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Self-Assessment Questions

Internal Medicine

Treatment of Postherpetic Neuralgia: Review Questions

Kenneth J. Smith, MD, FACP

Dr. Smith is an Assistant Professor of Medicine, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; and a member of the Hospital Physician Editorial Board.


Choose the single best answer for each question.

1. A 69-year-old woman had a dermatomal rash consistent with herpes zoster 2 months ago, followed by moderately severe burning pain in the same area once the rash had healed. Which of the following medications would be ineffective for this patient?
  1. Celecoxib
  2. Extended release morphine sulfate
  3. Gabapentin
  4. Lidocaine transdermal patch
  5. Nortriptyline
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2. Which of the following statements regarding treatment of postherpetic neuralgia with antidepressant medication is true?

  1. Antidepressant agents are approved by the US Food and Drug Administration (FDA) for treatment of postherpetic neuralgia
  2. Antidepressant agents are ineffective if dysesthesia is present
  3. Antidepressant agents should not be used in persons older than 70 years
  4. The dosage for treatment of postherpetic neuralgia is similar to the dosage for treatment of depression
  5. Selective serotonin reuptake inhibitors are less effective than are tricyclic antidepressant agents in the treatment of postherpetic neuralgia
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3. Which of the following statements regarding narcotic analgesic treatment of postherpetic neuralgia is true?

  1. Addiction frequently occurs when narcotic agents are used to treat postherpetic neuralgia
  2. Mental slowness is worse with narcotic agents than with other agents used for treatment of postherpetic neuralgia
  3. Narcotic medications are ineffective in treating neuropathic pain
  4. Respiratory problems are infrequent adverse reactions of narcotic analgesic treatment
  5. Short-acting narcotic agents, rather than longer-acting medications, are preferred for the treatment of postherpetic neuralgia
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4. Which of the following statements regarding the use of gabapentin in patients with postherpetic neuralgia is true?
  1. Gabapentin is less expensive than are other agents used to treat postherpetic neuralgia
  2. Gabapentin is more likely to elicit adverse effects than are other agents used to treat postherpetic neuralgia
  3. Gabapentin is not FDA-approved for the treatment of postherpetic neuralgia
  4. Gabapentin is not recommended in patients with cardiac disease
  5. Gabapentin is usually given at a dose of 600 mg 3 times daily to patients with postherpetic neuralgia
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5. An otherwise healthy 76-year-old man has had intractable thoracic dermatomal pain from postherpetic neuralgia for over a year, despite the use of a variety of usually effective oral medications. Which of the following treatments may be beneficial, according to clinical trial results?

  1. Acupuncture
  2. Capsaicin
  3. Hypnosis
  4. Intrathecal corticosteroid injection
  5. Transcutaneous electrical nerve stimulation
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Updated 1/04/08 • kkj