Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine II > Rheuma: Low Back Pain > Flashcards

Rheuma: Low Back Pain Flashcards

1
Q

risk factors for low back pain

A
  • age
  • gender
  • social class
  • occupation and level of activity
  • height
  • weight
  • psychological and psychosocial factors including attitudes to work and income
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how can you define low back pain?

A

pain and discomfort below the costal margin and above the inferior gluteal folds, with or without leg pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how can low back pain be classified?

A
  • aetiology
  • pain localisation/radiation
  • time course of the pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how can the degree of aetiology be classified?

A

into serious and nonserious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is non-serious low back pain?

A

one which usually goes away with either rest or exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

classification of low back pain according to site

A
  • no radiation
  • radiates above the knee
  • radiates below the knee
  • radiates below the knee + neurological signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what does radiation below the knee means?

A

more likely that a nerve root has been involved and irritated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how does a simple back ache present?

A
  • patient is 20-55yo
  • pain in the lumbrosacral, buttocks or thighs
  • pain related to activity (mechanical pain)
  • patient is otherwise well
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

characteristics of mechanical pain

A
  • worse with activity

- relieved by rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

characteristics of nerve root pain

A
  • unilateral leg pain worse than the back pain
  • radiates to the foot or toes
  • numbness and paraesthesia in the same distribution
  • local neurological signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which test reproduces the leg pain?

A

straight leg raise test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

major categories of LBP

A
  • degenerative
  • traumatic
  • metabolic
  • infectious
  • inflammatory
  • neoplastic
  • psychogenic
  • referred
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

example of metabolic bone disease

A

Paget’s disease of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

which infections can cause low back pain?

A
  • TB
  • brucellosis
  • other bacterial infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are some specific mechanical lumbar spine problems

A
  • prolapsed intervertebral disc
  • facet joint problems
  • spinal stenosis
  • lumbar instability and spondylolithesis
  • sacroiliac problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are problems that spinal stenosis can cause?

A
  • cauda equina
  • simian stance
  • feel pain walking downhill rather than uphill
17
Q

red flags in the history

A
  • age not in the range mentioned above
  • cause is violent trauma
  • upper back problem or upper lumbar pain
  • pain is persistent, progressive, not relieved by rest and worse in bed
  • severe morning stiffness
  • associated cancer symptoms
  • past medical history of imp medical conditions or steroid use
18
Q

which medications increase the chances of having spinal fractures

A

steroids

19
Q

red flags in clinical examinations

A
  • deformity (espec if painful)
  • severe and symmetrical restriction of spinal movements
  • saddle anaesthesia
  • severe and progressive neurological signs, often with muscle wasting
  • multiple levels of root signs or bilateral root signs
20
Q

important things to distinguish in examinations

A
  • spinal or non-spinal pain
  • mechanical or non-mechnical pain
  • presence or absence of neurological feature
21
Q

radiological investigations for LBP

A
  • plain xrays
  • CT
  • MRI
  • isotope bone scans
  • bone densitometry
22
Q

things to look out for in radiology

A
  • narrowing of disc spaces
  • osteophyte formation
  • inflammation on MRI
  • fusion of the longitudinal ligaments in xray
  • bone marrow oedema on MRI
23
Q

how can you diagnose a herniated disc?

A

CT/MRI

24
Q

how to check for bone destruction?

A

nuclear medicine

25
Q

how positive/negative blood results useful

A

positive - yes

negative - no

26
Q

investigations for LBP

A
  • ESR
  • CRP
  • FBC
  • urinalysis
  • LFTs
  • calcium/phosphate
  • serum protein electrophoresis
  • renal function
27
Q

what does an elevated alkaline phosphatase mean?

A

suggests Paget’s disease

28
Q

drug therapy in rheumatology

A
  • paracetamol
  • NSAIDs
  • weak opioid compounds
  • muscle relaxant
29
Q

how do you prescribe analgesics?

A

at regular intervals

NOT PRN

30
Q

what should not be recommended as treatment for back pain?

A

bed rest

31
Q

advice on staying active

A
  • regular exercise
  • increase activity over a few weeks
  • if they work, recommend that they continue work
32
Q

non-pharmacogical treatment

A
  • physiotherapy
  • transcutaneous electrical nerve stimulation
  • acupuncture
  • manipulation
  • epidural steroid injection
33
Q

what are yellow flags

A

these slow down the patient’s recovery by a long shot

34
Q

yellow flags in LBP

A
  • inappropriate beliefs about back pain
  • inappropriate back behaviour
  • work-related problems or compensation issues
  • emotional problems
35
Q

what are the options in back pain diagnostic triage

A
  • possible serious spinal pathology
  • nerve root problem
  • simple backache

Medicine II (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions