PSA Pain Management 1 — Questions and Answers
Question 1: What is the WHO analgesic ladder?
- A stepped approach to pain management: Step 1 (non-opioids), Step 2 (weak opioids), Step 3 (strong opioids) (Correct answer)
- A physical therapy exercise
- A surgical pain treatment
- A single drug protocol
Correct answer: A stepped approach to pain management: Step 1 (non-opioids), Step 2 (weak opioids), Step 3 (strong opioids)
The WHO ladder provides a systematic approach to pain management, starting with simple analgesics and progressing to stronger options based on pain severity and response.
Question 2: What is the maximum daily dose of paracetamol for adults?
- 4 grams (4000mg) in divided doses with at least 4 hours between doses (Correct answer)
- 10 grams
- 1 gram
- No maximum exists
Correct answer: 4 grams (4000mg) in divided doses with at least 4 hours between doses
The maximum safe dose is 4g daily for healthy adults, with at least 4 hours between doses. Lower maximums apply to elderly patients and those with liver impairment.
Question 3: What are the main risks of NSAID use?
- Gastrointestinal bleeding, renal impairment, and cardiovascular events (Correct answer)
- No significant risks
- Only headache
- Only allergic reactions
Correct answer: Gastrointestinal bleeding, renal impairment, and cardiovascular events
NSAIDs carry risks of GI bleeding/ulceration, kidney damage (especially with dehydration), and increased cardiovascular events with prolonged use.
Question 4: Why are opioids prescribed cautiously?
- Risk of dependence, tolerance, respiratory depression, and constipation (Correct answer)
- They are always ineffective
- They cost too much
- They only work for headaches
Correct answer: Risk of dependence, tolerance, respiratory depression, and constipation
Opioids carry significant risks including physical dependence, tolerance requiring increasing doses, life-threatening respiratory depression, and universal constipation.
Question 5: What is neuropathic pain and how is it treated differently?
- Pain caused by nerve damage, often treated with antidepressants or anticonvulsants rather than standard analgesics (Correct answer)
- Pain that responds well to paracetamol
- Pain only in the feet
- Pain that does not require treatment
Correct answer: Pain caused by nerve damage, often treated with antidepressants or anticonvulsants rather than standard analgesics
Neuropathic pain (burning, shooting, tingling) results from nerve damage and responds poorly to standard painkillers but often improves with amitriptyline, gabapentin, or pregabalin.
Question 6: What is a pain assessment tool and why is it important?
- A standardized method for measuring pain intensity to guide treatment decisions and monitor response (Correct answer)
- A surgical instrument
- A type of medication
- Only useful for children
Correct answer: A standardized method for measuring pain intensity to guide treatment decisions and monitor response
Pain assessment tools (like the numeric rating scale 0-10) provide consistent measurement, enabling appropriate treatment selection and monitoring of response.
PSA Pain Management 1
What is the WHO analgesic ladder?