Special populations and acute pain: curriculum recognition: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Special populations and acute pain: curriculum recognition

Sample item

A 48-year-old woman has persistent burning pain and allodynia along her thoracotomy scar five months after lung resection. There is no infection or tumour recurrence, and no swelling, sweating or colour change of the skin. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Chronic postsurgical pain

Chronic postsurgical pain is pain that persists beyond the expected healing time, commonly taken as three months or more after surgery, and is often neuropathic from intercostal nerve injury. Risk factors include severe acute pain, nerve injury and anxiety. Good acute analgesia and regional techniques may reduce the risk.

Option by option

  • A. Opioid-induced hyperalgesia

    Opioid-induced hyperalgesia causes diffuse, escalating pain on rising opioid doses, not a scar-limited pattern.

  • B. Complex regional pain syndrome

    Complex regional pain syndrome needs disproportionate pain with autonomic, sudomotor or trophic changes, which are absent here.

  • C. Postherpetic neuralgia

    Postherpetic neuralgia follows a vesicular dermatomal rash, and none is described.

  • D. Chronic postsurgical pain (correct)

    Correct. Neuropathic pain confined to the scar beyond three months fits chronic postsurgical pain.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Chronic postsurgical pain. Chronic postsurgical pain is pain that persists beyond the expected healing time, commonly taken as three months or more after surgery, and is often neuropathic from intercostal nerve injury.

Why is "Opioid-induced hyperalgesia" not the answer?

Opioid-induced hyperalgesia causes diffuse, escalating pain on rising opioid doses, not a scar-limited pattern.

Why is "Complex regional pain syndrome" not the answer?

Complex regional pain syndrome needs disproportionate pain with autonomic, sudomotor or trophic changes, which are absent here.

Why is "Postherpetic neuralgia" not the answer?

Postherpetic neuralgia follows a vesicular dermatomal rash, and none is described.

What concept does this question test?

It tests Special populations and acute pain: curriculum recognition in Anaesthesia. Risk factors include severe acute pain, nerve injury and anxiety. Good acute analgesia and regional techniques may reduce the risk.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Special populations and acute pain: curriculum recognition?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.