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Clin Med II > Clin Med- Low Back I > Flashcards

Clin Med- Low Back I Flashcards

1
Q

Spinal malignancy is multiple _________

A

myeloma

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2
Q

Spinal malignancy is a primary malignant tumor in the _______ ________
This is typically in ________ individuals

A

bone marrow; older

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3
Q

Spinal malignancy:

________ metastases is secondary and is the _____ MOST common serious spinal pathology

A

Spinal; 2nd

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4
Q

What are the most common tumors of the spine?

A

Spinal Mestastases

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5
Q

Spinal metastases is MOST often from __________, __________, prostate, _______, GI, and thyroid

A

breast; lung; kidney

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6
Q

__________ is the 3rd MOST common area of metastasis, behind lung and liver

A

bone

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7
Q

With bone metastasis, the ______ ______ is the MOST common structure involved and typically in the _______ portion… this leads to wedging (disc rarely involved)

A

vertebral body; anterior

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8
Q

With spinal malignancy, the _________ region is the MOST area involved (70%)

A

thoracic

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9
Q

With spinal malignancy, _____% created cord compression or myelopathy

A

20

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10
Q

With spinal malignancy risk factor:

97% of spinal tumors are the result of metastases, this means that _______ of _______ is the MOST useful indicator

A

PMH; cancer

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11
Q

With spinal malignancy, _______ bone is replaced by _______

A

healthy; tumor

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12
Q

Which imaging is the GOLD standard for spinal malignancy?

A

MRI

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13
Q

What should you mainly ask in the subjective self/family Hx for ANY patient?

A

Hx of cancer

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14
Q

Cancer S&S the pain is _______ and ________

A

local; referred

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15
Q

With cancer, it worsens as the tumor grows and enroaches on other ________ with more ________

A

tissue; inflammation

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16
Q

With cancer S&S, if someone wakes up at the same time every night it is due to what usually?

A

metabolic activity

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17
Q

As cancer worsens, it is often invariable with ______ or movement and may become constant

A

position

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18
Q

Additional cancer S&S?

A

N&V

Loss of appetite

unexplained weight loss ≥ 5-10% over a 3-6 month period

fever, chills, night sweats

swollen, non-tender lymph nodes

unusual malaise and fatigue

secondary infections (lowered immunity)

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19
Q

What S&S would likely be present due to the involvement of vertebral body? NOT spinal cord yet….

_____ segmental

______ S&S

_____ P!

______reflexive

A

multi

UMN

Spinal

Hyper

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20
Q

With spinal malignancy, the MOST common initial symptom is?

A

spinal P!

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21
Q

With spinal malignancy, there is a ________ and ______ P! that may become progressive and constant

A

unfamiliar; severe

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22
Q

With spinal maligancy, there could be possible bony alterations including ___ and subsequent ______ instability

A

fxs; joint

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23
Q

With spinal malignancy, thay be unable to lie ______ due to P!

A

flat

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24
Q

With spinal malignancy, there will most likely be __________ P! with scan and biomechanical exam components that stress the ______ ________ and lumbar will possibly be +

A

mechanical; verterbal body

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25
Q

With spinal malignancy, there will be a _______ referral to MD unless cord S&S you would want to immobilize for _________ referral

A

urgent; emergency

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26
Q

_______ myelopathy is slow, gradual, and often progressive compression of the cord

A

Lumbar

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27
Q

What level does the spinal cord end?

A

L1-L2

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28
Q

The ______ region is the 2nd MOST common area of spine for compression

A

lumbar

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29
Q

Lumbar myelopathy is ______ due to trauma

A

NOT

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30
Q

lumbar myelopathy MOST commonly due to _________ spinal changes

A

degenerative

31
Q

With lumbar myelopathy and degenerative spinal changes, it has:

Lax and buckling _______ ________

Age-related joint _________ with enlarging and enroaching ______ bone aka stenosis

Age-related _______ disease with _________

______ ______ collapse

Pathological __________ such as spondylolithesis

A

Ligamentum Flavum

disease; athritic

disc; herniations

vertebral body

instability

32
Q

With lumbar myelopathy and malignancy, 20% of the time only well validated RED flag being hx of _________

A

cancer

33
Q

With lumbar myelopathy, there is rare ______ disc herniation

A

central

34
Q

With observation of lumbar myelopathy, it is NOT _____ and NOT likely to ______

A

acute; splint

35
Q

With lumbar myelopathy and A/PROM- there will be extreme ______ pain with _________ reproduction with scan and biomechanical exam

A

spinal; mechanical

36
Q

With lumbar myelopathy, A/PROM- there will be extreme spinal pain with mechanical reproduction with scan and biomechanical exam, possibly for:

_____-_______ changes

_______ body

Instability

A

age-related

vertebral

37
Q

With lumbar myelopathy, _____ stress tests will be positive possibly or ______ symptoms

A

PA; neuro

38
Q

With lumbar myelopathy:

DTRs ______reflexive

_______ myotomes

_______ bowel and bladder

Clonus and Babinski ________

Dural mobility _____

Superficial reflexes _______active

A

hyper
fatiguing
spastic/retentive
+
-
hypo

39
Q

With lumbar myelopathy, it is a. _______ referral

A

urgent

40
Q

With lumbar myelopathy, there will be _____ segmental numbness and ______/paralysis of lower extremities and trunk below level of injury likely leading to impaired balance

A

multi; weakness

41
Q

________ _________ syndrome is compression on some degree of the 20 spinal nn. that originate from the end of spinal cord or conus medularis in the vertebral canal

A

Cauda Equina

42
Q

Cauda Equina syndrome is ______ or _____ and below what segment?

A

acute; chronic; L1-L2

43
Q

Cauda Equina syndrome is ____ with 2% of lumbar age-related ____ changes

A

rare; disc

44
Q

Cauda Equina syndrome is PRIMARILY due to ____ to ______ lumbar age-related disc changes

A

mid; lower

45
Q

Cauda Equina syndrome is SECONDARILY due to other _______ spinal changes and ________

A

degenerative; malignancy

46
Q

What are the risk factors for Cauda Equina syndrome?

Mid to lower lumbar
- _______ IDD, central> postlat IDD

  • ________ stenosis
  • surgery
  • < ______ years
  • Obesity
A

Persistent

central

50

47
Q

Cauda Equina syndrome clinical manifestations S&S Hx including (LMN):

____ _____ P!

Bowel and bladder _________

_________ dysfunction

Possible _____ S&S if malignancy contributing

A

Low back

incontinence

sexual

cancer

48
Q

With Cauda Equina syndrome, limited and worse with _____ and better with ______ activities

A

EXT; FLX

49
Q

With Cauda Equina syndrome, there are progressive or even alternating LE/_______ findings due to movement of ______ ______

A

patchy; spinal nerves

50
Q

With Cauda Equina syndrome, there are paresthesia’s and decreased sensation in multiple dermatomes in what areas?

A

saddle or groin area

51
Q

With Cauda Equina syndrome, there a multiple ______ weaknesses and _____ abnormality

A

myotomial; gait

52
Q

With Cauda Equina syndrome, there are ______active DTRs

A

hypo

53
Q

Is dural moblity + for cauda equina syndrome?

A

yes

54
Q

What kind of referral is Cauda Equina syndrome?

A

emergency

55
Q

What imaging is the GOLD standard for Cauda Equina syndrome?

A

MRI

56
Q

______ __________ is the infectious disease of spinal structures

A

spinal infections

57
Q

Osteomyelitis is associated with _______ infections and affects the ______

A

spinal; bone

58
Q

Discitis means what?

A

disc infection

59
Q

Spinal infections is uncommon in ________ countires but resurgence with longevity and IV drug use

A

wealthier

60
Q

Discitis is more common in ______ spine

A

lumbar

61
Q

Spinal infections etiology:

Primarily from _____ _______ bacteria

What is the secondary?

A

air born

staph bacteria

62
Q

What are risk factors for spinal infection?:

________ suppression

_________ particularly of the spine and repeated procedures

_____ drug use

________ depravation

Hx of _____ or other recent infections

A

Immuno

Surgery
IV
social
TB

63
Q

With spinal infection, it may take days, _____ or ______ to spread to the spine

A

months
years

64
Q

With spinal infections, it spreads to the disc MORE commonly in the ______ spine

A

lumbar

65
Q

With spinal infection, it is NOT common but as abscess grows the following may occur:

____ ______ irritation

_______ ______ collapse/fx

______ compression may develop

A

nere root

vertebral body

cord

66
Q

What is the MOST common presenting symptom for spinal infection?

A

age-related changes with back P!/stiffness

67
Q

With spinal infections, there are __________ and ________ symptoms NOT common initially

A

constitutional; infection

68
Q

What are the infection S&S?

_______ (MOST common early symptom)

Fever, _____, ______

N&V

Enlarged and likely ________ lymph nodes

_________ (maybe lymphangitis or streaks toward lymph nodes) abcess, _____, and or swelling

A

Malaise

chills; sweats

tender

Redness; heat

69
Q

Spinal infection is usually ______ and ______ spinal P! that limits motion

A

localized; progressive

70
Q

With spinal infections, it is likely _______ pain for disc > ______ _______ involvement with scan and biomechanical exam

A

mechanical; vertebral body

71
Q

Spinal infection, infection S&S particularly they would experience ______ fatigue and have a _____ since onset of back P!

A

abnormal; fever

72
Q

If spinal infection is left untreated, it could lead to:

______ weight loss of ≥ 5-10% over a 3-6 month period with loss of appetite

_______ S&S influence LE and coordination as well with bowel and bladder ________

Loss of lumbar ______

A

unexplained

neurological; dysfunction

lordosis

73
Q

Spinal infection is a _______ referral unless cord or Cauda equina S&S then _______ referral to MD

A

urgent; emergency

Clin Med II (7 decks)

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