Question 1

What are common causes of myalgia?

Accepted Answer

Overexertion, trauma, infection, vitamin D deficiency, rheumatic or thyroid disease, or certain drugs. (Like an engine overheating from too much strain or poor fuel.)

Question 2

How does myalgia typically present?

Accepted Answer

Dull ache, fatigue, weakness, worsens with contraction. (Like an overused spring losing tension.)

Question 3

What is tendonitis?

Accepted Answer

Inflammation of a tendon from overuse or injury, causing pain and limited motion. (Like a squeaky door hinge from friction.)

Question 4

Common causes of tendonitis?

Accepted Answer

Overexertion, trauma, fluoroquinolone antibiotics, inflammatory disease. (Like using the same joint too many times without rest.)

Question 5

What is bursitis?

Accepted Answer

Inflammation of the fluid-filled sacs cushioning joints, causing constant pain and redness. (Like an overfilled balloon between two surfaces.)

Question 6

What is a sprain?

Accepted Answer

Stretching or tearing of ligaments that stabilize joints. (Like overstretching a rubber band.)

Question 7

Grades of sprains?

Accepted Answer

I = stretch, II = partial tear, III = complete tear. (Like cracking a stick—slightly bent, partly split, or fully broken.)

Question 8

What is a strain?

Accepted Answer

Overextension of a muscle or tendon causing pain, weakness, and swelling. (Like over-pulling an elastic band until it frays.)

Question 9

Main goals of therapy for musculoskeletal pain?

Accepted Answer

Reduce pain, restore function, prevent re-injury, and avoid chronic pain. (Like fixing the leak, not just mopping water.)

Question 10

Exclusions for self-treatment of pain/inflammation?

Accepted Answer

Pain > 6/10 or > 10 days, worsening pain, deformity, numbness, pregnancy, < 2 years old, infection, or bowel/bladder loss. (Like a warning light—call a mechanic, not DIY.)

Question 11

Key non-drug measures for myalgia?

Accepted Answer

Rest, gentle stretching, hydration, massage, avoid bouncing movements. (Like slowly warming up cold taffy instead of snapping it.)

Question 12

When to use ice therapy?

Accepted Answer

Immediately after injury, 10–15 min 3–4×/day up to 72 h. (Like putting a hot phone in front of a fan to cool it.)

Question 13

When to use heat therapy?

Accepted Answer

After 48 h for non-inflammatory pain (low back pain, OA). (Like turning on a heater once condensation clears.)

Question 14

RICE stands for what?

Accepted Answer

Rest, Ice, Compression, Elevation. (Like the quick-response kit for joint injuries.)

Question 15

Compression technique?

Accepted Answer

Wrap distal → proximal, overlap ⅓ to ½, loosen upward. (Like wrapping a burrito evenly—not too tight.)

Question 16

Elevation recommendation?

Accepted Answer

Keep injury at/above heart 2–3 h per day. (Like storing a wet book upright so it dries evenly.)

Question 17

First-line systemic analgesics?

Accepted Answer

Acetaminophen and NSAIDs. (Like the default tools in your repair kit.)

Question 18

Acetaminophen mechanism?

Accepted Answer

Central inhibition of prostaglandin synthesis. (Like muting the alarm system instead of cutting wires.)

Question 19

Acetaminophen onset and duration?

Accepted Answer

Onset ≈ 30 min; duration ≈ 4 h (6–8 h for ER). (Like a short-acting battery that lasts the morning.)

Question 20

Maximum labeled daily acetaminophen dose?

Accepted Answer

3,250 mg/day. (Like a lower speed limit set for safety.)

Question 21

Main acetaminophen toxicity?

Accepted Answer

Liver damage > 4 g/day—leading cause of acute liver failure. (Like overcharging a phone battery until it bursts.)

Question 22

NSAID mechanism of action?

Accepted Answer

Blocks COX enzymes → ↓ prostaglandins → ↓ inflammation and pain. (Like closing a leaking valve.)

Question 23

Key NSAID counseling point with aspirin?

Accepted Answer

Take aspirin 1 h before or 8 h after NSAID. (Like watering plants before shutting off the faucet.)

Question 24

Common NSAID adverse effects?

Accepted Answer

GI upset, heartburn, ulcers, ↑ BP, fluid retention. (Like great power tools that can strip screws if misused.)

Question 25

Who is at highest risk for NSAID ulcers?

Accepted Answer

Age > 60, prior ulcers, anticoagulant use, high dose, long use, alcohol. (Like thin glass cracking easier when reused often.)

Question 26

FDA 2015 NSAID update?

Accepted Answer

MI/stroke risk may start within weeks of use, dose-related, even without heart disease. (Like a storm that forms sooner than expected.)

Question 27

Max OTC ibuprofen dose?

Accepted Answer

1,200 mg/day (200–400 mg every 4–6 h). (Like four standard tabs per day limit.)

Question 28

Max OTC naproxen dose?

Accepted Answer

660 mg/day (220 mg every 8–12 h). (Like morning and evening schedule.)

Question 29

Topical NSAID example?

Accepted Answer

Diclofenac 1 % gel QID (max 32 g/day). (Like a thin coat of paint for localized repair.)

Question 30

Key counseling for diclofenac gel?

Accepted Answer

Avoid bathing 1 h post-use; wash hands before/after; avoid sun on treated area. (Like letting glue set before touching.)

Question 31

What are topical counterirritants?

Accepted Answer

Agents that relieve pain by producing mild surface irritation to distract from deeper pain. (Like scratching near a mosquito bite.)

Question 32

Four types of counterirritants?

Accepted Answer

Rubefacients, Cooling agents, Vasodilators, Irritants. (Like four “modes” on a therapy device.)

Question 33

Mechanism of methyl salicylate?

Accepted Answer

Rubefacient—causes local inflammation and vasodilation (“hot” feeling). (Like turning on a mini heat pad.)

Question 34

Methyl salicylate safety points?

Accepted Answer

Avoid heat pads, tight bandages, open wounds, children, asthma, aspirin allergy. (Like not doubling heat sources.)

Question 35

Camphor and menthol mechanism?

Accepted Answer

Cooling sensation via TRPM8 nerve activation to distract from pain. (Like peppermint airflow cooling the skin.)

Question 36

Serious camphor risk?

Accepted Answer

Ingestion can cause seizures or death in children. (Like a small battery that can be fatal if swallowed.)

Question 37

Histamine dihydrochloride effect?

Accepted Answer

Increases blood flow and reduces oxidative and inflammatory signals. (Like opening more lanes for repairs.)

Question 38

Capsaicin mechanism?

Accepted Answer

Stimulates TRPV1 and depletes substance P, producing warmth and long-term pain relief. (Like desensitizing a loud alarm over time.)

Question 39

How long for capsaicin to work?

Accepted Answer

Relief starts ≈ 14 days, may take 4–6 weeks. (Like getting in shape after consistent training.)

Question 40

Capsaicin side effects?

Accepted Answer

Burning, redness, stinging (decrease with use), coughing on application. (Like touching chili and then your skin.)

Question 41

Key capsaicin counseling?

Accepted Answer

Wash hands after use and avoid eyes/mouth. (Like handling hot peppers.)

Question 42

Counterirritant drug interactions?

Accepted Answer

Avoid mixing same mechanism agents, local anesthetics, or skin protectants. (Like stacking multiple filters and blocking air flow.)

Question 43

FDA guidelines for topical analgesics?

Accepted Answer

Stop if blistering; don’t use heat; avoid damaged skin or mucosa. (Like “Caution Hot Surface” labels for safety.)

Question 44

Topical lidocaine strength and use limit?

Accepted Answer

0.5–4 %, apply ≤ 3×/day, max 7 days. (Like a short-term numbing patch.)

Question 45

Who should avoid self-treating fever?

Accepted Answer

Adults > 104 °F, infants < 6 mo > 101 °F, immunocompromised, CNS damage, severe infection, > 3 days duration. (Like when the system overheats beyond manual control.)

Question 46

Where is temperature regulated?

Accepted Answer

Anterior hypothalamus. (Like the body’s internal thermostat.)

Question 47

Difference between fever and hyperthermia?

Accepted Answer

Fever = regulated rise; hyperthermia = failed temperature control. (Like a smart heater vs a broken one.)

Question 48

Temperature criteria for fever by site?

Accepted Answer

Rectal > 100.4 °F, Oral > 99.7 °F, Axillary > 99.3 °F, Tympanic > 100 °F, Temporal > 100.7 °F. (Like different thermometers giving slightly different readings.)

Question 49

Preferred temperature method for infants < 6 mo?

Accepted Answer

Rectal. (Like checking the core for the most accurate read.)

Question 50

What are febrile seizures?

Accepted Answer

Brief seizures in children 6 mo–5 yrs triggered by fever; antipyretics don’t prevent recurrence. (Like a temporary power surge.)

Question 51

How do pyrogens cause fever?

Accepted Answer

Trigger cytokine release → ↑ PGE₂ → hypothalamus raises set point. (Like turning up a thermostat when cold.)

Question 52

Why treat fever?

Accepted Answer

High temp ↑ O₂ demand (≈ 13 % per 1 °C); may worsen heart/lung disease. (Like running a car engine too hot.)

Question 53

Non-drug fever management?

Accepted Answer

Hydration, light clothes, 68 °F room, avoid ice baths and alcohol sponging. (Like cooling gently instead of shock cooling.)

Question 54

Antipyretic mechanism?

Accepted Answer

Inhibit COX in CNS → ↓ PGE₂ → lower hypothalamic set point. (Like resetting a smart thermostat.)

Question 55

Acetaminophen dose for children (fever).

Accepted Answer

10–15 mg/kg every 4–6 h (max 5 doses/day). (Like giving measured cups not spoonfuls of medicine.)

Question 56

Ibuprofen dose for children (fever).

Accepted Answer

5–10 mg/kg every 6–8 h (max 4 doses/day). (Like a longer-lasting coolant.)

Question 57

Ibuprofen age restriction?

Accepted Answer

Not for infants < 6 months. (Like strong medicine for a tiny engine — not yet.)

Question 58

Adult ibuprofen fever dose?

Accepted Answer

200–400 mg every 4–6 h (max 1,200 mg/day). (Like a standard limit per shift.)

Question 59

Adult naproxen fever dose?

Accepted Answer

220 mg every 8–12 h (max 660 mg/day). (Like morning and evening routine.)

Question 60

Duration limit for fever self-care?

Accepted Answer

≤ 3 days without HCP consult. (Like a 3-day trial before calling for support.)

Question 61

Why avoid alternating acetaminophen and ibuprofen?

Accepted Answer

Increases complexity and risk of dosing errors. (Like mixing two recipes and ruining both.)

Question 62

Why avoid alcohol baths in children?

Accepted Answer

Toxicity risk and causes shivering. (Like trying to cool too fast and causing shock.)

Question 63

Why older adults may show low fevers?

Accepted Answer

Blunted thermoregulatory response. (Like a slow thermostat in an old house.)

Question 64

Parent education points for fever?

Accepted Answer

Monitor correctly, avoid “fever phobia,” use measuring device, seek care if worsens. (Like checking gauges before calling for repairs.)

Question	Answer
	Generalized muscle pain or muscle cramp due to prolonged spasm. (Like a knot in a rope that tightens when pulled.)
What are common causes of myalgia?	Overexertion, trauma, infection, vitamin D deficiency, rheumatic or thyroid disease, or certain drugs. (Like an engine overheating from too much strain or poor fuel.)
How does myalgia typically present?	Dull ache, fatigue, weakness, worsens with contraction. (Like an overused spring losing tension.)
What is tendonitis?	Inflammation of a tendon from overuse or injury, causing pain and limited motion. (Like a squeaky door hinge from friction.)
Common causes of tendonitis?	Overexertion, trauma, fluoroquinolone antibiotics, inflammatory disease. (Like using the same joint too many times without rest.)
What is bursitis?	Inflammation of the fluid-filled sacs cushioning joints, causing constant pain and redness. (Like an overfilled balloon between two surfaces.)
What is a sprain?	Stretching or tearing of ligaments that stabilize joints. (Like overstretching a rubber band.)
Grades of sprains?	I = stretch, II = partial tear, III = complete tear. (Like cracking a stick—slightly bent, partly split, or fully broken.)
What is a strain?	Overextension of a muscle or tendon causing pain, weakness, and swelling. (Like over-pulling an elastic band until it frays.)
Main goals of therapy for musculoskeletal pain?	Reduce pain, restore function, prevent re-injury, and avoid chronic pain. (Like fixing the leak, not just mopping water.)
Exclusions for self-treatment of pain/inflammation?	Pain > 6/10 or > 10 days, worsening pain, deformity, numbness, pregnancy, < 2 years old, infection, or bowel/bladder loss. (Like a warning light—call a mechanic, not DIY.)
Key non-drug measures for myalgia?	Rest, gentle stretching, hydration, massage, avoid bouncing movements. (Like slowly warming up cold taffy instead of snapping it.)
When to use ice therapy?	Immediately after injury, 10–15 min 3–4×/day up to 72 h. (Like putting a hot phone in front of a fan to cool it.)
When to use heat therapy?	After 48 h for non-inflammatory pain (low back pain, OA). (Like turning on a heater once condensation clears.)
RICE stands for what?	Rest, Ice, Compression, Elevation. (Like the quick-response kit for joint injuries.)
Compression technique?	Wrap distal → proximal, overlap ⅓ to ½, loosen upward. (Like wrapping a burrito evenly—not too tight.)
Elevation recommendation?	Keep injury at/above heart 2–3 h per day. (Like storing a wet book upright so it dries evenly.)
First-line systemic analgesics?	Acetaminophen and NSAIDs. (Like the default tools in your repair kit.)
Acetaminophen mechanism?	Central inhibition of prostaglandin synthesis. (Like muting the alarm system instead of cutting wires.)
Acetaminophen onset and duration?	Onset ≈ 30 min; duration ≈ 4 h (6–8 h for ER). (Like a short-acting battery that lasts the morning.)
Maximum labeled daily acetaminophen dose?	3,250 mg/day. (Like a lower speed limit set for safety.)
Main acetaminophen toxicity?	Liver damage > 4 g/day—leading cause of acute liver failure. (Like overcharging a phone battery until it bursts.)
NSAID mechanism of action?	Blocks COX enzymes → ↓ prostaglandins → ↓ inflammation and pain. (Like closing a leaking valve.)
Key NSAID counseling point with aspirin?	Take aspirin 1 h before or 8 h after NSAID. (Like watering plants before shutting off the faucet.)
Common NSAID adverse effects?	GI upset, heartburn, ulcers, ↑ BP, fluid retention. (Like great power tools that can strip screws if misused.)
Who is at highest risk for NSAID ulcers?	Age > 60, prior ulcers, anticoagulant use, high dose, long use, alcohol. (Like thin glass cracking easier when reused often.)
FDA 2015 NSAID update?	MI/stroke risk may start within weeks of use, dose-related, even without heart disease. (Like a storm that forms sooner than expected.)
Max OTC ibuprofen dose?	1,200 mg/day (200–400 mg every 4–6 h). (Like four standard tabs per day limit.)
Max OTC naproxen dose?	660 mg/day (220 mg every 8–12 h). (Like morning and evening schedule.)
Topical NSAID example?	Diclofenac 1 % gel QID (max 32 g/day). (Like a thin coat of paint for localized repair.)
Key counseling for diclofenac gel?	Avoid bathing 1 h post-use; wash hands before/after; avoid sun on treated area. (Like letting glue set before touching.)
What are topical counterirritants?	Agents that relieve pain by producing mild surface irritation to distract from deeper pain. (Like scratching near a mosquito bite.)
Four types of counterirritants?	Rubefacients, Cooling agents, Vasodilators, Irritants. (Like four “modes” on a therapy device.)
Mechanism of methyl salicylate?	Rubefacient—causes local inflammation and vasodilation (“hot” feeling). (Like turning on a mini heat pad.)
Methyl salicylate safety points?	Avoid heat pads, tight bandages, open wounds, children, asthma, aspirin allergy. (Like not doubling heat sources.)
Camphor and menthol mechanism?	Cooling sensation via TRPM8 nerve activation to distract from pain. (Like peppermint airflow cooling the skin.)
Serious camphor risk?	Ingestion can cause seizures or death in children. (Like a small battery that can be fatal if swallowed.)
Histamine dihydrochloride effect?	Increases blood flow and reduces oxidative and inflammatory signals. (Like opening more lanes for repairs.)
Capsaicin mechanism?	Stimulates TRPV1 and depletes substance P, producing warmth and long-term pain relief. (Like desensitizing a loud alarm over time.)
How long for capsaicin to work?	Relief starts ≈ 14 days, may take 4–6 weeks. (Like getting in shape after consistent training.)
Capsaicin side effects?	Burning, redness, stinging (decrease with use), coughing on application. (Like touching chili and then your skin.)
Key capsaicin counseling?	Wash hands after use and avoid eyes/mouth. (Like handling hot peppers.)
Counterirritant drug interactions?	Avoid mixing same mechanism agents, local anesthetics, or skin protectants. (Like stacking multiple filters and blocking air flow.)
FDA guidelines for topical analgesics?	Stop if blistering; don’t use heat; avoid damaged skin or mucosa. (Like “Caution Hot Surface” labels for safety.)
Topical lidocaine strength and use limit?	0.5–4 %, apply ≤ 3×/day, max 7 days. (Like a short-term numbing patch.)
Who should avoid self-treating fever?	Adults > 104 °F, infants < 6 mo > 101 °F, immunocompromised, CNS damage, severe infection, > 3 days duration. (Like when the system overheats beyond manual control.)
Where is temperature regulated?	Anterior hypothalamus. (Like the body’s internal thermostat.)
Difference between fever and hyperthermia?	Fever = regulated rise; hyperthermia = failed temperature control. (Like a smart heater vs a broken one.)
Temperature criteria for fever by site?	Rectal > 100.4 °F, Oral > 99.7 °F, Axillary > 99.3 °F, Tympanic > 100 °F, Temporal > 100.7 °F. (Like different thermometers giving slightly different readings.)
Preferred temperature method for infants < 6 mo?	Rectal. (Like checking the core for the most accurate read.)
What are febrile seizures?	Brief seizures in children 6 mo–5 yrs triggered by fever; antipyretics don’t prevent recurrence. (Like a temporary power surge.)
How do pyrogens cause fever?	Trigger cytokine release → ↑ PGE₂ → hypothalamus raises set point. (Like turning up a thermostat when cold.)
Why treat fever?	High temp ↑ O₂ demand (≈ 13 % per 1 °C); may worsen heart/lung disease. (Like running a car engine too hot.)
Non-drug fever management?	Hydration, light clothes, 68 °F room, avoid ice baths and alcohol sponging. (Like cooling gently instead of shock cooling.)
Antipyretic mechanism?	Inhibit COX in CNS → ↓ PGE₂ → lower hypothalamic set point. (Like resetting a smart thermostat.)
Acetaminophen dose for children (fever).	10–15 mg/kg every 4–6 h (max 5 doses/day). (Like giving measured cups not spoonfuls of medicine.)
Ibuprofen dose for children (fever).	5–10 mg/kg every 6–8 h (max 4 doses/day). (Like a longer-lasting coolant.)
Ibuprofen age restriction?	Not for infants < 6 months. (Like strong medicine for a tiny engine — not yet.)
Adult ibuprofen fever dose?	200–400 mg every 4–6 h (max 1,200 mg/day). (Like a standard limit per shift.)
Adult naproxen fever dose?	220 mg every 8–12 h (max 660 mg/day). (Like morning and evening routine.)
Duration limit for fever self-care?	≤ 3 days without HCP consult. (Like a 3-day trial before calling for support.)
Why avoid alternating acetaminophen and ibuprofen?	Increases complexity and risk of dosing errors. (Like mixing two recipes and ruining both.)
Why avoid alcohol baths in children?	Toxicity risk and causes shivering. (Like trying to cool too fast and causing shock.)
Why older adults may show low fevers?	Blunted thermoregulatory response. (Like a slow thermostat in an old house.)
Parent education points for fever?	Monitor correctly, avoid “fever phobia,” use measuring device, seek care if worsens. (Like checking gauges before calling for repairs.)

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