47. MSK back pain

Question 1

2 most common location of herniation

Answer 1

1. L4-5

2. L5-S1

Question 2

Signs of central herniation

Answer 2

 cauda equine syndrome (CES)
 loss of function on lumbar plexus
 pain down both legs and saddle anesthesia
 bowel/bladder dysfunction

Question 3

4 most common CA with bone mets

Answer 3

1. Lung
2. Breast
3. Prostate
4. Kidney

Question 4

What is + SLR

Answer 4

+ if pain from back to past knee at 30-40 deg

Question 5

What does contralateral SLR indicate

Answer 5

Radiculopathy

Question 6

What is motor, sense, and reflex test for L3 herniation

Answer 6

Motor: Hip flex and Knee ext
Sense: Ant thigh
Reflex: Knee

Question 7

What is motor, sense, and reflex test for L4 herniation

Answer 7

Motor: Knee ext
Sense: Knee
Reflex: Knee

Question 8

What is motor, sense, and reflex test for L5 herniation

Answer 8

Motor: Foot dorsiflex
Sense: Web of big toe
Reflex: None

Question 9

What is motor, sense, and reflex test for S1 herniation

Answer 9

Motor: Foot plantar flex
Sense: Lateral foot
Reflex: Ankle

Question 10

8 indications for advanced imaging

Answer 10

1. Malignancy
2. Fever
3. IVDU
4. New neuro deficit
5. Direct trauma
6. Post surgery
7. Sudden onset on anti-coagulation
8. Recent epidural or procedure

Question 11

MGMT of abscess and oseto

Answer 11

1. OR

2. Ceftri, flagyl, vanco

Question 12

MGMT of malignancy

Answer 12

1. can do OP FU

2. 10mg dex IV