April 2021 Treating Pain & Addiction Pre-training Survey of Knowledge

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* 2. Please choose the organization in which you provide services from the choices below:

A health system (such as Affinia, Ascension, Metro U of M, Spectrum, United Health, etc..)

A Federally Qualified Health Center

A Rural Health Clinic

An independent practice (A practice not owned by a health system)

University student or residency program

Other (please specify)

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* 3. Please choose your role:

Provider (MD, DO, PA-C, NP, etc.)

Nurse Care Manager/Care Coordinator

Social Worker Care Manager/Care Coordinator

Behavioral Health Specialist

Pharmacist

Other Clinical (CMA, RMA, etc.)

Non-Clinical (Practice Manager, Support Staff, etc.)

Leadership

Other (please specify)

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* 4. What specific topics are you hoping to learn about from this course?

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* 5. On a scale of 1-5 please rate your confidence in managing chronic pain.

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* 6. Please check the box that best explains your current approach to managing patients with chronic pain:

I prefer to manage/treat patients myself

I prefer to refer patients to a specialist

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* 7. Fibromyalgia or centralized pain patients are more frequently diagnosed with:

A. Irritable bowel syndrome

B. Tension headache

C. Temporomandibular disorder

D. Chronic fatigue syndrome

E. All the above

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* 8. Regarding the interplay between fibromyalgia and depression, which statement is not true

A. The rate of depression in fibromyalgia patients is somewhat higher than other chronic pain syndromes, but not overly so

B. All antidepressants are effective in fibromyalgia

C. The analgesic response to the drug is independent of the antidepressant response (i.e. people without depression respond just as well as those with depression)

D. Depression and fibromyalgia share similar neurotransmitters leading to many people having both conditions

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* 9. Classes of drugs that have been shown to be efficacious in fibromyalgia and other central pain states include:

A. Opioids

B. Compounds that raise both serotonin and norepinephrine

C. NSAIDs

D. Alpha -2- delta ligands (e.g. gabapentin, pregabalin)

E. B and D

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* 10. Drugs that are generally effective in peripheral/nociceptive pain states include which of the following:

A. NSAIDs

B. Opioids

C. Acetaminophen

D. Tramadol

E. All of the above

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* 11. All antidepressants are effective analgesics

True

False

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* 12. Central nervous system neurotransmiter abnormalities that are present in fibromyalgia include all of the following except:

A. Low serotonin and norepinephrine

B. High Glutamate

C. Low GABA

D. High Nerve growth factor

E. Low endogenous opioids

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* 13. Cannabinoids have generally been shown to be safe and effective in treating neuropathic pain and fibromyalgia

True

False

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* 14. The clinical feaures of centralized pain include:

A. Multifocal pain

B. Fatigue

C. Sleep disturbances

D. Sensitivity to sensory stimuli

E. All of the above

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* 15. When individuals develop centralized pain, their pain is generally less responsive to:

A. Opioids

B. NSAIDs

C. Injections

D. Surgical procedures

E. All of the above

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* 16. Opioids are generally the most effective treatment for severe chronic pain

True

False

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* 17. Neuroimaging studies suggest that chronic pain…

A. is primarily a sensory event

B. contains more affect than sensory aspects

C. does not exist – brains of people with chronic pain look like healthy normal people

D. is the same as depression

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* 18. Which of the following symptoms use the same neurotransmitters and brain pathways as pain processing?

A. Affect

B. Sleep

C. Memory

D. Fatigue

E. All of the above

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* 19. Which statement(s) are true about Chronic Overlapping Pain Conditions (COPCs)?

A. Central sensitization is thought to be the mechanism behind COPCs

B. Osteoarthritis is a form of COPC

C. COPCs respond well to surgery and opioid therapy

D. A & C are correct

E. A,B, & C are correct

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* 20. Which statement(s) are true about Biopsychosocial factors and pain?

A. Psychological factors only become clinically relevant when there is a co-morbid depression or anxiety disorder present

B. If surgery or opioids don’t help with pain, you are likely dealing with a psychiatric disorder

C. A biomedical approach should always be tried first given the evidence is strongest for this approach to pain

D. All of the above are true

E. None of the above are true

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* 21. Combining analgesics that work by different mechanisms (e.g., combining an NSAID with an opioid) may result in better pain control for acute nociceptive pain.

True

False

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* 22. Benzodiazepines are not effective pain relievers and are rarely recommended as part of an analgesic regimen

True

False

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* 23. Anticonvulsant drugs such as gabapentin (Neurontin) produce optimal pain relief after a single dose

True

False

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* 24. Following abrupt discontinuation of an opioid, physical dependence is manifested by the following:

A. Sweating, yawning, diarrhea and agitation with patients when the opioid is abruptly discontinued.

B. Impaired control over drug use, compulsive use, and craving

C. The need for higher doses to achieve the same effect

D. All of the above

E. None of the above

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* 25. Regarding opioids the following are true

A. Wean individuals by decreasing morphine equivalent by 25 percent every two days

B. Use the Chronic Opioid Withdrawal Symptom score to keep individuals in the mild category.

C. Do not decrease opioids faster than every four weeks

D. Opioids and benzodiazepines are widely considered to be safe to use together

E. C and D

F. All of the above

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* 26. Severe joint arthritis on x-ray or MRI almost always leads to severe chronic pain unless surgical intervention is done

True

False

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* 1. Personal Information

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* 2. Please choose the organization in which you provide services from the choices below:

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* 3. Please choose your role:

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* 4. What specific topics are you hoping to learn about from this course?

Question Title

* 5. On a scale of 1-5 please rate your confidence in managing chronic pain.

Question Title

* 6. Please check the box that best explains your current approach to managing patients with chronic pain:

Question Title

* 7. Fibromyalgia or centralized pain patients are more frequently diagnosed with:

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* 8. Regarding the interplay between fibromyalgia and depression, which statement is not true

Question Title

* 9. Classes of drugs that have been shown to be efficacious in fibromyalgia and other central pain states include:

Question Title

* 10. Drugs that are generally effective in peripheral/nociceptive pain states include which of the following:

Question Title

* 11. All antidepressants are effective analgesics

Question Title

* 12. Central nervous system neurotransmiter abnormalities that are present in fibromyalgia include all of the following except:

Question Title

* 13. Cannabinoids have generally been shown to be safe and effective in treating neuropathic pain and fibromyalgia

Question Title

* 14. The clinical feaures of centralized pain include:

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* 15. When individuals develop centralized pain, their pain is generally less responsive to:

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* 16. Opioids are generally the most effective treatment for severe chronic pain

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* 17. Neuroimaging studies suggest that chronic pain…

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* 18. Which of the following symptoms use the same neurotransmitters and brain pathways as pain processing?

Question Title

* 19. Which statement(s) are true about Chronic Overlapping Pain Conditions (COPCs)?

Question Title

* 20. Which statement(s) are true about Biopsychosocial factors and pain?

Question Title

* 21. Combining analgesics that work by different mechanisms (e.g., combining an NSAID with an opioid) may result in better pain control for acute nociceptive pain.

Question Title

* 22. Benzodiazepines are not effective pain relievers and are rarely recommended as part of an analgesic regimen

Question Title

* 23. Anticonvulsant drugs such as gabapentin (Neurontin) produce optimal pain relief after a single dose

Question Title

* 24. Following abrupt discontinuation of an opioid, physical dependence is manifested by the following:

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* 25. Regarding opioids the following are true

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* 26. Severe joint arthritis on x-ray or MRI almost always leads to severe chronic pain unless surgical intervention is done