Pain Physiology & Types
Why is chronic pain considered maladaptive rather than protective?
It serves no beneficial purpose and persists beyond tissue healing
What is the most dangerous adverse effect of opioid medications? (ABC)
Respiratory depression
Which disorder causes gradual peripheral vision loss due to increased intraocular pressure?
Open-angle glaucoma
What diagnostic measurement is used to assess glaucoma?
Intraocular pressure (IOP)
What type of hearing loss involves impaired sound transmission in the outer or middle ear?
Conductive hearing loss
Which type of pain is caused by nerve damage and is often poorly responsive to opioids?
Neuropathic pain
Which medication reverses opioid overdose and how does it work?
Naloxone (Narcan); opioid inverse agonist that decreases receptor activity
Which visual disorder presents with sudden eye pain, fixed pupil, and nausea/vomiting?
Angle-closure glaucoma
What is the priority patient education for conjunctivitis?
Strict hand hygiene to prevent spread
What type of hearing loss results from inner ear or nerve damage and is usually permanent?
Sensorineural hearing loss
What is the role of second-order neurons in pain transmission?
Transmit signals from spinal cord to thalamus
Why must patients on opioids receive dietary education?
Risk of constipation → need increased fiber and fluids
What is the pathophysiologic cause of cataracts?
Lens opacity blocking light transmission
Bonus: Tell a good joke for a chance at the points
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What is the pathophysiology of Ménière’s disease (chronic dizziness unrelieved by positional changes)
Excess inner ear fluid causing pressure and vestibular dysfunction
Which nerve fibers transmit fast, sharp, well-localized pain that triggers immediate withdrawal? (Hint: Acute)
A-delta fibers
What is the key difference between an opioid antagonist and an inverse agonist?
Antagonists block receptors; inverse agonists decrease receptor activity
Which disorder causes central vision loss and difficulty recognizing faces?
Macular degeneration
Why is open-angle glaucoma often undiagnosed early?
It is asymptomatic until significant vision loss occurs
What causes benign paroxysmal positional vertigo (BPPV)?
Displaced calcium crystals in the inner ear
Explain why C-fiber–mediated pain is associated with protective behaviors like immobilizationv
It produces slow, dull pain that encourages rest and healing
Why can naloxone precipitate acute withdrawal in opioid-dependent patients?
It rapidly displaces opioids and reverses receptor effects
When an individual is physically dependent on opioids, their nerve cells have adapted to function normally only while opioids are attached to those receptors.
Explain why retinal detachment presents with “flashes, floaters, and a curtain”
Separation of retina disrupts photoreceptors, causing visual disturbances and progressive vision loss
Why does uncontrolled diabetes lead to retinopathy?
Chronic hyperglycemia damages small retinal blood vessels
How can you clinically differentiate Ménière’s disease from BPPV?
Ménière’s = hearing loss + not position-dependent; BPPV = triggered by head movement, no hearing loss