Q.1 Which of the following is considered a first-line treatment for mild acute pain?
Morphine
Acetaminophen
Fentanyl
Oxycodone
Explanation - Acetaminophen is widely used as a first-line analgesic for mild acute pain due to its safety profile and efficacy.
Correct answer is: Acetaminophen
Q.2 Which type of pain is typically described as sharp, well-localized, and often due to tissue injury?
Neuropathic pain
Visceral pain
Somatic pain
Referred pain
Explanation - Somatic pain arises from skin, muscles, or joints and is usually sharp and well-localized.
Correct answer is: Somatic pain
Q.3 Which opioid is considered safest for use in patients with renal impairment?
Morphine
Hydromorphone
Fentanyl
Codeine
Explanation - Fentanyl has minimal active metabolites and is safer in patients with renal impairment compared to morphine or codeine.
Correct answer is: Fentanyl
Q.4 Which of the following adjuvant medications is commonly used for neuropathic pain?
Ibuprofen
Gabapentin
Acetaminophen
Prednisone
Explanation - Gabapentin is an anticonvulsant that is effective in treating neuropathic pain by modulating calcium channels in the nervous system.
Correct answer is: Gabapentin
Q.5 Which non-pharmacological therapy is recommended for chronic low back pain?
Bed rest
Ice packs only
Exercise therapy
Prolonged immobilization
Explanation - Exercise therapy helps improve function and reduce pain in chronic low back pain, unlike prolonged rest which may worsen outcomes.
Correct answer is: Exercise therapy
Q.6 Which is the primary mechanism of action of NSAIDs in pain management?
Opioid receptor agonism
Inhibition of COX enzymes
Sodium channel blockade
GABA receptor modulation
Explanation - NSAIDs inhibit cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis which mediates pain and inflammation.
Correct answer is: Inhibition of COX enzymes
Q.7 Which type of pain often responds poorly to opioids alone and may require adjuvant therapy?
Acute nociceptive pain
Neuropathic pain
Musculoskeletal pain
Post-surgical pain
Explanation - Neuropathic pain arises from nerve injury and may require adjuvant agents like anticonvulsants or antidepressants in addition to opioids.
Correct answer is: Neuropathic pain
Q.8 Which route of opioid administration provides the fastest onset for severe pain relief?
Oral
Intravenous
Transdermal
Subcutaneous
Explanation - IV administration delivers the drug directly into circulation, providing rapid onset compared to oral or transdermal routes.
Correct answer is: Intravenous
Q.9 Which side effect is most commonly associated with chronic opioid therapy?
Hypertension
Constipation
Hyperglycemia
Diarrhea
Explanation - Opioids reduce gastrointestinal motility, making constipation the most common chronic side effect.
Correct answer is: Constipation
Q.10 Which pain assessment tool is most appropriate for non-verbal adults?
Visual Analogue Scale (VAS)
Numeric Rating Scale (NRS)
FLACC scale
McGill Pain Questionnaire
Explanation - The FLACC scale (Face, Legs, Activity, Cry, Consolability) is designed for patients unable to verbally communicate their pain.
Correct answer is: FLACC scale
Q.11 Which opioid has a ceiling effect for analgesia but not for respiratory depression?
Codeine
Morphine
Fentanyl
Methadone
Explanation - Codeine exhibits a ceiling effect for pain relief due to limited conversion to morphine, but respiratory depression risk persists at higher doses.
Correct answer is: Codeine
Q.12 Which of the following is considered an adjuvant analgesic in cancer pain management?
Duloxetine
Aspirin
Acetaminophen
Ibuprofen
Explanation - Duloxetine, a serotonin-norepinephrine reuptake inhibitor, is used as an adjuvant to treat neuropathic components of cancer pain.
Correct answer is: Duloxetine
Q.13 Which type of pain arises from internal organs and is often poorly localized?
Somatic pain
Visceral pain
Neuropathic pain
Referred pain
Explanation - Visceral pain originates from internal organs and is typically dull, diffuse, and difficult to localize.
Correct answer is: Visceral pain
Q.14 Which non-opioid analgesic is also effective as an antipyretic?
Acetaminophen
Morphine
Gabapentin
Fentanyl
Explanation - Acetaminophen is effective for mild pain relief and fever reduction (antipyretic effect).
Correct answer is: Acetaminophen
Q.15 Which class of medications is often first-line for acute musculoskeletal pain?
NSAIDs
Opioids
Antidepressants
Anticonvulsants
Explanation - NSAIDs provide effective pain relief and anti-inflammatory effects for musculoskeletal injuries and acute pain.
Correct answer is: NSAIDs
Q.16 Which of the following is a serious risk associated with long-term NSAID use?
Hepatic failure
Gastrointestinal bleeding
Hypoglycemia
Renal hypoperfusion only during surgery
Explanation - Long-term NSAID use increases risk of gastrointestinal ulceration and bleeding due to COX-1 inhibition.
Correct answer is: Gastrointestinal bleeding
Q.17 Which type of pain is described as burning, tingling, or electric shock-like?
Somatic pain
Neuropathic pain
Visceral pain
Referred pain
Explanation - Neuropathic pain results from nerve injury and often manifests as burning, tingling, or shooting sensations.
Correct answer is: Neuropathic pain
Q.18 Which analgesic is preferred for managing mild osteoarthritis pain?
Morphine
Acetaminophen
Fentanyl patch
Methadone
Explanation - Acetaminophen is first-line for mild osteoarthritis due to its safety and efficacy profile.
Correct answer is: Acetaminophen
Q.19 Which of the following is an example of a multimodal analgesia approach?
Using only opioids
Combining acetaminophen with NSAIDs
Using only NSAIDs
Bed rest
Explanation - Multimodal analgesia uses drugs with different mechanisms to improve pain control and reduce opioid requirements.
Correct answer is: Combining acetaminophen with NSAIDs
Q.20 Which adjuvant therapy may help reduce opioid requirements in chronic pain?
Antidepressants
Antihistamines
Diuretics
Beta-blockers
Explanation - Certain antidepressants (like SNRIs or TCAs) help modulate neuropathic pain and can reduce opioid needs.
Correct answer is: Antidepressants
Q.21 Which of the following is a potential complication of epidural steroid injections?
Infection
Hypothyroidism
Hyperlipidemia
Hepatitis
Explanation - Epidural injections carry a small risk of infection at the injection site or rarely meningitis or abscess formation.
Correct answer is: Infection
Q.22 Which pain scale uses facial expressions to assess pain intensity in children?
FLACC scale
Wong-Baker FACES scale
Numeric Rating Scale
Visual Analogue Scale
Explanation - The Wong-Baker FACES scale uses facial expressions to help children indicate their pain intensity.
Correct answer is: Wong-Baker FACES scale
Q.23 Which of the following interventions is recommended for acute post-operative pain?
Early mobilization and multimodal analgesia
Prolonged bed rest
Opioids only
Ice only
Explanation - Combining early mobilization with multimodal analgesia improves recovery and reduces complications post-surgery.
Correct answer is: Early mobilization and multimodal analgesia
Q.24 Which type of chronic pain lasts beyond normal tissue healing and often requires long-term management?
Acute pain
Chronic pain
Post-surgical pain
Referred pain
Explanation - Chronic pain persists beyond the expected healing period (usually >3 months) and often requires comprehensive management.
Correct answer is: Chronic pain
Q.25 Which of the following is a risk factor for opioid-induced respiratory depression?
Young age
Obesity and sleep apnea
Mild pain
Regular exercise
Explanation - Obesity and sleep apnea increase susceptibility to respiratory depression during opioid therapy.
Correct answer is: Obesity and sleep apnea