The term “fourth vital sign” refers to:
temperature
pulse
respiration
pain
Aversive sensory and emotional experience that elicits protective motor actions, results in learned avoidance, and may modify species-specific behavior traits, including social behavior, is best known as:
modulation
distress
nociception
Known as “ouch” pain, which of the following protective sensations of pain occurs when there is a possibility of or actual tissue injury?
physiologic pain
adaptive pain
pathologic pain
Chemical mediators, such as prostaglandin and histamine, are responsible for:
inflammatory pain
neuropathic pain
idiopathic pain
Pain originating from the musculoskeletal system is best described as:
visceral pain
somatic pain
chronic pain
A common class of drugs utilized to treat and target specific receptors in the pain pathway includes:
antibiotics.
antihistamines.
nonsteroidal antiinflammatory drugs.
anthelmintics.
The concept of utilization of pain management therapies to target two or more receptors is:
primary hyperalgesia.
mediators.
secondary hyperalgesia
multimodal therapy.
Of the following, which is not typically associated with neuroendocrine changes that occur in response to pain?
Release of ACTH
Increased norepinephrine
Increased insulin
Adrenocorticotropic hormone release
The use of preemptive analgesia is likely to:
cause anthropomorphization.
prevent “windup.”
include the “five freedoms.”
lead to increased morbidity and/or mortality.
The differentiating factor(s) between emergence delirium and pain is(are):
duration and response to sedation.
response to analgesic administration.
response to analgesic administration and pain.
response to analgesic administration and duration.
Patients that are suffering from pain are likely to experience noticeable alterations in their:
facial expressions, appearance, and attitude.
facial expressions, appearance, and sleep patterns.
bodily movements, appearance, and attitude.
bodily movements, sleep patterns, and attitude.
Patients that have undergone major surgery should have their pain assessed how frequently?:
Every 60 seconds
Every 2 minutes
Every 60 minutes
At shift changes
Perioperative analgesia is the concurrent use of:
preemptive analgesia and pain assessment.
pain assessment and multimodal therapy.
pharmacologic analgesia therapy and pain assessment.
preemptive analgesia and multimodal therapy.
Of the following, which is not an anticipated benefit of multimodal analgesic therapy?
Increased individual drug dose
Decreased overall anesthetic drug requirements
Increased healing time
Decreased risk of adverse effects
Opioid agonist drugs act in which of the following ways?
Peripherally: in the spinal cord and joints
Centrally: to inhibit perception in the brain and sensitization in the spinal cord
Centrally: to increase perception in the brain and spinal cord
Peripherally: in the brain and spinal cord on the opioid receptors
A patient requires the selection of an opioid with the most potent analgesic effects. Which of the following would most accurately fit this criteria?
Partial mu agonists
Agonist–antagonists
Antihistamines
Mu receptor agonists
Caution should be taken with rapid intravenous injection of morphine in canine patients due to the potential for:
histamine release.
locomotor activity.
dysphoria.
restlessness.
The most common adverse side effect secondary to morphine administration is likely to be:
gastrointestinal upset.
respiratory depression.
excitement.
This paradoxical response in canine patients after the administration of oxymorphone can make which of the following procedures difficult?
Blood pressure analysis
Intravenous catheter placement
Thoracic radiography
Application of a CRI
The drug that is most similar to oxymorphone in duration and effect is:
morphine.
buprenorphine.
butorphanol.
hydromorphone.
Of the synthetic opioids, which is known to also act as an antagonist at the NMDA receptor?
Methadone
Hydromorphone
Oxymorphone
Fentanyl
In contrast to other pure opioid agonists, the duration of action achieved with intravenous fentanyl administration is:
20 to 30 seconds
2 to 3 minutes.
20 to 30 minutes.
2 to 3 hours.
The synthetic opioid pethidine is also more commonly known as:
meperidine.
ketoprofen.
acepromazine.
Due to the pH of the feline mucosa, which injectable narcotic can be administered orally for analgesia?
Morphine
Buprenorphine
General duration of action for buprenorphine following intramuscular injection is thought to be:
6 to 12 hours.
60 to 120 minutes.
60 to 120 seconds.
18 to 24 hours.
The first use of butorphanol in veterinary medicine was to act as a(n):
antihistamine.
cough suppressant.
anesthetic.
analgesic.
Use of butorphanol in which of the following routes can potentially lead to a toxicity?
IV
IM
SQ
Epidural
Butorphanol can be used as an antagonist to partially reverse respiratory depression/sedation secondary to the use of:
kappa antagonist opioids.
mu antagonist opioids.
kappa agonist opioids.
mu agonist opioids.
In the United States, which of the following is the only injectable opioid that is not classified as a controlled drug?
Acepromazine
Nalbuphine
Meperidine
Patients considered “high risk” for use with opioids include all of the following except:
hypotension.
hepatic disease.
neurologic disorders.
normovolemic.
The use of morphine administered through an epidural route is most likely to illicit which adverse effect?
Urine retention
Sedation
Excitement
Respiratory depression
When considering transdermal use of fentanyl in feline patients, application should take place at least how many hours prior to the start of the procedure?
1 hour
4 hours
6 hours
12 hours
Which opioid should not be administered concurrently with the use of transdermal fentanyl due to risk of partial blockage of opioid receptors and reduced analgesic effect?
The NSAID that acts as a potent analgesic for both somatic and visceral pain is:
carprofen.
acetylsalicylic acid.
tramadol.
Clinical effects of NSAIDs are due to their inhibition of what chemical synthesis within the body?
ACTH
Insulin
Prostaglandin
Acetaminophen
Which of the following systems is not responsible for the elimination and metabolism of NSAIDs?
Hepatic
Renal
Biliary
Lymph
Most NSAIDs prevent pain and inflammation by inactivating which enzyme?
EPO
ACE
COX
T4
All of the following aspects about the COX-2 isoenzyme are true except:
it is inducible.
it is found in the CNS, kidney, and eyes.
it is linked to analgesic effects.
it is present in most tissues.
The use of NSAIDs that results in renal toxicity is most likely due to the blockage of:
PGE-2
COX-1
COX-2
misoprostol
The use of NSAIDs is considered “high risk” in all of the following conditions except:
hyperthyroidism.
congestive heart failure.
hemostatic disorders.
Opioids are effective in the nociceptive pathway in all areas except:
perception.
modulation.
transmission.
transduction.
Local anesthetics are effective in the nociceptive pathway in all areas except:
perception
transmission
transduction
Corticosteroids are ineffective in the nociceptive pathway in all areas except:
In order to properly administer tramadol it must be given:
PO
Absence of pain sensation is best known as:
allodynia.
distress.
analgesia.
stress
During nociception all of the following occurs except:
conjugation
The concurrent use of NSAIDs and corticosteroids is contraindicated due to which adverse side effect?
Gastric ulceration
Coagulopathy
Renal insufficiency
Hepatic insufficiency
Nonpharmacologic analgesic therapies that can be used to manage both acute and chronic pain include:
massage therapy.
topical anesthetics.
NSAIDs.
NMDA agonists.
Perception of pain takes place in the:
spinal cord.
cerebral cortex.
sensory nerves.
nociceptors.
Transmission of pain takes place in the:
Modulation of pain takes place in the: