ABA Pain Medicine Certification
Examination – Full-Length Practice
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
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
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.
|| || || || || ||
