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Interdisciplinary Pain Management

The second most common cause of pain in the elderly is

(A) musculoskeletal

(B) cancer

(C) temporal arteritis

(D) postherpetic neuralgia

(E) diabetic neuropathy

(B) Many other studies have verified that the predominant cause of pain in the elderly is, by far, musculoskeletal. The second most common source of pain is caused by cancer. Rheumatologic diseases are, therefore, important to the pain practitioner because these diseases are usually amenable to various treatment modalities. Other types of pain found commonly in the elderly include herpes zoster, postherpetic neuralgia, temporal arteritis, polymyalgia rheumatica, atherosclerotic and diabetic peripheral vascular disease, cervical spondylosis, trigeminal neuralgia, sympathetic dystrophies, and neuropathies from diabetes mellitus, alcohol abuse, and malnutrition.

Pain assessment in the elderly is usually more difficult than in the young because it is often complicated by

(A) good health status which may confuse the physician

(B) poor memory

(C) depression, which is only seen in cancer pain patients

(D) most complains are psychiatric as opposed to organic

(E) none of the above

(B) Pain assessment in the elderly is usually more difficult than in the young because it is often complicated by poor health, poor memory, psychosocial concerns, depression, denial, and distress. Caution in not attributing new pain complaints to preexisting disease processes is mandatory. Most pain complaints in the elderly are of organic, not psychiatric, origin. Nonetheless, concomitant depression is also usually present among the elderly with chronic, nonmalignant pain.

Which of the following includes recommendations by the American Geriatric Society for pain patients?

(A) Pain and its response to treatment do not necessarily need to be measured

(B) Nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in older patients

(C) Acetaminophen is the drug of choice for relieving mild to moderate pain

(D) Nonopioid analgesic medications may be appropriate for some patients with neuropathic pain and other chronic pain syndromes

(E) Nonpharmacologic approaches (eg, patient and caregiver education, cognitive-behavioral therapy, exercise) have no role in the management of geriatric pain

(C) Recommendations from the American Geriatric Society for the management of patients with pain are

  1. Pain should be an important part of each assessment ...

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