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Physical Assessment > Chapter 24, Module 6; Lower back pain (acute) > Flashcards

Chapter 24, Module 6; Lower back pain (acute) Flashcards

1
Q

Trauma to spine or back; pain is felt near site of injury

A

Spinal fracture

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2
Q

Palpable tenderness over site of fracture

A

Spinal fracture

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3
Q

DIAGNOSTIC STUDIES of Spinal fracture

A

Considered an emergency; immobilize patient and transport for radiographs

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4
Q

History of cancer; progressive pain is unremitting; occurs at night and at rest

A

Tumor

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5
Q

Weight loss, fever, tenderness near tumor

A

Tumor

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6
Q

DIAGNOSTIC STUDIES OF tumor

A

ESR; bone scan

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7
Q

Neck or back pain not relieved by aspirin; occurs in older adolescents and young adults

A

Osteoblastoma

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8
Q

Localized tenderness; may have scoliosis with muscle pain

A

Osteoblastoma

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9
Q

DIAGNOSTIC STUDIES OF Osteoblastoma?

A

Plain film shows an expansive osteolytic lesion surrounded by thin peripheral rim of bone; bone scan; CT scan

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10
Q

Occurs primarily in adolescents; rare in patients older than age 40; well- localized pain that may be more se¬ were at night and relieved by aspirin or other prostaglandin inhibitors

A

Osteoid osteoma

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11
Q

Painful, well-localized scoliosis may be present

A

Osteoid osteoma

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12
Q

DIAGNOSTIC STUDIES OF Osteoid osteoma?

A

Bone scan

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13
Q

History of infection, invasive procedure; continuous, dull back pain; chronic back pain

A

Infection (vertebral osteomyelitis)

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14
Q

Acute onset with fever, diaphoresis; tenderness over affected disk; positive SLR

A

Infection (vertebral osteomyelitis)

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15
Q

DIAGNOSTIC STUDIES OF Infection (vertebral osteomyelitis)?

A

ESR; blood culture; bone biopsy; CT scan; MRI

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16
Q

Pain aggravated by movement; more common in children

A

Diskitis

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17
Q

Tenderness over affected disk

A

Diskitis

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18
Q

DIAGNOSTIC STUDIES OF Diskitis?

A

ESR

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19
Q

LBP radiating down the buttock to below the knee, symptoms present less than 1 mo

A

Herniated disk

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20
Q

Positive SLR

A

Herniated disk

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21
Q

DIAGNOSTIC STUDIES OF Herniated disk ?

A

None

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22
Q

Constant pain in a saddle distribution; urinary retention, fecal incontinence, radiculopathy

A

Cauda equina syndrome

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23
Q

Positive SLR, abnormal DTRs, motor weakness

A

Cauda equina syndrome

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24
Q

DIAGNOSTIC STUDIES OF Cauda equina syndrome?

A

MRI, surgical emergency

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25
Q

Acute back pain with radiculopathy; history of strain or trauma, relief with sitting

A

Sciatica

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26
Q

Paravertebral tenderness and spasm; positive SLR; sitting knee extension, sensory findings

27
Q

DIAGNOSTIC STUDIES OF Sciatica?

A

EMG if chronic

28
Q

Pain in back, buttocks; history of new activity or exertion; relief of pain with sitting

A

Musculoskeletal strain

29
Q

Paravertebral tenderness, scoliosis, or loss of lumbar lordosis; no neurological signs

A

Musculoskeletal strain

30
Q

DIAGNOSTIC STUDIES OF Musculoskeletal strain?

31
Q

Young person in a sport that demands rapid movement between hyperflexion and hyperextension or requires excess loading in hyperextension

A

Spondylolisthesis

32
Q

No neurological signs; pain localized to low back, just below level of iliac crest; tight hamstrings

A

Spondylolisthesis

33
Q

DIAGNOSTIC STUDIES OF Spondylolisthesis?

A

Lumbar spine radiographs

34
Q

Younger than age 40: insidious onset; progressive morning back pain relieved with exercise

A

Ankylosing spondylitis

35
Q

Painful sacroiliac joints, reduced spine mobility; may have uveitis

A

Ankylosing spondylitis

36
Q

DIAGNOSTIC STUDIES OF

A

ESR; spinal radiographs

37
Q

Pain worse throughout day; aggravated by standing, relieved by rest; pseudoclaudication

A

Spinal stenosis

38
Q

Signs of osteoarthritis of joints; may have neurological signs

A

Spinal stenosis

39
Q

DIAGNOSTIC STUDIES OF Spinal stenosis?

40
Q

Affects mostly adolescent males; mild to moderately severe pain, worse at end of day, relieved by rest

A

Scheuermann disease

41
Q

Normal examination; may show an exaggerated thoracic kyphosis that is fixed in attemptedhyperextension

A

Scheuermann disease

42
Q

DIAGNOSTIC STUDIES OF Scheuermann disease?

A

Thoracic spine radiographs

43
Q

Chronic, poorly localized back pain; postmenopausal; slight build; history of inactivity or endocrine disorder

A

Osteoporosis

44
Q

Palpable tenderness over area of compression fracture; kyphosis or lordosis; loss of height

A

Osteoporosis

45
Q

DIAGNOSTIC STUDIES OF Osteoporosis?

A

Bone densitometry; spinal radiograph to assess fracture

46
Q

Severe, acute-onset pain not related to activity or movement; increased risk older than age 30; pallor, diaphoresis, anxiety, confusion

A

Aortic aneurysm

47
Q

Intact aneurysm will be a visible pulsatile midline upper quadrant abdominal mass; in a dissected aneurysm, upper extremity pulse and pulse pressures are asymmetric; posterior thoracic pain may be felt

A

Aortic aneurysm

48
Q

DIAGNOSTIC STUDIES OF Aortic aneurysm?

A

Emergency surgical referral

49
Q

Increased incidence with age; steady, intense pain in RUQ with radiation to right scapula or shoulder; belching, bloating, fatty food intolerance

A

Gallstones

50
Q

Normal physical examination or positive Murphy sign on palpation of abdomen

A

Gallstones

51
Q

DIAGNOSTIC STUDIES OF Gallstones?

A

Surgical referral

52
Q

Ill-appearing; sweating, nausea, back or flank pain, headache

A

Pyelonephritis

53
Q

Fever; cloudy, malodorous urine; CVA tenderness on percussion

A

Pyelonephritis

54
Q

DIAGNOSTIC STUDIES OF Pyelonephritis?

A

Urinalysis; urine culture

55
Q

History of recent URI; pleuritic pain

56
Q

Normal examination or crackles and bronchial breath sounds

57
Q

DIAGNOSTIC STUDIES OF Pleuritis?

A

PPD; chest radiograph

58
Q

Sexually active female; low back and abdominal pain; history of urinary or vaginal symptoms, sexually transmitted disease, IUD, multiple sex partners

A

Pelvic inflammatory disease

59
Q

Cervical and uterine motion tenderness, adnexal tenderness; cervicitis, fever

A

Pelvic inflammatory disease

60
Q

DIAGNOSTIC STUDIES OF Pelvic inflammatory disease?

A

Gonorrhea, Chlamydia cultures; ESR

61
Q

History of psychosocial stressors,depression, exaggerated expressions of pain

A

Psychologicalback pain

62
Q

Exaggerated or inconsistent reactions to testing; normal examination

A

Psychologicalback pain

63
Q

DIAGNOSTIC STUDIES OF Psychologicalback pain?

Physical Assessment (27 decks)

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