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19 Cards in this Set
- Front
- Back
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221. Key feature Lumbosacral strain?
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a. Nontender
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222. Key feature Cord compression?
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a. Tender
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223. Key features of epidural abscess?
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a. Tender and fever
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224. Key feature Spinal Stenosis?
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a. Pain on walking downhill.
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225. Syringomyelia?
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a. This is a defective fluid cavity in the centre of the cord caused by trauma, tumours, or a congenital problem.
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226. Presentation of syringomyelia?
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a. Loss of sensation of pain and temperature in the upper extremities bilaterally in a cape-like distribution over the neck, shoulders, and down both arms.
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227. Diagnose w/syringomyelia?
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a. MRI.
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228. Tx of syringomyelia?
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a. Surgically.
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229. Presentation of Cord Compression?
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a. Metastatic cancer presses on the cord, resulting in pain and tenderness of the spine.
b. Lumbosacral strains does not give tenderness of the spine itself. |
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230. Diagnosis of Cord compression?
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a. Scan w/MRI.
b. Biopsy is the most accurate test if the diagnosis is not clear from the hx. |
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231. Tx of Cord Compression?
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a. The most effective therapy depends on the cause.
b. The most urgent step in cases of cord compression is to give steroids to ↓ swelling. |
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232. Presentation of Spinal Epidural abscess?
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a. Presents w/back pain w/tenderness and fever.
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233. Diagnosis of Spinal Epidural Abscess?
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a. Scan the spine w/MRI
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234. Treatment of Spinal Epidural Abscess?
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a. Give Abx against staphylococcus, such as oxacillin or nafcillin.
b. Large accumulations require surgical decompression. |
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235. Presentation of Spinal Stenosis?
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a. Leg pain on walking and can look like peripheral arterial disease.
b. The pulse will be intact, and the pain is worse upon walking downhill, when the patient is leaning backward, but improved when walking uphill. |
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236. Diagnosis of Spinal Stenosis?
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a. Diagnose w/MRI
b. Treat w/surgical decompression. |
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237. Presentation of Anterior Spinal Artery Infarction?
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a. All sensation is lost except position and vibratory sense, which travel down the posterior column.
b. There is no specific therapy. |
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238. Cause and presentation of Brown-Sequard Syndrome?
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a. Results from traumatic injury to the spine, such as a knife wound.
b. The patient loses: i. ipsilateral position ii. Vibration iii. Contralateral pain and temperature |
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239. A 58 yo woman w/metastatic breast cancer comes in w/back pain. The spine is tender. She has hyperreflexia of the legs. What is the most urgent step?
a. X-ray? b. CT? c. MRI? d. Biopsy? e. Steroids? f. Chemo? g. Radiation? |
1. E. Steroids. The most urgent step in the management of cord compression is to administer steroids as soon as possible and to relieve pressure on the cord.
2. Imaging studies are done after steroids are given, if the diagnosis of cord compression is clear (as it is in this case w/pain, tenderness, and signs of hyperreflexia in the legs). |
