ABPM Certification Exam

Sample Examination Questions

1. One of the effects created by activation or increased release of substance P is

(A) vasoconstriction.

(B) membrane stabilization.

(C) analgesia.

(D) vasodilation.


2. A 23-year-old female patient, who was recently discharged from the hospital following open reduction and internal fixation of a fractured femur, suddenly develops severe chest pain. Which of the following medications in her history would seem to be implicated in the etiology of her pain?

(A) Oral contraceptives

(B) Nonsteroidal anti-inflammatory agents

(C) Opioid analgesics

(D) Benzodiazepines


3. Patients who present with fever and pain of recent onset over the neck, upper back, chest, and upper limbs should be assessed for the possibility of abscess in the

(A) cervical epidural space.

(B) posterior nasopharynx.

(C) subdiaphragmatic space.

(D) T 7-8 disk space.


4. Disability due to chronic pain is felt to be primarily related to the

(A) number of somatic sites in which pain exists.

(B) reinforcement of pain behaviors.

(C) presence of a life-threatening disease.

(D) presence of neuropathic, as opposed to muscular, pain causes.


5. Further testing with CT scan or MRI is mandatory

in headaches accompanied by all of the following EXCEPT

(A) prolonged long-term, unchanging band-like headaches.

(B) hemiparesis and contralateral sensory deficit.

(C) the appearance of seizures.

(D) olfactory hallucinations.


6. Referral to a multidisciplinary pain center is usually most appropriate when patients demonstrate evidence of

(A) purely psychiatric mechanisms.

(B) purely neuropathic mechanisms.

(C) both psychological tension and physical muscle tension.

(D) both somatic and psychological factors.


7. Which tricyclic antidepressant is most appropriate for treatment of pain in an 80-year-old male with postherpetic neuralgia and urinary retention?

(A) Amitriptyline (Elavil)

(B) Doxepin (Sinequan)

(C) Desipramine (Norpramin)

(D) Imipramine (Tofranil)


8. In disability determination under most workers' compensation systems, the presence of pain is given

(A) more attention than the underlying physical impairment.

(B) as much attention as the underlying physical impairment.

(C) less attention than the underlying physical


(D) no attention whatsoever.


9. Which of the following is true regarding the use of antidepressants to reduce chronic pain?

(A) Only tertiary amine tricyclics are effective.

(B) Serotonergic agents are not clearly superior to noradrenergic ones.

(C) Serotonin potentiation is a necessary characteristic of effective agents.

(D) Only noradrenergic agents are effective.


10. DREZ lesions have been documented to provide long-term pain relief in

(A) cervical root avulsion.

(B) sciatica.

(C) diabetic neuropathy.

(D) thalamic pain syndrome.


11. A 52-year-old patient presents with a history of acute low back pain, without trauma, which is unrelieved by bed rest and is associated with paroxysms of pain and an elevated erythrocyte sedimentation rate. Radiographs of the spine reveal an absent pedicle. The most likely diagnosis is

(A) lupus erythematosus.

(B) multiple myeloma.

(C) metastatic lesion.

(D) disc space infection.


12. Which of the following is true regarding patients with cluster headaches?

(A) They are more likely to be female.

(B) They are likely to lie in a quiet, dark room with an ice pack over the affected temple during an attack.

(C) They are usually nonsmokers and nondrinkers.

(D) They are known to attempt suicide secondary to their pain.


13. Which of the following is true of the physical or sensory component of pain perception?

(A) It is less variable than the anxiety produced by the pain.

(B) It is more variable than the anxiety produced by the pain.

(C) It is generally equal to the anxiety produced by the pain.

(D) It is reduced in patients with hypochondriasis.


14. A patient who has been taking high doses of benzodiazepines and opioids experiences withdrawal symptoms during detoxification. Which of the following specifically indicates that the opioid is being tapered too rapidly?

(A) Hyperreflexia

(B) Diaphoresis

(C) Hyperactive bowel sounds

(D) Tachycardia


15. The depression commonly seen in those with chronic pain of nonmalignant origin differs from the most typical major depressions in that in the former there is likely to be

(A) anhedonia.

(B) weight gain.

(C) guilty ruminations.

(D) insomnia.


16. All of the following are true of migraine headache EXCEPT

(A) Aura (prodrome) is not present in common migraine.

(B) The neurologic symptoms of classic migraine may persist beyond the headache phase.

(C) Ergotamine (Ergostat) is effective in treating acute attacks when used daily for 7-14 days.

(D) 70% of migraine patients have a positive family migraine history.


17. The essential feature of pain that can be used to differentiate it from other somatic sensations is its

(A) intensity.

(B) threshold.

(C) chronicity.

(D) unpleasantness.


18. Aching pain in the suprapubic region is most likely caused by abnormalities of the

(A) ureter.

(B) prostate.

(C) coccyx.

(D) sacroiliac joints.

Answer Key:

1. D, 2. A, 3. A, 4. B, 5. A, 6. D, 7. C, 8. C, 9. B, 10. A, 11. C, 12. D, 13. A, 14. C, 15. B, 16. C, 17. D, 18. B