Week 3

Question 1

What are some of the GI causes of back pain?

Answer 1

Gallbladder
Peptic ulcer disease
Colonic disease
Pancreatitis

Question 2

What are the common metastasis to the spine?

Answer 2

Bad Boys Pee Through Kidneys

Breast, bronchus, prostate, thyroid, kidney

Question 3

Patient presents with sharp shooting pain in the back radiating down the leg to the foot. They have reduced function in that leg and tingling in the same strip. Diagnosis

Answer 3

Sciatica- root leg pain

E.g compression of a nerve root

Question 4

If there is referred pain from the spine to the lower limbs, what typeof pain would you expect?

Answer 4

Dull/ knawing pain, around the buttock and thigh region. Rarely below knee and ill defined

Question 5

If there is a prolapse in the L5/S1 disc, what nerve root will be effected?

Answer 5

The S1 nerve roots

Question 6

Patient with back pain is able to hip flex, dorsiflex the foot, but unable to extend their knee. Diagnosis?

Answer 6

Disc prolapse of the L3/4 or L2/3

As; hip flexion involves L1/2, dorsiflexion of the foot is L5 so these nerve levels must be intact

Question 7

Patient with possible cauda equina syndrome presents. What test must you do?

Answer 7

PR exam to assess sensation and anal sphincter tone as if lost then suggests a nerve root issue

Question 8

What is the treatment for disc prolapse?

Answer 8

If no red flag symptoms then not urgent e.g GI issues

Physiotherapy and pain relief mainly as should settle within 3-24 months

Question 9

Genu varum of the knees is what kind of deformity?

Answer 9

Where there is an outward bending of the legs (bow knees)

Question 10

Genu valgum of the knees is what kind of deformity?

Answer 10

Where the knees are bent inwards so get knock knees

Question 11

At what point in development is genu varum considered physiological?

Answer 11

Up to 2 years unless it is assymetrical

Question 12

At what age is genu valgum considered physiological?

Answer 12

Up to 7 years with peak age of 3.5 years. After this it is pathological as should have resolved

Question 13

What is the treatment for achild presenting with curly toes?

Answer 13

NOTHING
Dont splint they will resolve with age
Reassure the parents

Question 14

Once a baby reaches 2 month milestone what would you expect in terms of their functions?

Answer 14

To have head control

Question 15

At 6-9months old what developmental mile stones would you expect a baby to reach?

Answer 15

Be able to sit alone, crawl, have head control

Question 16

By 9-12 months what milestones would you expect a normal child to have reached?

Answer 16

Head control, able to stand, sit, crawl, have a few words

Question 17

At what month mark(s) would you expect a child to be walking?

Answer 17

14-17 months

Question 18

What is spondylosis?

Answer 18

Where the intervertebral disc loses water content with aging causing compression of the facet joints leading to spinal osteoarthritis

Question 19

What are the most common vertebrae effected in sponylosis

Answer 19

L4/5

L5/S1

Question 20

What is spinal stenosis? What aggrevates the pain associated?

Answer 20

The narrowing of the spinal canal due to osteophyte formation, disc prolapse.

Wlaking downhill more difficult as extension of the back narrows the spinal canal putting more stress on the nerves

Question 21

If want to do a lumbar puncture, what vertebral level would you go in?

Answer 21

L4- posterior iliac crest

Question 22

What are the red flags of GI

Answer 22

Night sweats, constant pain (metastasis), incontinence, loss of control, saddle anaethesia, full leg symptoms, weight loss

Question 23

Where does the spinal cord end and become the cauda equina

Answer 23

L2

Question 24

What is the epidemiological group for acute osteomyelitis?

Answer 24

Post operative patient
Trauma
Immunosuppresed
Children

Question 25

If yoususpect osteomyelitis what investigation would you order?

Answer 25

MRI

Question 26

Gas in tissues feeling like bubble wrap is a common feature of what skin condition?

Answer 26

Cellulitis commonly by staph or strep

Question 27

When prescribing an NSAID long term what else should be co-prescribed? Why?

Answer 27

PPI like omeprazole as NSAID has common complicaiton of peptic ulcers