LOBS

Question 1

what is an ‘error’?

Answer 1

A failure of planned actions to achieve the intended outcome
A deviation between what was actually done and what should have been done.

Question 2

what is a slip error?

Answer 2

When there is a distraction during a routine task for example getting distracted and mis calculating a dose

Question 3

what is a lapse error?

Answer 3

When there is unintended deviation from a routine procedure or standard approach

Question 4

what type of errors are unlikely to be repeated?

Answer 4

Slip

lapse

Question 5

what is a mistake?

Answer 5

failure in judgement due to a lack of knowledge

applying an incorrect rule to a problem

Question 6

what is a violation?

Answer 6

A deliberate attempt not to follow accepted approaches

Question 7

what is an active error>

Answer 7

errors occurring close to the patient

Question 8

what is a latent error?

Answer 8

A system error upstream of the patient

Question 9

what is the swiss cheese model of causation?

Answer 9

there are various layers of defences, barriers and safeguards but there are holes due to latent conditions so errors slip through

Question 10

what are yellow flags of back pain?

Answer 10

• inappropriate attitudes and beliefs about back pain
• inappropriate pain behaviour
• work related problems or compensation
• emotional issues

Question 11

what are typical symptoms of mechanical back pain?

Answer 11

• the symptoms vary with posture and activity
• typically between 20-55
• pain distribution often doesn’t go below the knees

Question 12

what are the typical clinical features of inflammatory back pain?

Answer 12

• age between 20-40 years
• a slow onset of symptoms
• chronic pain
• morning stiffness that improves with activity
• usually affects the axial skeleton
• extra- skeletal features like uveitis may be present

Question 13

what are some examples of causes of inflammatory back pain?

Answer 13

ankylosing spondylitis
reiters syndrome
reactive arthritis

Question 14

what are clinical features of back pain due to nerve roots?

Answer 14

• usually occur at the lumbar levels
• sciatica can spread down the feet and cause weak calves
• unilateral leg pain
• radiates below the knees
• numbess and parathesia
• motor, sensory and reflex changes

Question 15

what way does a vertebral disk herniate?

Answer 15

posterior-lateral

Question 16

what are signs of a prolapsed vertebral disk?

Answer 16

lower back pain
muscle spasm
often unilateral
radiates to the buttocks

Question 17

what are the changes in an L2 nerve impingement?

Answer 17

sensory changes in the front of the thigh
no reflex changes
weak hip flexion and adduction

Question 18

what nerve root is affect in an L1/L2 prolapse?

Answer 18

the lower of the two adjacent vertebrae

L2

Question 19

what are the changes in an L3 nerve impingement?

Answer 19

sensory changes of the inner thigh and knee
loss of knee reflex
weak knee extension

Question 20

what are the changes in an L4 nerve impingement?

Answer 20

sensory loss of inner calf
loss of knee reflex
weak knee extension

Question 21

what are the changes in an L5 nerve impingement?

Answer 21

sensory changes of outer calf and middle/upper foot
no reflex change
weak inversion and dorsiflexion

Question 22

what are the changes in an S1 nerve impingement?

Answer 22

Sensory changes in the posterior calf and lateral foot
loss of ankle reflex
weak plantar flexion

Question 23

what is spondylolisthesis?

Answer 23

A vertebrae slips anteriorly

Question 24

what are causes of proximal myopathy?

Answer 24

PEACH POD
P- polymyositis
E- endocrine
A- alcohol
C- carcinoma 
H- HIV
P-eriodic hypokalaemia paralysis
O- osteomalacia
D- drugs
S- sarcoidosis

Question 25

what are endocrine causes of proximal myopathy?

Answer 25

Thyroid changes, raised ACTH, raised glucocorticoids, adrenal insufficiency, raised PTH

Question 26

what carcinomas tend to cause proximal myopathy?

Answer 26

small cell, breast, prostate

Question 27

what drugs are known to cause proximal myopathy?

Answer 27

statins

steroids

Question 28

what are red flags of back pain?

Answer 28

T- trauma
U- unexplained weight loss
N- neurological sighs
A- age >50/<20
F- fever
I- IVDU
S- steroids
H- history of prostate, renal, breast cancer

Question 29

what are signs of cauda equine?

Answer 29

lower limb weakness
sacral numbness
urine retention
erectile dysfunction
decreased reflexes

Question 30

what are the actions of PTH?

Answer 30

• causes calcium release from bone
• acts on the kidney to increase calcium reabsorption
• increases osteoclast activity
• increases intestinal calcium absorption

Question 31

what are the actions of calcitonin?

Answer 31

decreases calcium in the blood

inhibits PTH