ABA Pain Medicine Certification
Examination – Full-Length Practice
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A patient with chronic low back pain has MRI findings of Modic type I
changes at L4-L5. These changes most likely represent:
A. Fatty marrow replacement
B. Subchondral sclerosis
C. Active inflammatory endplate changes
D. Disc calcification
Answer: C
Modic type I changes reflect bone marrow edema and inflammation
at the vertebral endplates, often associated with pain.
2. The primary mechanism of action of gabapentin in neuropathic pain is:
A. Sodium channel blockade
, B. NMDA receptor antagonism
C. Binding to the alpha-2-delta subunit of voltage-gated calcium
channels
D. GABA-A receptor activation
Answer: C
Gabapentin decreases excitatory neurotransmitter release by
modulating calcium channel function.
3. Which nerve root is most commonly involved in a posterolateral L5-S1
disc herniation?
A. L3
B. L4
C. L5
D. S1
Answer: D
Posterolateral herniations at L5-S1 typically compress the traversing
S1 nerve root.
4. The most appropriate initial treatment for postherpetic neuralgia in an
elderly patient is:
A. Oral corticosteroids
B. Opioids
C. Topical lidocaine patch
D. Benzodiazepines
Answer: C
, Topical lidocaine provides effective localized analgesia with minimal
systemic effects.
5. Which spinal cord tract is primarily responsible for pain and
temperature sensation?
A. Dorsal columns
B. Corticospinal tract
C. Spinocerebellar tract
D. Spinothalamic tract
Answer: D
The spinothalamic tract transmits nociceptive and thermal sensory
information.
6. A patient on long-term opioid therapy develops decreased analgesic
effect requiring dose escalation. This phenomenon is best described
as:
A. Addiction
B. Pseudoaddiction
C. Tolerance
D. Physical dependence
Answer: C
Tolerance refers to reduced drug effect over time, requiring higher
doses to achieve the same effect.
7. Which medication is a mixed agonist-antagonist opioid?
A. Morphine
, B. Fentanyl
C. Buprenorphine
D. Methadone
Answer: C
Buprenorphine is a partial mu-opioid receptor agonist with
antagonist properties.
8. The recommended maximum daily dose of acetaminophen for most
adults is:
A. 2 grams
B. 3 grams
C. 4 grams
D. 6 grams
Answer: C
Exceeding 4 grams per day increases the risk of hepatotoxicity.
9. Which structure is targeted in a stellate ganglion block?
A. Cervical sympathetic chain at C2
B. Cervicothoracic sympathetic ganglion near C6-C7
C. Vagus nerve
D. Phrenic nerve
Answer: B
The stellate ganglion lies near the C6-C7 vertebral level and is part of
the cervical sympathetic chain.
Examination – Full-Length Practice
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A patient with chronic low back pain has MRI findings of Modic type I
changes at L4-L5. These changes most likely represent:
A. Fatty marrow replacement
B. Subchondral sclerosis
C. Active inflammatory endplate changes
D. Disc calcification
Answer: C
Modic type I changes reflect bone marrow edema and inflammation
at the vertebral endplates, often associated with pain.
2. The primary mechanism of action of gabapentin in neuropathic pain is:
A. Sodium channel blockade
, B. NMDA receptor antagonism
C. Binding to the alpha-2-delta subunit of voltage-gated calcium
channels
D. GABA-A receptor activation
Answer: C
Gabapentin decreases excitatory neurotransmitter release by
modulating calcium channel function.
3. Which nerve root is most commonly involved in a posterolateral L5-S1
disc herniation?
A. L3
B. L4
C. L5
D. S1
Answer: D
Posterolateral herniations at L5-S1 typically compress the traversing
S1 nerve root.
4. The most appropriate initial treatment for postherpetic neuralgia in an
elderly patient is:
A. Oral corticosteroids
B. Opioids
C. Topical lidocaine patch
D. Benzodiazepines
Answer: C
, Topical lidocaine provides effective localized analgesia with minimal
systemic effects.
5. Which spinal cord tract is primarily responsible for pain and
temperature sensation?
A. Dorsal columns
B. Corticospinal tract
C. Spinocerebellar tract
D. Spinothalamic tract
Answer: D
The spinothalamic tract transmits nociceptive and thermal sensory
information.
6. A patient on long-term opioid therapy develops decreased analgesic
effect requiring dose escalation. This phenomenon is best described
as:
A. Addiction
B. Pseudoaddiction
C. Tolerance
D. Physical dependence
Answer: C
Tolerance refers to reduced drug effect over time, requiring higher
doses to achieve the same effect.
7. Which medication is a mixed agonist-antagonist opioid?
A. Morphine
, B. Fentanyl
C. Buprenorphine
D. Methadone
Answer: C
Buprenorphine is a partial mu-opioid receptor agonist with
antagonist properties.
8. The recommended maximum daily dose of acetaminophen for most
adults is:
A. 2 grams
B. 3 grams
C. 4 grams
D. 6 grams
Answer: C
Exceeding 4 grams per day increases the risk of hepatotoxicity.
9. Which structure is targeted in a stellate ganglion block?
A. Cervical sympathetic chain at C2
B. Cervicothoracic sympathetic ganglion near C6-C7
C. Vagus nerve
D. Phrenic nerve
Answer: B
The stellate ganglion lies near the C6-C7 vertebral level and is part of
the cervical sympathetic chain.
