
Priscilla Angeles #250 pg. 346 Which of the following opioids would be the best choice for ER patients who have experienced some sort or head trauma and may need serial neurological exams? a. Morphine b. Methadone c. Fentanyl d. Remifentanil	d. Remifentanil
Priscilla Angeles #257 pg. 346 Which of the following neurotransmitters plays a role in the process of pain perception as well as in the vomiting reflex? a. Substance P b. TrpV1 c. Epinephrine d. Norepinephrine	a. Substance P
Kelly Wieghmink #91 (pg 335) What pain scoring systems are available for horses? a. Obel Laminitis Pain Scale b. AAEP lameness grade definition c. Horse Grimace Scale d. All of the above	d. All of the above http://www.vetfolio.com/anesthesia/equine-essentials-understanding-the-equine-pain-score https://aaep.org/horsehealth/lameness-exams-evaluating-lame-horse http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0092281 As each of these websites clearly demonstrates one pain scale isn’t enough for determining the true level of pain an animal is experiencing in every situation. Since horses cannot describe their level of pain it is better to have multiple references and tactics for determining their pain level so a correct response can be taken.
Kelly Wieghmink #105 (pg 336) What type of needle is recommended for an epidural catheter? a. Tuohy-type b. Butterfly catheter needle c. 16-gauage IV catheter needle d. Auto-vac needle	a. Tuohy-type https://www.cliniciansbrief.com/column/procedures-pro/epidural-injection-catheter-placement Tuohy-type needles have a curved tip which allows the technician to control the direction of the catheter as it is moved through the needle.
Malissa Parr #47 pg. 333 If a tourniquet is used when injecting a local anesthetic intravenously, the block is referred to as the: a. Baer's block b. Bayer's block c. Byer's block d. Bier's block	d. Bier's block https://accessanesthesiology.mhmedical.com/content.aspx?bookid=413&sectionid=39828193
Malissa Parr #121 pg. 337 A traumatic cause of OA in dogs includes obesity as a risk factor. What is the most common traumatic cause of OA in dogs? a. Ruptured cruciate ligaments b. Torn Achilles group c. Hip dysplasia d. Phalangeal fracture	a. Ruptured cruciate ligaments https://www.acvs.org/small-animal/osteoarthritis-in-dogs
Alyson Zillner #18, pg. 330 Which of the following describes a myofasical trigger point? A. A point in the muscle at which a reflex can be elicited B. A transcutaneous electrical nerve stimulation C. A painful area of sustained muscle contraction that cannot easily self-release D. A technique where needles are used to pierce the skin at certain points to bring about a physiologic change to treat or prevent disease	C. A painful area of sustained muscle contraction that cannot easily self-release Prendergast, Heather, Review Questions and Answers for Veterinary Technicians, 5th edition
Alyson Zillner #43, pg. 332 In the Pain Buster Soaker catheter, the local anesthetic is delivered by: A. Elastomeric reservoir pump B. CRI C. Syringe pump IV infusion	A. Elastomeric reservoir pump http://veterinarymedicine.dvm360.com/local-and-regional-anesthesia-techniques-part-1-overview-and-five-simple-techniques?id=&sk=&date=&pageID=6
Alyson Zillner #67, pg. 334 Transcutaneous electrical nerve stimulation is a form of: A. LLLT B. NEMS C. EEG D. EMG	B. NEMS Prendergast, Heather, Review Questions and Answers for Veterinary Technicians, 5th edition
Danya Yarce 40. Which of the following is not one of the 3 primary factors included in a quality-of-life scale? A. Social factors B. Interpersonal factors C. Physical factors D. Behavioral factors	B. Interpersonal factors (Review questions and answers for veterinary technicians pg. 379)
49. Which of the following statements is not true regarding acupuncture? A. The points and channels of acupuncture follow neurovascular pathways B. Acupuncture treats pain by inducing neuromodulation along peripheral, central, and autonomic pathways C. Acupuncture treatments can involve: needling, electroacupuncture, low-level laser, and manual pressure D. Acupuncture relies on nonspecific identification of the structures responsible for generating pain	D. Acupuncture relies on nonspecific identification of the structures responsible for generating pain (Review questions and answers for veterinary technicians pg. 379)
Danya Yarce 101. What are the advantages of an interpleural block over the intercostal block? A. Ability to redose easily B. Ease of administration C. Ability to provide analgesia following median sternotomy D. All of the above	D. All of the above (Review questions and answers for veterinary technicians pg. 379)
Kimara Kavanagh #53 pg. 333 Herbs used for COX inhibition do NOT include: a. ginger b. devils claw c. capsaicin d. white willow bark	c. capsaicin Capsaicin is a TRPV1 antagonist and is therefore not used for COX inhibition. Ginger, devils claw, and white willow bark are used for COX inhibition. (Resources - Prendergast: Evolve Resources for Review Questions and Answers for Veterinary Technicians, 5th Edition)
Kimara Kavanagh #141 pg. 339 Where do the peripheral nerve fibers A-delta and C fibers terminate? a. the brain b. the hypothalamus c. the skin d. the dorsal horn of the spinal cord	d. the dorsal horn of the spinal cord Dr. G: The long answer is usually the correct answer, from the 2nd Zoom meeting. The A-delta and C nerve fibers can start in the skin, but they terminate in the dorsal horn of the spinal cord. Excitatory neurotransmitters must be used for the signal to jump from the dorsal horn of the spinal cord to the brain. The hypothalamus is part of the brain. (Resources - Prendergast: Evolve Resources for Review Questions and Answers for Veterinary Technicians, 5th Edition)
Kimara Kavanagh #258 pg. 347 Which of the following analgesic adjuncts works to block NK-1 receptors and subsequent activation of substance P? a. gabapentin b. amantadine c. maropitant d. bisphosphonates	c. maropitant (Cerenia) "The biological effects of substance P in the CNS, namely regulation of affective behavior and emesis in the brain and nociception in the spinal cord, are mediated by its binding to the NK1 receptor" (https://www.ncbi.nlm.nih.gov/pubmed/12562137). Maropitant is an NK-1 receptor antagonist and it works to block NK-1 receptors and subsequent activation of substance P. Bisphosphonates are the drug class used for patients with osteosarcoma, which acts by preventing loss of bone mass. Gabapentin and amantadine both function to suppress neuropathic pain and to prevent the wind-up phenomenon that leads to central sensitization and allodynia. (Resources - Prendergast: Evolve Resources for Review Questions and Answers for Veterinary Technicians, 5th Edition)
Michelle Cashpal #8 p 329 Which of the following describes "wind up"? a. An increase in the excitability of spinal neurons, mediated in part by the activation of NMDA receptors in dorsal horn neurons. b. it occurs when tissue inflammation leads to the release of a complex array of chemical mediators, resulting in reduced nociceptor thresholds. c. When brief trauma or noxious stimulus result in physiological pain. d. The perceived increase in pain intensity with time when a given painful stimulus is delivered repeatedly in excess of a critical rate.	d. The perceived increase in pain intensity with time when a given painful stimulus is delivered repeatedly in excess of a critical rate Wind up is when the neurons of the spinothalamic tract of the spinal cord are stimulated repeatedly, they apparently become sensitized and discharge at a much lower threshold. Applied Pharmacology for Veterinary Technicians. Boyce P. Wanamaker 5th ed. p 301
Michelle Cashpal #39 p 332 The Colorado State University Veterinary Medical Center Acute Pain Scale uses which of the following options as an indication of pain? a. Number scale b. Recorded sounds c. Artistic renderings of animals at various levels of pain d. Happy to sad faces	c. artistic renderings of animals at various levels of pain The Colorado State University Veterinary Medical Center Acute Pain Scale uses numeric, pictorial and descriptive assessments McCurnin's 8th ed. p 1048
Michelle Cashpal #134 p 338 What are the two main nerve fiber types associated with transmitting pain sensation information to the central nervous system? a. A-delta and C-fibers b. A-beta and C-fibers c. A-nociceptors and C nociceptors d. Interleukins and substance P	b. A-delta and C-fibers The two fibers involved in tranmission are type C unmyelinated fibers are responsible for dull, and type A delta fibers responsible for sharp, localized pain Applied Pharmacology for Veterinary Technicians. Boyce P. Wanamaker 5th ed. p 299
Hallie Volman #46 pg. 332 The sciatic nerve block provides analgesia to the: a. Medial portion of the thigh, tibia, and tarsus and akinesia of the quadriceps femoris muscle b. Caudal muscles of the thigh c. Portions distal to the elbow d. Lumbosacral space and the first or second intercoccygeal space	b. caudal muscles of the thigh
Hallie Volman #152 pg 339 Which of the following painful conditions is not an example of chronic pain? a. Osteoarthritis b. Chronic otitis externa c. Incisional pain following castration d. Prolonged cancer treatment	c. Incisional pain following castration
Hallie Volman #254 pg. 347 Which drug class acts by preventing the loss of bone mass by blocking osteoclasts and helping to manage osteosarcoma pain? a. Opioids b. Bisphosphonates c. Gabapentinoids d. Neurokinin-1 inhibitors	b. Bisphosphonates
Jennifer Navarro #5 pg.329 Which guidelines have elevated pain to the fourth vital sign? a. American College of Veterinary Anesthesiologist's Pain Management Guidelines b. The international Veterinary Academy of Pain Management's Guidelines c. AAHA/AAFP Pain Management Guidelines for Dogs and Cats d. The AVMA Pain Management Guidelines	c. AAHA/AAFP Pain Management Guidelines for Dogs and Cats
Jennifer Navarro #58 pg.333 The primary benefit of cryokinetics is to: a. Aid the patient's ability to perform pain-free, low level exercise b. Cool down a body that is overheating c. Allow an athlete to compete at the highest levels with no pain d. Take the place of local anesthetic injections in advance of athletic stress	a. Aid the patient's ability to perform pain-free, low level exercise
Jennifer Navarro #59 pg.333 Cold or white skin after a 20-minutes cryotherapy session may indicate: a. circulation is restored and normal b. Possible cold-induced tissue damage c. The need for external heat creams or rubs d. The need for more melanin in the diet	b. Possible cold-induced tissue damage
Melissa Siauw #159, pg 340: The inflammatory mediator histamine originates where? A. Mast cells B. Damaged tissue C. C-fibers D. a-delta fibers	A. Mast cells https://en.wikipedia.org/wiki/Histamine
Melissa Siauw #215, pg 344: Which of the following does NOT function as NMBA receptor antagonist? A. Ketamine B. Methadone C. Hydromorphone D. Amantidine	C. Hydromorphone While ketamine, methadone, and amantadine function as NMBA antagonists, hydromorphone does not. https://www.uspharmacist.com/article/the-emerging-role-of-nmda-antagonists-in-pain-management
Melissa Siauw #242 pg 346: What is the standard dose of lidocaine that should be administered as a "loading" dose before starting a lidocaine CRI? A. 1mg/kg IV B. 2mg/kg IV C. 0.2mg/kg IV D. No loading dose is needed	B. 2mg/kg https://academic.oup.com/bjaed/article/16/9/292/1743710
Erika Gutierrez #12 pg. 330 Which of the Following classes of drugs would include gabapentin? a. Corticosteroids b.Sodium channel blockers c. Antiepileptics d. Neutraceuticals	c. Antiepileptics https://medlineplus.gov/druginfo/meds/a694007.html
Kylie Morales pg 333 # 56 When should cyrotherapy be applied for best response? a. during acute inflammatory phase of tissue healing b. after exercise to lessen infammatory response c. immediately following surgery d. all of the above	d. all of the above
Kylie Morales pg 334 #71 a. pregnancy b. osteoarthritis c. neoplasms d. heart disease	b. osteoarthritis
Erika Gutierrez #178 pg. 341 Which of the following can be used to reverse all the opioids agonist effects at all receptors? a. Butorphanol b. Naloxone hydrochloride c. Morphine d. Hydromorphone	b. Naloxone hydrochloride
Jennifer McCaleb #57 pg 333 Caution should be used with cryotherapy if a patient has... a. a large percentage of fat b. localized vascular compromise c. areas of previous frostbite d. b and c	d. localized vascular compromise and areas of previous frostbite https://todaysveterinarypractice.com/physical-rehabilitation-for-veterinary-practices/
Jennifer McCaleb # 197 pg 343 What nerve block is commonly used to desensitize nerves and add additional analgesia to an onychectomy procedure a. retrobulbar block b. epidural c. circumferential nerve block d. sacrococcygeal nerve block	c. circumferential nerve block https://ams.aaha.org/eweb/images/AAHAYC2011/pdfs/Local_Blocks.pdf
Ramon Ortiz (pg.330) 17. What is a benefit of cryotherapy? a. Decreased metabolism so patient is less hungry b. Decreased production of pain mediators, leading to analgesia c. Prevention of hyperthermia d. Useful 2–3 weeks post injury	b. Decreased production of pain
Ramon Ortiz (Pg.330) 21. Veterinary technicians that advocate for pain management are most closely compared to what group of nurses? a. Orthopedic nurses b. Psychiatric nurses c. Human neonatal and pediatric nurses d. Emergency and critical care nurses	c. Human neonatal and pediatric nurses
Michelle Antonio #45 pg. 315 The rapid intravenous administration of large amounts of potassium can result in: A. Respiratory arrest B. Cardiac arrest C. Polyuria D. Polydipsia	B. Cardiac arrest
Michelle Antonio #64 pg.316 Which of the following would petechiation on the mucous membranes indicate? A. Hemoglobinemia B. Methemoglobinemia C. Mygoglobemia D. Thrombocytopenia	D. Thrombocytopenia
Michelle Antonio #142 pg. 322 Which toxicity will cause salivation, lacrimation, urination, and defecation? A. Acetaminophen B. Grapes C. Lilies D. Organophosphates	D. Organophosphates
Ariel Campos #32.) In cats, some diseases cause behavioral changes that are often been ascribed to “old age” rather than pain. Examples include all of the following, except: A. Facet pain of spondylosis B. Intervertebral disc disease C. Osteoarthritis D. Basal cell tumor	D. Basal cell tumor Basal cell tumors are relatively common in middle-aged to old cats. https://vcahospitals.com/know-your-pet/skin-basal-cell-tumors
Ariel Campos #48.) An epidural injection in a dog is injected between: A. L7-S1 B. L4-L5 C. L5-L6 D. S1-S2	A.) L7-S1 **Pain Management in Small Animal Medicine, Steven M Fox pg 214
Stephany Tohaza #3 pg. 329 3) During hospitalization, how often should a pain assessment be performed? A. Every 4-6 hours B. Every 30 minutes to 1 hour C. Every 12-24 hours D. Every 8 hours	Answer: A) Every 4-6 hours
Stephany Tohaza #60 pg.333 60) Cryotherapy can include: A. Ice packs B. Cold immersion baths C. Ice massage D. All of the above	Answer: D) All of the above
Shelby Milosch #123 pg. 337 What inhibits the aggrecanase enzyme responsible for cartilage degradation in cats? a. Docosahexaenoic acid (DHA) b. Eicosapentaenoic acid (EPA) c. Arachidonic acid (AA) d. Methionine	Answer: a. Docosahexaenoic acid (DHA) (RQ&A)
Shelby Milosch #145 pg.339 Which of the following answers represents the three zones of gray matter in the spinal cord? a. dorsal horn, ventral horn, intermediate zone b. dorsal horn, ventral horn, lateral horn c. dorsal horn, intermediate zone, central zone d. Ventral horn, lateral horn, white matter	Answer: a. dorsal horn, ventral horn, intermediate zone (RQ&A)
Avery Jemine #34 pg.332 The "gold standard" to assess pain is A. A physiological assessment B. A clinical pathological assessment C. A behavioral assessment D. There is none	D. There is none
Avery Jemine #72 pg.334 Which tool is used to measure passive range of motion in companion animals? A. Calipers B. Slide rule C. Goniometer D. Oliometer	C. Goniometer
Stacey Perlman #201 pg.343 To prolong the duration of action because of vasoconstriction, lidocaine is often available in combination with what other drug? A.Buptivicaine B.Epinephrine C.Atropine D.Dexmedetomidine Answer-B-Epinephrine	Answer-B-Epinephrine Plumb's Veterinary Drug Handbook
Stacey Perlman #232 pg.345 Which of the following opioids is commonly used for epidural analgesia? A.Morphine B.Buprenorphine C.Bupivicaine D.Lidocaine	Answer A-Morphine Plumb's Veterinary Drug Handbook 5th Edition Pg.782
Stacey Perlman #233 pg.345 Which of the following take-home medicines should be reserved for canine patients only? A.Acepromazine B.Tramadol C.Tylendol with Codeine D.Fentanyl Patch e	Answer C-Tylenol with Codeine Plumb's Veterinary Drug Handbook

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