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9 Cards in this Set

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History of CA and radiculopathy, how does XR influence your mgmt?
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.
What are risk factors for vertebral mets
older patient, known CA, unexplained wt loss, pain at rest or worse at night
What are the spinal emergencies?
Cauda equina, vertebral mets, epidural abscess, fracture
What is most sensitive finding in cauda equina syndrome besides back pain?
Urinary retention - sometimes present with overflow incontinence; If PVR>100 cc, suspect this Dx.
What are 4 signs of cauda equina?
Hyporeflexia, urinary retention, decreased rectal tone, saddle anesthesia
Causes of cauda equina syndrome
central disk herniation, hematoma (trauma, esp if on coumadin), malignancy, epidural abscess, surgery)
What are risk factors for Epidural abscess and what Percentage of Epidural abscess patients have no risk factors?
IVDA, alcohol use, immunocompromised, DM, dental work
What is classic triad for EDA and what percentage of patients have all 3?
Fever, back pain, neuro deficits, but only see all 3 in 15% of patients
What is sensitivity of ESR for detecting EDA?
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)