Paeds Vivas · adolescent-and-young-adult-medicine
Adolescent chronic pain and functional symptoms — branching viva
Branching viva on validating chronic pain, screening for red flags once, reframing with central sensitisation, co-building a function-first interdisciplinary plan, school reintegration and avoiding opioid escalation.
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Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
You are the paediatric registrar in adolescent clinic. The examiner will move from a first presentation of chronic widespread pain, to central sensitisation counselling, to an interdisciplinary plan, to a school-absence disclosure and a red-flag challenge.
Stem
The examiner will test whether you can run a validating, function-first chronic-pain pathway under pressure — refusing both over-investigation and dismissal. [1] [2]
References8ShowHide
- [1]Simons LE; Basch MC State of the art in biobehavioral approaches to the management of chronic pain in childhood. Pain management, 2016.PMID 26678858
- [2]King S; Chambers CT; Huguet A The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain, 2011.PMID 22078064
- [3]Woolf CJ Central sensitization: implications for the diagnosis and treatment of pain. Pain, 2011.PMID 20961685
- [4]Fisher E; Law E; Dudeney J Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane database of systematic reviews, 2018.PMID 30270423
- [5]Kashikar-Zuck S; Ting TV; Arnold LM Cognitive behavioral therapy for the treatment of juvenile fibromyalgia: a multisite, single-blind, randomized, controlled clinical trial. Arthritis and rheumatism, 2012.PMID 22108765
- [6]Logan DE; Simons LE; Stein MJ School impairment in adolescents with chronic pain. The journal of pain : official journal of the American Pain Society, 2008.PMID 18255341
- [7]Logan DE; Simons LE; Carpino EA Too sick for school? Parent influences on school functioning among children with chronic pain. Pain, 2012.PMID 22169177
- [8]Sherry DD; Sonagra M; Gmuca S The spectrum of pediatric amplified musculoskeletal pain syndrome. Pediatric rheumatology online journal, 2020.PMID 33046102