Intro and Red Flags

Question 1

T/F LBP affects men more than women

Answer 1

F affects them equally, typically between ages 30-50 yo.

Question 2

____ of adults have LBP at one time

Answer 2

2/3

Question 3

1 in ___ suffer with chronic LBP

Answer 3

4

Question 4

Back pain accounts for approximately ____ of all patients treated in outpatient PT practices

Answer 4

50%

Question 5

5 risk factors for LBP

Answer 5

smoking
> 1hr/day in car
>1hr/day in activity with vibratory forces
full term pregnancy with vaginal delivery
repetitive heavy lifting

Question 6

Most expensive cause of work-related disability is ____ and most common cause of work-related disability in people under ____

Answer 6

LBP, 45 years

Question 7

Greatest predictor of surgery is _____

Answer 7

the number of surgeons in the local population

Question 8

What are the 3 levels of classification made by the therapist in the TBC

Answer 8

1- is the pt. appropriate for PT
2- what is the level of acuity
3- what treatment should be used

Question 9

Red flag- history of major or minor trauma, fall, Motor vehicle accident, strenuous lifitng

Answer 9

possible fracture, especially in an older or OA patient.

Question 10

Red flag- immuno-suppression from transplant, IV drug abuse, or prolonged steroid use

Answer 10

increased risk of infection

Question 11

Red flag- Age over 50

Answer 11

Higher risk of cancer, AAA, fracture, and infection

Question 12

Red flag- past or present history of any type of cancer

Answer 12

increased risk of cancer-causing LBP. common metastatic cancers that cause LBP are from prostate, breast, kidney, thyroid, lung, and lymphoma. (PB KTLL “lead kettle”)

Question 13

Red flag- pain not relieved with rest or wakes at night, not related to movement or positioning

Answer 13

increased risk of cancer, infection, and AAA

Question 14

Red flag- Fevers, chills, night sweats (fevers > 100, chills, waking up sweating, temp changes at night

Answer 14

increased risk of infection or cancer

Question 15

Red flag- weight loss

Answer 15

unexplained loss of 10+ lbs in 3 mo that is unrelated to change in diet or activity may indicate infection or cancer

Question 16

Red flag- Recent bacterial infection

Answer 16

increased risk or infection

Question 17

Red flags- Cauda equina syndrome

Answer 17

saddle anesthesia, bladder dysfunction, progressive or severe neuro deficit in the LE

Question 18

What pt population is at higher risk for spinal infection

Answer 18

DM, IV drug use, alcoholics on corticosteriods, SCI with neurogenic bladder, other immune-suppression, 3rd decade

Question 19

Spinal infection signs and symptoms

Answer 19

severe night pain, increasing severity over up to 2-3mo, fever, chills, fatigue, concurrent infection or drug use, possible redness, swelling, warmth, local tenderness over SP; spinal percussion painful

Question 20

AAA is a abdominal aortic vessel distension of 3 cm or more and risk for rupture increases as diameter approaches __ cm

Answer 20

5-6

Question 21

AAA is most common in individuals aged ___ and older. More common in ___

Answer 21

60, males

Question 22

What is the most common clinical presentation of AAA

Answer 22

LBP

Question 23

The clinical presentation of AAA increases with _____ but not with _____

Answer 23

general activity, spinal movement

Question 24

How do examine for AAA

Answer 24

palpation of diameter, auscultation for a bruit, bounding mass (not just pulse) indicative of rupture

Question 25

two question depression screen

Answer 25

1. over the past 2 weeks, have you felt down, depressed, or hopeless?
2. over the past 2 weeks, have you felt little interest or pleasure in doing things?

Question 26

Key factors of Anklyosing Spondylitis

Answer 26

1. morning stiffness > 30 min
2. improvement in LBP with exercise but not with rest
3. Night pain during second half of night only
4. alternating buttock pain
   if 3/4 are present than there is a good +LR