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9 Cards in this Set
- Front
- Back
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History of CA and radiculopathy, how does XR influence your mgmt?
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If evidence of mets, almost 100% chance cord compression, but even if not evidence of mets still 25% chance of cord compression. Should have low threshold for MRI.
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What are risk factors for vertebral mets
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older patient, known CA, unexplained wt loss, pain at rest or worse at night
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What are the spinal emergencies?
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Cauda equina, vertebral mets, epidural abscess, fracture
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What is most sensitive finding in cauda equina syndrome besides back pain?
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Urinary retention - sometimes present with overflow incontinence; If PVR>100 cc, suspect this Dx.
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What are 4 signs of cauda equina?
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Hyporeflexia, urinary retention, decreased rectal tone, saddle anesthesia
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Causes of cauda equina syndrome
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central disk herniation, hematoma (trauma, esp if on coumadin), malignancy, epidural abscess, surgery)
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What are risk factors for Epidural abscess and what Percentage of Epidural abscess patients have no risk factors?
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IVDA, alcohol use, immunocompromised, DM, dental work
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What is classic triad for EDA and what percentage of patients have all 3?
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Fever, back pain, neuro deficits, but only see all 3 in 15% of patients
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What is sensitivity of ESR for detecting EDA?
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if cutoff is 30, sens = 81%
if cutoff is 20, sense = 98% Problem is that in the at risk population, ESR is often high (HIV, EtOHics, IVDAs) |
