Medical Screening & LBP

Question 1

Test Question! Cluster of hx findings that rule out cancer

Answer 1

Sensitivity 100% & -LR 0.06
Age >= 50
or unexplained weight loss
or hx of cancer
or failure to improve over 1 month

Question 2

General factors for screening cancer

Answer 2

• Neurologic sx
• Unexplained weight loss
• Not improved after 1 month
• Age >= 50
• no relief with bed rest
• Insidious onset

Question 3

Spinal infection screening

Answer 3

-Local tenderness, painful spinal percussion (Sn .86) (most powerful factor)

• Fever, chills, fatigue (Sn .27-.83)
• Concurrent infection or drug use (Sn .4)

Question 4

Cauda Equina Syndrome Screening

Answer 4

• Urinary retention (Sn .9, Sp .95)

- High Sn: sciatica, motor or sensory deficits, + SLR, saddle anesthesia

Question 5

Abdominal Aortic Aneurysm Screening

Answer 5

Many factors, not going to type them all out. 2 mentioned in lecture:

• Smoking +LR 3-5
• Family hx LR 1.2-1.8

Question 6

Vertebral Fracture Screening

Answer 6

• Major Trauma +LR 12.8 -LR .37
• Pn & Tenderness +LR 6.7 -LR .44
• Age > 50 +LR 2.2 -LR .34
• Female +LR 2.3 -LR .67
• Distracting pnful injury +LR 1.7 -LR .78

Question 7

Major Depressive Disorder Screening

Answer 7

1 or more of the following factors every day for 2 weeks:

• Depressed mood most of the day, nearly every day
• Markedly diminished interest or pleasure in all, or almost all, activities

More criteria, but the above are most important

Question 8

GI Disorder Screening

Answer 8

• Difficulty swallowing
• Heartburn and indigestion
• Specific food intolerance
• Change in appetite
• Bowel dysfunction

Question 9

Renal/urinary tract screening

Answer 9

• Trouble with urination

- Color, stream initiation, incontinence, flow changes, pn

Question 10

Akylosing Spondylitis Screening

Answer 10

• Morning stiffness > 30 min
• Improvement of LBP with exercise but not rest
• Night pn during 2nd half of night
• Alternating butock pn

2 or more: Sn .37, Sp .84
3 or more: Sn .37, Sp .97