NCS Pain Management in Neurology 2

Question 1

A patient with central sensitization presents with allodynia. Which neuroplastic mechanism best explains this phenomenon?

Accepted Answer

Wind-up and long-term potentiation in dorsal horn neurons

Answer

Wind-up and LTP in dorsal horn neurons lower the activation threshold so normally non-painful stimuli become painful.

Question 2

Which opioid receptor subtype is primarily responsible for supraspinal analgesia?

Accepted Answer

Mu (μ)

Answer

Mu opioid receptors mediate the primary supraspinal analgesic effects and are the main target of most clinical opioids.

Question 3

A patient on long-term opioids requires escalating doses for the same pain relief. Which pharmacological process best describes this?

Accepted Answer

Pharmacodynamic tolerance

Answer

Pharmacodynamic tolerance refers to reduced receptor responsiveness requiring higher doses to achieve the same analgesic effect.

Question 4

The 'gate control theory' of pain proposes that pain transmission is modulated at the level of the:

Accepted Answer

Spinal cord dorsal horn

Answer

The gate control theory posits that large-fiber (Aβ) activity can inhibit pain signal transmission via interneurons in the dorsal horn.

Question 5

Which descending pain modulation pathway utilizes serotonin and norepinephrine as primary neurotransmitters?

Accepted Answer

Dorsolateral funiculus (PAG-RVM system)

Answer

The PAG-RVM-dorsolateral funiculus system uses serotonin and norepinephrine to exert descending inhibitory control over dorsal horn neurons.

(NCS) Neurologic Clinical Specialist Practice Test