OCS OCS Pharmacology & Pain Management 1 — Questions and Answers
Question 1: NSAIDs reduce pain and inflammation primarily by inhibiting which enzyme?
- Cyclooxygenase (COX) (Correct answer)
- Lipoxygenase (LOX)
- Phospholipase A2
- Hyaluronidase
Correct answer: Cyclooxygenase (COX)
NSAIDs inhibit cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis and thereby decreasing inflammation, pain, and fever.
Question 2: Which category of medication is most commonly injected into joints (intra-articular injection) to reduce inflammation in orthopedic conditions such as knee osteoarthritis?
- Corticosteroids (Correct answer)
- Opioids
- Muscle relaxants
- Bisphosphonates
Correct answer: Corticosteroids
Corticosteroids such as triamcinolone or methylprednisolone are injected intra-articularly to reduce synovial inflammation in conditions like knee osteoarthritis.
Question 3: A patient taking long-term corticosteroids presents for physical therapy; which musculoskeletal side effect should the OCS be most vigilant about?
- Osteoporosis and increased fracture risk (Correct answer)
- Muscle hypertrophy
- Ligament laxity alone
- Increased bone density
Correct answer: Osteoporosis and increased fracture risk
Long-term corticosteroid use suppresses osteoblast activity and increases osteoclast activity, leading to osteoporosis and significantly elevated fracture risk.
Question 4: The gate control theory of pain proposes that non-painful sensory input can inhibit pain transmission at the spinal cord level; which treatment modality most directly applies this mechanism?
- Transcutaneous electrical nerve stimulation (TENS) (Correct answer)
- Ultrasound
- Iontophoresis
- Cryotherapy
Correct answer: Transcutaneous electrical nerve stimulation (TENS)
TENS activates large-diameter Aβ fibers that inhibit pain signal transmission from small-diameter C and Aδ fibers at the dorsal horn, consistent with gate control theory.
Question 5: Central sensitization in chronic musculoskeletal pain is best described as:
- Amplified pain processing within the central nervous system independent of peripheral input (Correct answer)
- Increased peripheral nociceptor sensitivity at the injury site
- Purely psychological amplification of pain
- Damage to inhibitory interneurons at the dorsal horn only
Correct answer: Amplified pain processing within the central nervous system independent of peripheral input
Central sensitization involves amplified, persistent pain processing in the CNS characterized by allodynia, hyperalgesia, and wind-up that is disproportionate to peripheral tissue damage.
Question 6: Which assessment tool is most commonly used by OCS practitioners to screen for central sensitization features in chronic pain patients?
- Central Sensitization Inventory (CSI) (Correct answer)
- Visual Analog Scale (VAS)
- Numeric Pain Rating Scale (NPRS)
- McGill Pain Questionnaire short form
Correct answer: Central Sensitization Inventory (CSI)
The Central Sensitization Inventory (CSI) is a validated 25-item self-report questionnaire specifically designed to identify symptoms associated with central sensitization.
OCS OCS Pharmacology & Pain Management 1
NSAIDs reduce pain and inflammation primarily by inhibiting which enzyme?