Multiple Choice Questions (MCQs) – Pain

Which of the following represent the step III of Pain Management Ladder?

1. Strong opioids + NSAIDS ± adjuvants

2. NSAID + Mild opioids ± adjuvant

3. NSAIDs ± adjuvants

4. Opioids ± adjuvants


Which of the following is the most common symptom of disease?

1. Hot flushes

2. Pain

3. Diarrhea

4. Nausea


Which of the following is the most common side effect of NSAD drugs?

1. Constipation

2. Xerophthalmia

3. Gastric Irritation

4. Tremors


Identify the NSAID reflecting more inhibtory selectivity for COX1?

1. Celecoxib

2. Diclofenac

3. Indomethacin

4. Flurbiprofen


Which of the following is not associated with pain?

1. Emotional experience

2. Pleasant sensation

3. Potential tissue damage

4. Acute or chronic condition


The mild to moderate pain is managed by the use of non-opioid drugs. All of the following are non-opioid drugs except:

1. Ibuprofen

2. Ketorolac

3. Codeine

4. Indomethacin


The word pain is derived from ___________ word:

1. Latin

2. American

3. Greek

4. Portuguese


Noxa is a latin word which means ____________:

1. Pain

2. Bleeding

3. Injury

4. Inflammation


The location of opioid receptors in the body is ____________:

1. Peripheral nervous system, spinal cord and brain

2. Skeletal muscles, brain and spinal cord

3. Smooth muscles and peripheral nervous system

4. Hypothalamus, peripheral nervous system and visceral organs


The activity of COX2 (cyclooxygenase) mediate _____________:

1. Fever, nausea and drowsiness

2. Inflammation, fever, pain and inhibit platelet aggregation

3. Pain, lethargy, blackout and inhibit platelet aggregation

4. Inflammation, tinnitus, drowsiness


According to the WHO analgesic ladder, the first line of drug therapy for pain management is:

1. Codeine and Thebaine

2. Paracetamol or NSAID

3. Morphine and Meloxicam

4. Sulfasalazine and Codeine


NSAIDs reflect more effectiveness than the paracetamol for the treatment of __________ pains:

1. Menstrual pain

2. Dental pain

3. Rheumatoid arthritis or gout

4. All of these


The intensity of the pain can be measured with the assistance of pain scale. It usually ranges from __________________:

1. 1 to 5

2. 0 to 10

3. 1 to 10

4. 0 to 5


10 at the standard pain scale represents _________________:

1. No pain

2. Mild pain

3. Moderate pain

4. Severe or worst pain


Which of the following pain is of short duration?

1. Chronic pain and nociceptive pain

2. Neuropathic pain

3. Radicular and chronic pain

4. Acute pain


The non-pharmacological means for treating pain are:

1. Physical therapies such as stretching, exercise

2. Cognitive behavior therapy (CBT)

3. Acupuncture

4. All of these


Cancer pain can be relieved through the use of:

1. High dose of Aspirin

2. Oxycodone

3. Gabapentin

4. Combination of COX-2 inhibitors


Identify the non-opioid analgesic involved in the management of pain:

1. NSAIDs such as celecoxib, naproxen, ibuprofen

2. Antidepressant such as duloxetine, amitriptyline

3. Anticonvulsants such as pregabalin, gabapentin

4. All of the above


Pain reliever medications function in enormous manner. These help in reducing the fever and inflammation and inhibit the production of ____________:

1. Adrenalin

2. Prostaglandlins

3. Bradykinin

4. Cytokinin


Gastric irritation leading to bleedings is quite common with the prolonged use of pain killer medication, NSAIDs. This side effect occurs due to _______________:

1. Vasodilation

2. Inhibition of Prostaglandlins

3. Accumulation of Bradykinin

4. Excessive production of Prostaglandlins


According to the European Union, how much percentage of capsaicin in the form of cutaneous patch is approved for treating the non-diabetic neuropathic pain?

1. 2%

2. 8%

3. 10%

4. 17%


Ginger (Zingiber officinale) is used for the analgesic properties of it. Which of the following active agent imparts these properties to it:

1. Gingerol

2. Gingeric

3. Paradols

4. Shogaols


The overdose of most commonly used analgesic, acetaminophen, is __________:

1. N-oxymorphone

2. Acetylene

3. N- acetyl cysteine

4. N -acetyl phosphate


The toxicity or overdose of _________ drugs in the children leads to Reye’s syndrome:

1. Sulfasalazine

2. Ibuprofen

3. Salicylates

4. Acetaminophen


Identify the synthetic opioid from the following:

1. Morphine

2. Fentanyl

3. Pholcodine

4. Oxymorphone


Which of the following is Indole derivative?

1. Sulindac, Piroxicam

2. ibuprfen, Diflunisal

3. Indomethacin, Sulindac

4. Ketorolac, Mephenamic acid


The pain that is characterized as the higher intensity occurring over the baseline of chronic pain is ____________:

1. Breakthrough pain

2. Migraine pain

3. Neuropathic pain

4. Chronic cancer pain


Neuropathic pain is characterized as ___________:

1. Intermittent and transitory pain

2. Tendered, stinging, shooting, burning, throbbing ache

3. Chronic non-malignant pain

4. Severe headache


The main elements of comprehensive pain management are assessment of _________:

1. Pain management history such as analgesic response, drug allergies

2. Clinical status such as underlying disease or trauma

3. Pain complaints such as symptomatology, chronology

4. All of the above


What is the maximum dose per day for Acetaminophen?

1. 2g

2. 4g

3. 5g

4. 8 g


Which of the following drug is used for pain management?

1. Leflunamide

2. Rituximab

3. Infliximab

4. All of these


The synthetic opioid, Fentanyl, is a powerful synthetic opioid used for treating severe pains such as cancer pain. How many, it is stronger than morphine?

1. 20 to 30 times

2. 50 to 100 times

3. 60 times

4. 30 to 40 times


The primary and leading cause of disability and pain throughout the word is ________________:

1. Non-specific low back pain (NS-LBP)

2. Cancer pain

3. Migraine

4. Neuropathic pain


The most effective and best pharmacological intervention leading to the optimum reduction of disability and pain for the non-specific low back pain (NS-LBP) is:

1. Muscle relaxant

2. Anti-depressant

3. NSAIDs and muscle relaxant

4. Opioids


Which of the following non-pharmacological intervention reduces NS-LPB:

1. Exercise

2. Manual therapy

3. Heat wrap

4. All of these


There are associated with the severity of GI pain that affects the quality of life:

1. Migraine, nausea, drowsiness, lethargy

2. Impaired cognition, depression, disturbed sleep patterns

3. Proximal deformity

4. Cerebral palsy, depression


NSAIDs can be administered for GI pain management but not without the administration or use of _____________:

1. Antidepressants

2. Acetaminophen

3. Proton Pump Inhibitors

4. Triptans


Further Reading:

Lippincott Illustrated Reviews: Pharmacology

https://amzn.to/3t4RnZV*

Comprehensive Pharmacy Review for NAPLEX

https://amzn.to/3GyhATS*

Nature Reviews. (2020). Gastrointestinal pain. Nat Rev Dis Primers, 6(1), 2. https://doi.org/10.1038/s41572-019-0142-8

Urits, I., Burshtein, A., Sharma, M., Testa, L., Gold, P. A., Orhurhu, V., Viswanath, O., Jones, M. R., Sidransky, M. A., Spektor, B., & Kaye, A. D. (2019). Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. Curr Pain Headache Rep, 23(3), 23. https://doi.org/10.1007/s11916-019-0757-1

Money, S., & Garber, B. (2018). Management of Cancer Pain. Current Emergency and Hospital Medicine Reports, 6(4), 141-146. https://doi.org/10.1007/s40138-018-0170-9

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Nagina Anwar

Nagina Anwar is Medical and Business graduate (Pharm. D - gold medalist, MPhil, MBA exec., B.Sc.). She is pursuing her career in the field of education and freelancing as a lecturer and content writer, respectively. Writing is her passion, which she is pursuing for the last 6 years. She is continuously unlocking new horizons with national and international projects.