NCS Pain Management in Neurology 3

Question 1

A patient with trigeminal neuralgia fails carbamazepine. Which second-line medication is most appropriate?

Accepted Answer

Oxcarbazepine

Answer

Amitriptyline

Answer

Gabapentin as monotherapy

Answer

Tramadol

Question 2

Which quantitative sensory testing (QST) finding is most characteristic of small-fiber neuropathy causing neuropathic pain?

Accepted Answer

Elevated cold detection threshold and impaired heat pain threshold

Answer

Elevated vibration detection threshold

Answer

Abnormal two-point discrimination

Answer

Reduced nerve conduction velocity

Question 3

A 55-year-old develops post-herpetic neuralgia. Which topical agent is FDA-approved as first-line for localized neuropathic pain?

Accepted Answer

Lidocaine 5% patch

Answer

Topical diclofenac gel

Answer

Topical ketamine cream

Answer

Topical baclofen

Question 4

The pain of central post-stroke syndrome (CPSP) most commonly follows infarction involving which brain region?

Accepted Answer

Thalamus (especially VPL nucleus)

Answer

Frontal lobe

Answer

Basal ganglia

Answer

Cerebellum

Question 5

Which intervention is considered when spinal cord stimulation (SCS) is indicated for failed back surgery syndrome?

Accepted Answer

Electrode placement covering the thoracic cord at T8-T10

Answer

Electrode placement at cervical C2 level

Answer

Intrathecal baclofen pump

Answer

Stereotactic radiosurgery

Question 6

Which pain assessment tool is most validated for use in patients with moderate-to-severe cognitive impairment who cannot self-report?

Accepted Answer

Pain Assessment in Advanced Dementia (PAINAD)

Answer

Numeric Rating Scale (NRS)

Answer

Visual Analog Scale (VAS)

Answer

McGill Pain Questionnaire

Question 7

A patient with fibromyalgia has failed multiple pharmacological treatments. Which non-pharmacological intervention has the strongest evidence base for fibromyalgia?

Accepted Answer

Aerobic exercise

Answer

Transcranial magnetic stimulation (TMS)

Answer

Opioid rotation

Answer

Spinal cord stimulation