DPNP Review Questions

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Noxious or painful stimuli are sent from the periphery to the central nervous system via the: A. ascending pathways. B. action potential pathways. C. descending pathways. D. dorsal horn pathways.: A. ascending pathways.
Which of the following statements is correct? A. The perception of pain cannot be modulated by a personÂ’s emotional state or external circumstances. B. Pain may be modulated via serotonergic and noradrenergic neurons in the descending pathways: B. Pain may be modulated via serotonergic and noradrenergic neurons in the descending
pathways.
Neuropathic pain: A. represents an adaptive, protective response to noxious stimuli. B. is mediated by nociceptors. C. arises from damaged nerves, which send pain signals in the absence of noxious stimuli. D. responds well to general: C. arises from damaged nerves, which send pain signals in the absence of noxious stimuli.
Which of the following changes does not appear to occur in neuropathic pain? A. Defects in the regulation of sodium and/or calcium entry into nerve cells, which leads to hyperexcitability of the nerve B. Increased reuptake of serotonin and nore: C. Alterations in the balance of excitatory and inhibitory neurotransmitters in the spinal
cord
Which of the following is not an example of a numeric rating scale that can be used for pain assessment? A. Faces scale B. Visual analog scale C. Verbal pain intensity scale D. McGill Pain Questionnaire: B. Visual analog scale
Which of the following is not a risk factor associated with the development of diabetic neuropathy? A. Long duration of disease B. Female gender C. Cigarette smoking D. High blood pressure: B. Female gender
Symptoms of distal symmetrical sensorimotor polyneuropathy include: A. gastroparesis, impotence, and bradycardia. B. postural hypotension, impotence, gastroparesis. C. tingling in fingers and toes, sharp pain, weak muscles. D. complet: C. tingling in fingers and toes, sharp pain, weak muscles.
It is currently estimated that ____ of patients with diabetes experience persistent pain associated with DN. A. 5% to 10% B. 10% to 20% C. 25% to 50% D. 30% to 60%: B. 10% to 20%
Which of the following is not characteristic of DPNP? A. Hyperalgesia B. Allodynia C. Burning pain D. Pain that worsens in the morning: D. Pain that worsens in the morning
TCAs inhibit the reuptake of __________ and norepinephrine, and block ____ receptors. A. serotonin; GABA B. dopamine; sodium C. glutamate; calcium D. serotonin; sodium: D. serotonin; sodium
Which of the following statements about gabapentin is true? A. Gabapentin relieves pain via interaction with GABA receptors. B. Gabapentin appears to block calcium channels on injured nerves, making them less likely to fire spontaneously.: B. Gabapentin appears to block calcium channels on injured nerves, making them less
Which of the following statements about pregabalin is correct? A. Pregabalin is not related to gabapentin. B. Pregabalin is a more potent inhibitor of calcium channels than gabapentin. C. The frequency of side effects with pregabalin is li: B. Pregabalin is a more potent inhibitor of calcium channels than gabapentin.
True or false? The use of opioids in the management of DPNP is controversial: True
Tramadol exerts its effects by binding to ______ receptors and moderately inhibiting ______ and ______ reuptake. A. GABA; serotonin; norepinephrine B. mu-opioid; enkephalin; endorphin C. GABA; serotonin; glutamate D. mu-opioid; seroto: D. mu-opioid; serotonin; norepinephrine
The dosage range of Effexor® XR shown to be effective in reducing DPNP in a clinical trial involving 224 adult patients was: A. 75-150 mg/day. B. 150-225 mg/day. C. 225-300 mg/day. D. 300-375 mg/day.: B. 150-225 mg/day.
Which of the following statements regarding the efficacy of SSRIs in the management of DPNP is correct? A. These agents have been studied extensively in the management of DPNP and other neuropathic pain syndromes. B. SSRIs are better toler: C. SSRIs are not currently recommended for monotherapy of DPNP.
The pain inhibitory action of C is believed to be mediated through potentiation of _______ inhibitory pain pathways in the _______. A. ascending; spinal cord B. ascending; peripheral nerves C. descending; peripheral nerves D. descendi: D. descending; spinal cord
Which of the following clinical trials included a treatment arm in which patients received C 20 mg QD? A. HMAW B. HMAVa C. HMAW-extension D. HMBT: A. HMAW
True or false? Patients with DPNP who met any DSM-IV diagnostic criteria for major depressive disorders were excluded from the HMAW and HMAVa trials: True
Which of the following was the primary efficacy variable in the HMAW and HMAVa trials? A. Night pain B. 24-hour average pain severity C. Short-form McGill Pain Questionnaire D. Dynamic allodynia: B. 24-hour average pain severity
True or false? In the HMAW trial, the difference in pain reduction between patients taking C 60 mg QD and 60 mg BID was not statistically significant.: True
The doses of C used in the HMAVa clinical trial were: A. 20 mg BID, 60 mg QD. B. 20 mg BID, 60 mg BID. C. 60 mg QD, 60 mg BID. D. 60 mg QD, 120 mg QD.: C. 60 mg QD, 60 mg BID.
How much time elapsed after initiating therapy before the treatment effect of C in DPNP was evident during the HMAVa study? A. 3 days B. 1 week C. 2 weeks D. 3 weeks: B. 1 week
The recommended starting dose of C for the management of DPNP is: A. 20 mg QD. B. 20 mg BID. C. 60 mg QD. D. 60 mg BID.: C. 60 mg QD.
Which of the following statements regarding C dosage and administration in special populations is correct? A. C may be used in patients with end-stage renal impairment. B. C is not recommended for patients with moderate renal impairment creatin: D. Dosage adjustment is not recommended for elderly patients on the basis of age alone.
Safety information for C in the management of DPNP was derived from a total of _______ patients who participated in clinical trials. A. 472 B. 449 C. 1,074 D. 10,074: C. 1,074
The most common treatment-emergent adverse events (incidence â‰¥5% and â‰¥2-times that of placebo) occurring in patients treated with C include: A. increased urinary frequency. B. nausea. C. erectile dysfunction. D. asthenia.: B. nausea.
During placebo-controlled trials in patients with DPNP, approximately ____ of the patients treated with C discontinued treatment due to adverse events, compared to ____ of placebo-treated patients. A. 10%, 4% B. 5%; 7% C. 7%; 14% D. 1: D. 14%; 7%
Which of the following describes changes in blood glucose control observed during the placebo-controlled C trials in patients with DPNP? A. Small increase in fasting blood glucose and stable HbA1c B. Significant increase in fasting blood glucos: A. Small increase in fasting blood glucose and stable HbA1c
Treatment with C in patients with DPNP was associated with ______ in heart rate, and _______ in weight. A. a small decrease; no change B. no change; a slight decrease C. a small increase; a slight increase D. a small increase; a sligh: D. a small increase; a slight decrease

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