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8 Cards in this Set
- Front
- Back
The rare, but emergent diagnoses must be excluded before assuming mechanical back pain x 6
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aortic dissection
abdominal aortic aneurysm cauda equina syndrome epidural abscess osteomyelitis tumor |
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LBP History- red flags x7
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h/o steroid use,
h/o cancer, unexplained fever > 38 degrees C, IV drug use, immunocompromising illness, H/o pain that is worse at rest, new onset back pain over 70 yo wt. loss - unexplained |
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physical red flags:
vascular x 4 neuro x 3 |
Vascular
-unequal pulse pressures, -hypotension, -pulsatile abdominal mass, -lower extremity vascular compromise, etc. neurological exam -loss of sphincter tone, -lower extremity weakness, -incontinence. |
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cauda equina syndrome:
sxs x 4 causes x 3 |
<1% of herniated discs
-bilateral leg pain and weakness, -urinary retention with overflow incontinence, - fecal incontinence or decreased rectal tone, and -"saddle anesthesia"; usually due to a large central herniated disk, and less often to tumor or infection. |
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Which is more common - aortic dissection or AAA?
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Aortic dissection is two to three times more common than Abdominal aortic aneurysm
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Indications for L spine x-rays in low back pain
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trauma
neurologic deficits, < 4 weeks h/o cancer, age over 50 |
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Spinal epidural abscess:
risk factors x 4 study of choice ? causative organism in 70%? initial focus of infection? |
- compromised immune systems such as those with diabetes, renal failure, cancer, or alcoholism.
-MRI is the study of choice. -causative organism is Staphylococcus aureus - it begins as a localized infection in the disk. |
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What syndrome presents with: acute back pain B leg weakness
B LE sensory defects B/B dysfunction ? What type of diseases is it associated with? examples x 6 |
transverse myelitis
often associated with autoimmune diseases: type 1 diabetes Lyme disease Epstein-Barr virus. multiple sclerosis, lupus (SLE), sarcoidosis |