Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
23 Cards in this Set
- Front
- Back
|
325. When are plain XR films used in the diagnosis of back pain?
|
a. Plain films of the lumbar spine are not indicated in all pts w/low back pain.
b. Most cases resolve w/rest and NSAIDs. c. If sx persist for longer than 3-4 weeks, radiographs are appropriate. d. If compression fracture, infection or tumour are suspected, radiographs should be obtained immediately. |
|
|
326. When is MRI indicated for low back pain?
|
a. If pt has failed a course of conservative treatment (rest, physical therapy, NSAIDs) for at least 3 months.
b. Pts w/neurologic signs or symptoms should have an MRI sooner, depending on the severity and acuteness of clinical findings. |
|
|
327. Tx of uncomplicated low back pain?
|
a. Most pts w/acute low back pain w/ or w/o radiculopathy are best managed conservatively w/NSAIDs, brief rest, and judicious use of narcotic analgesics and muscle relaxants if necessary.
b. Pts should be advised to continue ordinary activities w/in the limits permitted by pain. c. The acute pain lasts for several days. |
|
|
328. Tx of low-back pain if neurologic deficits are present?
|
a. A more aggressive approach is indicated.
b. An MRI should be obtained. c. If nerve root or spinal cord compression is present, evaluation by a spine specialist is recommended. |
|
|
329. How are most pts w/CHRONIC low back pain w/ or w/o radiculopathy treated?
|
a. Conservatively (w/physical therapy, NSAIDs, epidural steroid injections).
b. Physical therapy is focused on trunk stabilization exercises and aerobic conditioning. c. If these measures fail and symptoms persist for several months, surgery can be considered depending on findings on imaging studies and degree of disability |
|
|
330. Note: In general, outcomes from surgery are more predictable and successful when surgery is done for radiculopathy (to decompress nerve roots) than for low back pain per se.
|
330. Note: In general, outcomes from surgery are more predictable and successful when surgery is done for radiculopathy (to decompress nerve roots) than for low back pain per se.
|
|
|
331. Note: Pathology in other organ systems as a cause of back pain should always be ruled out. Some significant types are as follows.
|
331. Note: Pathology in other organ systems as a cause of back pain should always be ruled out. Some significant types are as follows.
|
|
|
332. Vascular causes of back pain to rule out?
|
1. Aortic aneurysm
2. Aortic dissection. |
|
|
333. GI causes of back pain to rule out?
|
a. Pancreatic disease
b. GB |
|
|
334. Urologic causes of back pain to rule out?
|
a. Prostate infection
b. Renal calculi |
|
|
335. ObGyn causes of back pain to rule out?
|
a. Endometriosis
b. Ectopic pregnancy c. PID |
|
|
336. Major Segmental Innervation of Hip Flexion- nerve root?
|
a. L2
|
|
|
337. Major Segmental Innervation of Knee extension- nerve root?
|
a. L3
|
|
|
338. Major Segmental Innervation of Ankle dorsiflexion- nerve root?
|
a. L4 and L5
|
|
|
339. Major Segmental Innervation of Great toe dorsiflexion- nerve root?
|
a. L5
|
|
|
340. Major Segmental Innervation of Ankle plantar flexion- nerve root?
|
a. S1
|
|
|
341. Most common cause of knee pain in older patients?
|
a. Osteoarthritis
|
|
|
342. Patellofemoral pain?
|
a. Very common cause of anterior knee pain.
b. Worse w/climbing and descending stairs. c. Physical therapy aimed at quadriceps/hamstrings rehabilitation (stretching/strengthening) is very effective. |
|
|
343. Degeneration or tear of a meniscus?
|
a. Meniscus tear may be due to a specific injury or 2° to degenerative process (the latter being a common cause of knee pain in older pts).
|
|
|
344. Symptoms/Signs of degeneration or tear of a meniscus?
|
a. Recurrent knee effusions
b. Tenderness along medial or lateral joint lines c. Positive McMurray test. |
|
|
345. What is the value of surgery for degeneration or tear of a meniscus?
|
a. If not arthritic changes present, surgery (arthroscopic meniscectomy or repair) is effective. Surgery is less effective when concomitant arthritic changes are present and results are less predictable.
|
|
|
346. Other causes of Knee pain?
|
a. RA
b. Psoriatic arthritis c. SLE d. Acute Monoarticular arthritis e. Osteochondritis dissecans (OCD) f. Osgood-Schlatter disease in adolescents g. Baker’s cyst h. Patellar tendinitis |
|
|
347. Causes of Acute monoarticular arthritis?
|
a. Septic arthritis
b. Disseminated gonorrhea c. Gout d. Pseudogout e. Rheumatic fever f. Seronegative spondyloarthropathy g. Lyme disease |
