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VTNE Practice 3
VTNE Pain Management and Analgesia
| Question | Answer |
|---|---|
| Which pain scale should be used? | It is important to choose one system to be used by the entire veterinary team |
| Of the veterinary approved alpha-2 agonists, which one produces the most side effects because of its affinity for the alpha-1 receptor as well as the alpha-2 receptor? | Xylazine |
| What is another term for an analgesic plan that involves combining different drug classes acting on different pain pathways? | Multimodal analgesia |
| What is the function of myelin? | To increase the rate of nerve impulse transmission |
| How much of a drug that is absorbed and reaches systemic circulation is termed ___________: | Bioavailability |
| What analgesic tool can be used to provide ≅72 hours of continuous analgesia for large incisions such as radical mastectomies? | Wound diffusion catheter |
| In chiropractic practice, what is the role of the veterinary technician? | Takes the preliminary history, conducts the initial examination, and Pain Assessment |
| Which of the following are characteristics of alpha-2 agonists? | Sedation, analgesia, muscle relaxation |
| What block can be performed before surgery of the abdominal cavity? | Incisional block |
| What is thermotherapy useful for? | chronic pain, muscle spasm, and Stretching to enhance collagen extensibility |
| If a tourniquet is used when injecting a local anesthetic intravenously, the block is referred to as the: | Bier's block |
| Epidurals are contraindicated in which of the following patients? | Patients with a coagulation disorder such as von Willebrand's |
| Which bones serve as a landmark for an intercostal block? | Ribs |
| Which of the following is a local block used for onychectomy procedures? | Circumferential ring block |
| Which of the following statements regarding pain assessment in dogs is true? | Multidimensional pain scales yield better interobserver agreement than unidimensional pain scales. |
| Which of the following words correctly identifies the tendency of a drug to combine with its intended receptor? | Affinity |
| What type of pain can be felt because of damage to internal organs? | Visceral pain |
| What side effect of alpha-2 agonists would warrant their cautious use in diabetic patients? | Hyperglycemia |
| Newer NSAIDs that are COX selective have fewer side effects because they only block which isoenzyme? | COX-2 |
| The "gold standard" to assess pain is: | There is none |
| What drug class should be avoided when a patient is on NSAIDs because of the likelihood of adverse GI effects occurring from concurrent administration? | Corticosteroids |
| What is the minimal stimulus required to elicit a transmittable electrical signal from a peripheral sensory receptor? | Threshold |
| A mental nerve block provides analgesia to the: | Lower lip and incisors on the ipsilateral side |
| In cats, aquatic therapy is contraindicated for: | Cardiac dysfunction |
| Which of the following is a risk associated with improperly placed retrobulbar nerve blocks? | Hemorrhage, Perforation of the globe, Damage to the optic nerve |
| What inhibits the aggrecanase enzymes responsible for cartilage degradation in cats? | Docosahexaenoic acid (DHA) |
| Which of the following clinical signs might a cow in pain exhibit? | Dull and depressed, Inappetant and grinding teeth, A stance with one foot behind the other |
| Which of the following drugs is commonly used in the postoperative period for its combined effects of analgesia and sedation? | Dexmedetomidine |
| Which of the following describes a myofascial trigger point? | A painful area of sustained muscle contraction that cannot easily self-release |
| Which of the following opioids is most commonly used for epidural analgesia? | Morphine |
| The primary benefit of cryokinetics is to: | Aid the patient's ability to perform pain-free, low-level exercise |
| What pain scoring systems are available for horses? | Obel Laminitis Pain Scale, AAEP lameness grade definition, Horse Grimace Scale |
| Which of the following drugs classes has been shown to be the most efficacious in the management of neuropathic pain? | NMDA receptor antagonists |
| Which of the following terms is used to describe the injection of a local anesthetic into the area around a peripheral nerve to block sensory and/or motor function? | Regional anesthesia |
| The Colorado State University Veterinary Medical Center Acute Pain Scale uses which of the following options as an indication of pain? | Artistic renderings of animals at various levels of pain |
| What nerve fibers are responsible for conducting harmless signals that provide information such as touch, pressure, vibration, and movement? | A-beta fibers |
| Goats are intolerant of painful procedures. How do sheep react to a painful procedure? | They show subtle signs of pain |
| Which of the following is a representation of how a drug can be eliminated from the body? | Urine excretion |
| Which of the following neurotransmitters plays a role in the process of pain perception as well as in the vomiting reflex? | Substance P |
| Which of the following describes "wind-up"? | The perceived increase in pain intensity with time when a given painful stimulus is delivered repeatedly in excess of a critical rate |
| Ketamine administration would be contraindicated in which of the following disease processes? | Hypertrophic cardiomyopathy, Congestive heart failure, and Unstable shock patients |
| Which of the following is not one of the 3 primary factors included in a quality-of-life scale? | Interpersonal factors |
| An example of an agent that is only administered topically and provides analgesia is: | EMLA cream |
| The Glasgow Composite Pain Scale is based on specific behavioral signs in which of the following species? | Canine |
| When a patient is switching from one NSAID to another, what is the best course of action? | The patient should experience a "washout" period of 3–5 days to minimize the risk of concurrent side effects |
| Which of the following methods is considered the least suitable choice for anesthetic induction in the canine and feline patient? | Chamber induction with isoflurane |
| Which of the following opioids is least likely to cause vomiting in cats? | Methadone |
| Which of the following take-home medications should be reserved for canine patients only? | Tylenol with codeine |
| Cats with chronic cystitis are often in pain. Which of the following drugs has been shown to provide relief of pain associated with chronic cystitis? | Amitriptyline |
| What area of the cerebrum is responsible for the higher processing and awareness of pain? | Somatosensory cortex |
| Which guidelines have elevated pain to the fourth vital sign? | AAHA/AAFP Pain Management Guidelines for Dogs and Cats |
| Side effects of NSAIDs most commonly affect what major organ system? | The gastrointestinal tract |
| Of the inhalant anesthetics, which is the only one thought to have analgesic properties? | Nitrous oxide |
| Which of the following time frames describes chronic pain? | Pain that is prolonged (days, weeks, months) |
| When should therapeutic ultrasound not be used? | When the patient's area of interest has plastic or metal implants |
| In what types of procedures would a wound diffusion catheter with local anesthetic be useful? | limb amputations, total ear canal ablations, or radical mastectomies |
| During hospitalization, how often should a pain assessment be performed? | Every 4 - 6 hours |
| Abnormal behavioral signs that could indicate pain in fish could include: | Anorexia, rapid opercular movements, clamped fins |
| How do nonsteroidal anti-inflammatory drugs exert their analgesic activity? | Inhibition of the enzyme cyclooxygenase (COX). |
| A traumatic cause of OA in dogs includes obesity as a risk factor. What is the most common traumatic cause of OA in dogs? | Ruptured cruciate ligaments |
| What is the name of the drug used to reverse the alpha-2 agonist dexmedetomidine? | Atipamezole |
| The preemptive scoring system is a: | Subjective scoring system |
| For what is EMLA cream most commonly used in veterinary medicine? | As a topical anesthetic to facilitate IV catheter placement |
| Gabapentin has proven useful for patients experiencing osteoarthritis pain, especially when used in combination with what other drug class? | NSAIDs |
| Many veterinary technicians are asked to calculate and administer constant rate infusions, as patients can benefit immensely. What are the benefits of a CRI? | CRIs provide a more stable plane of analgesia with less incidence of breakthrough pain, provide greater control over drug administration, and allow a lower dose of drug to be delivered at any given time |
| Which of the following NSAIDs has been proven effective in felines as an analgesic on the lower urinary tract associated with cystitis and urethritis? | Piroxicam |
| What is a benefit of using local anesthetics? | These drugs are nonscheduled agents, produce true analgesia resulting in the complete absence of pain for the duration of the block, and Long term (chronic) pain states may be diminished or eliminated |
| What are examples of active range of motion exercise? | Aquatic therapy, climbing stairs, and Walking in snow or sand |
| What type of pain can develop from damage to the peripheral nervous system? | Somatic pain |
| Which term describes the ability of neurons to change their structure and function in response to different environmental stimuli? | Neuroplasticity |
| What would be the most appropriate choice of opioid for preemptive analgesia for a patient undergoing surgery for OVH as a treatment for pyometra? | Hydromorphone |
| What are the routes of administration commonly used for alpha-2 agonists? | Transmucosal, Subcutaneous, and Intramuscular |
| Which of the following can be used to reverse all opioid agonist effects at all receptors? | Naloxone hydrochloride |
| What arrhythmias can be seen after administration of an alpha-2 agonist? | Ventricular bradycardia, Sinus bradycardia, and First- and second-degree AV block |
| Which NSAID is labeled for use in horses and cattle, but has extra label uses in other species? | Flunixin meglumine |
| What is one strategy the veterinary clinic can use to help decrease a patient's likelihood of developing central sensitization and all of the negative aspects associated with it? | Provide preemptive analgesia |
| What determines the potency and speed of onset of local anesthetics? | The lipid solubility of the drug |
| Why are the differences in expression among dogs and cats of all ages, and variations among certain breeds, important for pain assessment? | Certain breeds vocalize and appear more sensitive to pain whereas others seem to remain stoic in the face of pain |
| A contraindication for transcutaneous electrical nerve stimulation (TENS) includes: | Animals with pacemakers |
| Which of the following mu agonist opioids also has additional affinity for the NMDA receptor making it potentially useful for neuropathic pain? | Methadone |
| Pain arising from the skin and muscles is known as ________________. | Neuropathic pain |
| What kind of scale is a visual analog scale (VAS)? | Subjective |
| Extracorporeal shock wave treatment (ESWT) could be indicated for: | Osteoarthritis |
| A drug termed an antagonist has which characteristics? | Affinity present but no efficacy |
| Which of the following drugs has been useful in not only reducing opioid-related nausea and vomiting, but also in reducing the MAC of anesthetic gases needed when given preoperatively? | Maropitant |
| Which of the following is an NMDA antagonist medication? | Ketamine |
| Which of the following analgesic adjuncts is commonly applied topically? | Capsaicin |
| Which of the following terms describes the changing, inhibiting, or amplifying of an impulse within the spinal cord? | Modulation |
| Opioid agonist-antagonist drugs such as butorphanol and nalbuphine exert mild analgesic activity by stimulating which receptor? | Kappa |
| How painful is abscess drainage? | Mild |
| What modalities does thermotherapy encompass? | Heat and cold therapy |
| Prostaglandins play an important role in: | Mammalian renal physiology |
| Which of the following characteristics do cats exhibit when they are experiencing pain? | Resentment of being handled, aggression, and abnormal posture |
| Nociception is defined as: | The activity in the peripheral pathway that transmits and processes information about the stimulus to the brain |
| Which of the following opioid drugs is commonly administered via a transdermal patch? | Fentanyl |
| Which of the following drugs is not considered a local anesthetic? Bupivicaine, Lidocaine, Meperidine, Mepivicaine | Meperidine |
| It is sometimes difficult to distinguish normal from pain-associated behaviors in cats and dogs. Which of the following behaviors is most likely to be a normal, nonpainful behavior? | Stretching all four legs when the abdomen is touched |
| What type of needle is recommended for an epidural catheter? | Tuohy-type |
| Which of the following opioids is the best choice of analgesic for an ER patient for whom vomiting and/or abdominal contractions are contraindicated? | Methadone |
| Visceral pain is quite common among companion animals. Which of the following is not an example of visceral pain? Pancreatitis, Gastroenteritis, Bowel ischemia, Osteosarcoma | Osteosarcoma |
| When should low-level laser therapy not be used? | Over areas of malignancy or cancer |
| Veterinary technicians that advocate for pain management are most closely compared to what group of nurses? | Human neonatal and pediatric nurses |
| Benefits of massage include which of the following? | Decreased muscle spasms and increased local blood and lymphatic flow |
| What substance normally blocks the NMDA receptor so that it cannot allow ions to pass freely and generate an impulse? | Magnesium |
Created by:
Smgregory235
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