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ACR: Test 2 > Back Pain > Flashcards

Back Pain Flashcards

1
Q

What are red flags of back pain

A 
Acute tearing back pain 
duration >6 weeks 
fever 
neurologic deficit’s 
night pain 
unexplained weight loss 
chronic steroid use 
IV drug use 
significant trauma
Loss of bowel/urine control
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2
Q

What are emergent back pain diagnosis

A 
Cauda equina syndrome
Spondylolysis
Spondylolisthesis
Herniated disc
Compression fracture
Spinal stenosis
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3
Q

When should you image a patient with back pain

A

Long-term pain
whipping mechanism like in an MVA
direct trauma

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4
Q

What are some special test he might perform when evaluating back pain

A

Straight leg raise (L4/5, S1)

Neuro: sensations, DTR, rectal exam (S5)

Motor: heel walk (L4/5), toe walk (S1)

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5
Q 
If a patient has a herniated disc at L3 to L4 for 
what sensory loss will they have 
what motor weakness well they have 
what is the screening exam 
what reflex would you perform
A 
L4
Medial foot 
knee extension 
squat and raise 
patellar
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6
Q 
If a patient has a herniated disc at L4-L5 for 
what sensory loss will they have 
what motor weakness well they have 
what is the screening exam 
what reflex would you perform
A 
L5 
dorsal foot 
dorsiflexion ankle/great toe 
heel walking 
no reflex test
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7
Q 
If a patient has a herniated disc at L5-S1for 
what sensory loss will they have 
what motor weakness well they have 
what is the screening exam 
what reflex would you perform
A 
S1
lateral foot 
plantar flexion ankle/toes 
walking on toes 
Achilles reflex
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8
Q

____ Is where in tear in the age of the spine

A

Spondylosis

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9
Q

___ is The defect or stress fracture in the pars interarticularis

A

Spondylolysis

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10
Q

What is usually the cause of spondylolysis

A

Repetitive hypertension

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11
Q

What are signs and symptoms of Spondylolysis

A

Back pain worse with extension and hyperextension

Deep palpation elicits pain

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12
Q

What x-ray sign will you see with a patient with spondylolysis

A

Scotty collar fracture

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13
Q

What is the treatment for spondylolysis

A 
Conservative 
rest
lordotic racing
external bone stimulator
PT
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14
Q

___ is slippage if the vertebrae

A

Spondylolisthesis

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15
Q

What are signs and symptoms of spondylolisthesis

A

Back pain worse with extension hyperextension
neuro signs plus dural tension
maybe evident during single leg raise

Step off on palpation

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16
Q

What can you see on x-ray in a patient with spondylolithesis

A

Vertebral body slipped forward

17
Q

What is the treatment for spondylolisthesis

A

Rest
Bracing
PT
surgery if severe

18
Q

— is a systemic rheumatic dz w/ chronic inflammation that causes arthropathy of the Skelton and SI joints w/ progressive stiffness

A

Ankylosing spondylitis

19
Q

What are signs and symptoms of ankylosing spondylitis

A

Back pain and stiffness
skin issues
IBS
anterior uveitis

Loss of ROM

20
Q

What will you see on the x-ray of a patient with ankylosing spondylitis

A

Bamboo sign

21
Q

What labs should you order when working up a patient with Ankylosing spondylitis

A

HLA – B 27 genotype
CRP
ESR
rheumatoid factor

22
Q

What is the treatment of a patient with Ankylosingspondylitis

A

PT
NSAIDs
TNF alpha blockers (infliximab)
referred to rheumatology

23
Q

____ is compression of the cauda equina

A

Cauda equina syndrome

24
Q

What are signs and symptoms of cauda equina syndrome

A 
Severe low back pain
new onset about and bladder incontinence 
sciatica 
saddle anesthesia 
weakness and numbness
25
Q

What PE things you need to do to work up a patient with cauda equina syndrome

A

Straight leg raise
digital rectal exam
strength testing
DTRs

26
Q

What imaging do you need to work on the patient with cauda equina syndrome

A

Stat MRI

27
Q

What is the treatment for cauda equina syndrome

A

Emergent surgical decompression

28
Q

What is the other name for disc herniation

A

A cute lumbosacral radiculopathy

29
Q

What are physical exam findings in a patient with acute lumbosacral ridiculopathy

A

Radiating back pain to lower extremities

usually from L5 S1 spinal nerve roots

30
Q

What kind of imaging do you need to work on the patient with disc herniation

A

None

31
Q

What is the treatment for disc herniation

A

NSAIDs
Flexeril
tramadol

Refer to PT
Active rest

ACR: Test 2 (10 decks)

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