Back Pain Flashcards

0
Q

Lumbar disc herniation – pain must be exacerbated by these activities to be a herniated disc?

A

Coughing, sneezing, defecating

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1
Q

Lumbar disc herniation – spinal level? Description of pain?

A

L4-L5 or L5-S1

  1. They taking pain produced by pressure on anterior spinal ligament
  2. Later, sudden onset of neurogenic pain (Like electrical shock shooting down leg) precipitated by forced movement
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2
Q

Lumbar disc herniation – physical exam findings? Confirm diagnosis with? Management? When surgery?

A

Positive straight leg raising test

MRI

  1. Three weeks of bedrest
  2. Nerve blocks for pain
  3. Surgery if neurological deficits are progressing or cauda equina syndrome
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3
Q

Signs if Cauda equina syndrome? Surgery when?

A

Distended bladder, flaccid rectal sphincter, perineal saddle anesthesia

Immediate surgery

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4
Q

Ankylosing spondylitis – demographic? Pain worse when?

A

30-40 year old men

Pain worse at rest, improved with activity

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5
Q

Elderly patient with progressive back pain that is worse at night and unrelieved by rest or positional changes – Suspected diagnosis? Diagnostic tests?

A

Metastatic malignancy; x-ray or MRI

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