24years old, accident with diagnosis fracture femur sinistra.

doctor has been done open fracture

operation. one hour after operation feel pain
1. what is the type of pain in this case?
a. physiologic pain
b. nociceptive pain
c. mix nociceptive pain n neuropathic pain
d. chronic pain
e. neuropathic pain
2. Which one is not involve in the pain perception?
A. trasnduction
B. conduction
C. modulation
D. transmission
E. ectopic activation
3. Stimulus change to electrical signal at
A. Transmission
B. Modulation
C. Transduction
D. Perception
E. Ectopoc activation
4. Man with prostate cancer.. come with complaint abdominal pain. Treat with step ladder.Step
ladder, except
A. Specific drug
B. Specific type of pain
C. Based on quality pain
D. Combine with adjuvant
6. step 1 ladder, except
A. mild pain : VAS, nrs 3
B. non-opiod : codeine, tramadol
C. adjuvant : analgesic effect in certain pain condition
D. due to side effect
7. Five phases of 3 step ladder WHO, except:
A.by the mouth
B.by the clock
C.by the ladder
D.individualized for the patient
E.adjuvant
8. Extensive use of opioid is associated with a variety of perioperative side effect, except
A. drowsiness and sedation
B. pruritus

C. diarhea
D. can delay hospital discharge
E. PONV
9. When weak opioid combine with non-opioid drug for treatment:
A. preventive analgesia
B. premordial analgesia
C. preemptive analgesia
D. multimodal (balanced analgesia)
E. adjuvant analgesia
10. nociceptor process except:
a) transmission
b) transduction
c) perception
d) modulation
e) transition
12.Pharmacokinetic of NSAIDs
A.Strong acid and lipid soluble (90%)
B.Cross the blood brain barrier
C.Hepatic metabolism
D.Rapid absorption
E.Renal and hepatic excretion
13. side effect of NSAID towards renal?
a) fluid inbalance and electrolyte imbalance until it cause renal insufficiency
b) hypokalemia
c) increase sodium and water absorption
d) interstitial nephritis and nephritic syndrome
14.Pharmacokinetics of NSAIDs except:
A. Strong acid and lipid soluble(90%)
B. Cross the blood brain barrier
C. Hepatic Metabolism
D. Rapid absorbtion
E. Renal and Hepatic excretion
15. The side effect of ketamine, except:
A. Hypotensio
B. Nausea & vomitting
C. Dizziness & confusion
D. Diplopia
E. Cardiac arrythmia

17.related about transdermal patches

A. peak effect after application 24 hours
B. HIGH AFFINITY FOR OPIATE RECEPTOR
c.withdrawal symptoms
D.
e. strong kappa antagonist
19. Effect opioid of nausea and vomitting:
A. Initial side effect and usually resolve over a few days
B. take oral morphine
C. Metoclopramide 10mg
D. Haloperidol 1,5 mg
E. dietary fiber intake
18.common side effect of opiod
a.delirium
b.myoclonus
c.pruritus
d.sedation
e.headache
21. not related about COX-2
A. Rofecoxib
B. Parecoxib
C. Celecoxib
D. Meloxicam
E. Piracetam
23. Why access pain, except?
E. to know side effect
26.)opioid that can cause less addiction effect
A)morphine
B)fentanyl
C)tramadol
D)codeine
E)pethidine
31. Related about morhine except
A. Metabolize accumulate in renal
B. Severe sedation
C. Respiratory depression
D. Morphine by intravena is a strong opioid of the choice in cancer
33. according to the side effect of opioid, delirium:

a. hypercalcemia
b. opioid induced toxicity
c. haloperidol 0,5-2 mg
d. confusio, bad dreams
e. all above true
34. the classes of propionic acid
I. ibuprofen
II. diclofenac
III. ketoprofen
IV. indomethacine
35. yg termasuk fenamates acid
1 fenyl butazole
2 mefenamic acid
3 peroxicam
4 mechlofenamic acid
36. Pain is complex, it involve
- stimulus
- behavioral
- perception
ans: E (all true)
37. Endogenous opioids:
1. dynorphine
2. GABA
3. enkephaline
4. norepinephrine
38. if pain has occurred treating central sensitization NMDA antagonist except:
1. ketamine low dose
2. DMP
3. MK 801
4. 5HT agonist
40. Related about opiod
1.analgesia
2.dysphoria
3.reduced GI motility
4.myosis
41. A delta mechanothermal nociceptor:
1. respond to mechanical and thermal stimuli
2. first pain and well localized

3. rapid conduction
4. diffuse
42. Characteristic of C-fibers polimodal..
1. second pain
3. mechanical, touch, thermal receptor
44.two types of receptors at the DHN
1.WIDE GREY
2. NMDA
3.HIGH COGNITIVE NEURON
AMPA
43. Large myelinated fibre:
1. AB fibre
2. Fast conduction fibre
3. Touch & pressure
4. Ad & C-fibre
45. 2 types of 2nd order nociceptive neurons in dhn:
1.1. nociceptive-spesific neurons
2. NMDA
3. WDR neuron
4. AMPA
47. Pain has multidimensional experience
1. Sensory descriptive
2. Identifying intensity
3. Assess injury and meaning of injury
4. Mood and behavorial
49. 5 characteristics about visceral pain
1. is not linked to visceral injury
2. Refers to other location
3. lupa
4. Evoked from all visceral
answers from jurnal:
(i) is not evoked from all viscera,
(ii) is not linked to visceral injury,
(iii) is referred to other locations,
(iv) is diffuse and poorly localised, and
(v) is accompanied by motor and autonomic reflexes.
Delta mechanothermal receptor?
1 Mechanical n thermal pain

2 First n localised
3 Rapid conduction
4 Diffuse
Central sensitivation Nmda agonist except?
1 Ketamin
2 Dmp Antagonist
3 Ht5
4 Mk 801
Pain complex interaction?
1 Perception
2 Cognitif
3 Behavior
4 Stimulus
Tract accending pathway
a. spinothalamic pathway
b. spinoreticular pathway
c.
d.
e. spinal cord

TAMBAHAN
o 3. Stimulus change to electrical signal at
A. Transmission
B. Modulation
C. Transduction
D. Perception
E. Ectopoc activation
11. Which one is the protection of gi mucosa
A. PGI2.
B. PGE2.
C. Bradykinin.
D. Substance p.
E. Platelet.
39. When pain occured,to treat the central sensitization with inhibitor drug
A. GABA agonist.
B. Opioid agonist.
C. Methylserotonin.
D. Clonidine.

4. Man with prostate cancer.. come with complaint abdominal pain. Treat with
step ladder.
Step ladder, except
A. Specific drug
B. Specific type of pain
C. Based on quality pain
D. Combine with adjuvant
32. Opioids avoid in cancer, except
A. Meperidine
B. Nalbuphine
C. Pentazocine
D. Fentanyl patch
E. Buprenorphine
26.)opioid that can cause less addiction effect
A)morphine
B)fentanyl
C)tramadol
D)codeine
E)pethidine
10. nociceptor process except:
a) transmission
b) transduction
c) perception
d) modulation
e) transition
38. if pain has occurred treating central sensitization NMDA antagonist except:
1. ketamine low dose
2. DMP
3. MK 801
4. 5HT agonist
13. side effect of NSAID towards renal?
a) fluid inbalance and electrolyte imbalance until it cause renal insufficiency
b) hypokalemia
c) increase sodium and water absorption
d) interstitial nephritis and nephritic syndrome
41. A delta mechanothermal nociceptor:
1. respond to mechanical and thermal stimuli
2. first pain and well localized
3. rapid conduction
4. diffuse
24years old, accident with diagnosis fracture femur sinistra. doctor has been done
open fracture operation. one hour after operation feel pain
1. what is the type of pain in this case?

a. physiologic pain
b.nociceptive pain
c. mix nociceptive pain n neuropathic pain
d. chronic pain
e. neuropathic pain
6. step 1 ladder, except
A. mild pain : VAS, nrs 3
B. non-opiod : codeine, tramadol
C. adjuvant : analgesic effect in certain pain condition
D. due to side effect
34. the classes of propionic acid
I. ibuprofen
II. diclofenac
III. ketoprofen
IV. indomethacine
17. Transdermal patch:
a. Peak effects after application 24h
b. High affinity to opiate receptor
c. Symptom withdrawal
d. A dosage ceiling
e. A strong kappa agonist
45. 2 types of 2nd order nociceptive neurons in dhn:
1.1. nociceptive-spesific neurons
2. NMDA
3. WDR neuron
4. AMPA
9. When weak opioid combine with non-opioid drug fortreatment:
A. preventive analgesia
B. premordial analgesia
C. preemptive analgesia
D. multimodal (balanced analgesia)
E. adjuvant analgesia
37. Endogenous opioids:
1. dynorphine
2. GABA
3. enkphaline
4. norepinephrine
Huaaa...ni 1st time kte lupe soklan kte...sori...nmbo 31..sma ada psl codeine or psl
morphine..tp same ngn amel..hope dye salin..huu
7)5 phases of 3 step ladder WHO, xcept:
A.by the mouth
B.by the clock
C.by the ladder

D.individualized for the patient

E.adjuvant
1. nociceptive-spesific neurons,3. WDR neuron
sori jugak..lupe soalan 35..something about fenamic acid
18.common side effect of opiod
a.delirium
b.myoclonus
c.pruritus
d.sedation
e.headache
36.The pain complex interaction that involve
1.behaviour
2.perception
3.cognitive
4.stimulus
2. Which one is not involve in the pain perception?
A. trasnduction
B. conduction
C. modulation
D. transmission
E. ectopic activation
30. About caudal epidural analgesia except:
A. Applicable to child of all ages
B. Easiest and safest approach
C. Central block
D. Pain free awakening
E. Peripheral block
21. related about COX-2
A. Rofecoxib
B. Parecoxib
C. Celecoxib
D. Meloxicam
E. Piracetam
49. 5 characteristics about visceral pain
1. lupa
2. Refers to other location
3. lupa
4. Evoked from all visceral
(pilihan jwpn soal 49 bnyk xingt)
answers from jurnal:
(i) is not evoked from all viscera,
(ii) is not linked to visceral injury,
(iii) is referred to other locations,

(iv) is diffuse and poorly localised, and

(v) is accompanied by motor and autonomic reflexes.
Soalan aku black dh tulis..nombr 26
15. The side effect of ketamine, except:
A. Hypotensio
B. Nausea & vomitting
C. Dizziness & confusion
D. Diplopia
E. Cardiac arrythmia
43. Large myelinated fibre:
1. AB fibre
2. Fast conduction fibre
3. Touch & pressure
4. Ad & C-fibre
Titah ckp dye cm da ckup soklan pain
50. Acute pain :
1. Due to surgery, trauma and acute illnes
2. Effect behaviour , emotion and cognitive behaviour
........xigt..nnt smbung
31. Related about morhine except
A. Metabolize accumulate in renal
B. Severe sedation
C. Respiratory depression
D. Morphine by intravena is a strong opioid of the choice in cancer
23. Why access pain, except?
E. to know side effect
Delta mechanothermal receptor?
Mechanical n thermal pain
First n localised
Rapid conduction
Diffuse
Central sensitivation Nmda agonist except?
Ketamin
Dmp Antagonist
Ht5
Mk 801
Pain complex interaction?
Perception
Cognitif
Behavior
Stimulus

Spinal cord? Tract accending pathway

Morphine except
5 visceral pain characteristic except
19. Effect opioid of nausea and vomitting:
A. Initial side effect and usually resolve over a few days
B. take oral morphine
C. Metoclopramide 10mg
D. Haloperidol 1,5 mg
E. dietary fiber intake
47. Pain has multidimensional experience
1. Sensory descriptive
2. Identifying intensity
3. Assess injury and meaning of injury
4. Mood and behavorial