Clin Med- Low Back II

Question 1

________ _______ is a type of spondyarthropathy or spondyloarthride

Answer 1

Ankylosing Spondylitis

Question 2

Ankylosing Spondylitis etiology:

Genetics- ___% are + for ____ -______ antigen blood test

Environmental

Answer 2

90

HLA-B27

Question 3

Ankylosing Spondylitis is almost as common as ____

Onset < ____ and typically between ____-______ yrs.

Answer 3

RA

40

18; 30

Question 4

With Ankylosing Spondylitis, it is usually 2-3x more common in ______

Answer 4

MALES

Question 5

With Ankylosing Spondylitis, it is MOST common in the _________ region

Answer 5

lumbosacral

Question 6

With _______ ________ pathogenesis, there is chronic inflammation at cartilage, tendon, ligament, and synovium attacments to bone (entheses)

Answer 6

Ankylosing Spondylitis

Question 7

With _______ ________ , it has erosive bony overgrowth and osteopenia

Answer 7

Ankylosing Spondylitis

Question 8

Osteopenia is ______ bone

Answer 8

weakened

Question 9

Ankylosing Spondylitis leads to ______ of involved joints

Answer 9

fusion

Question 10

With Spondyloarthropathies or Spondyloarthritides and multiple joint inflammation and pain:

> ____ min. of P!/stiffness after prolonged positions

Improved P! with ____ and _____ movement

Chronic inflammation and p! of _____ skeleton MOST often

_________ or unilateral extremity involvement to a lesser degree (typically smaller extremity joints)
- Localized to ______ or insertions of ligaments, tendons, and fascia

Answer 10

30

early; regular

axial

asymmetry

entheses

Question 11

With Spondyloarthropathies or Spondyloarthritides common S&S:

_______ predisposition

__________ involvement of eyes, skin, GI tract, and renal and cardiac systems

Answer 11

Famial

Extraarticular

Question 12

With Spondyloarthropathies or Spondyloarthritides common S&S: some describe it as…. “hurts to”

Answer 12

see, pee, and bend my knee

Question 13

With Ankylosing Spondylitis, progressive LBP primarily from greatest influence on __________ joints > neck and lumbar regions

Answer 13

sacroiliac

Question 14

With Ankylosing Spondylitis, it is ________ lasting for > ____ months

Answer 14

insidious; 3

Question 15

With Ankylosing Spondylitis, there could be:

no _______ with rest

______ pain from static positioning

_______ and hip p!

Answer 15

change

night

buttock

Question 16

What would you observe possibly with someone who has ankylosing spondylitis?

Answer 16

hyper kyphosis

loss of lumbar lordosis

Question 17

With Ankylosing Spondylitis, in the Scan and biomechanical exam:

Multiple directions of ________ ROM/accesory motion of involved joints (possibly fused)

Combined motion- _________ block

Limited ______ excursion with manubrial and rib springs, possibly compromising cardiopulmonary function

_______ Berlin and Inflammatory Back Pain CPRs

Answer 17

limited

consistent

thorax

positive

Question 18

With ankylosing spondylitis it is an ______ referral to what specialist?

Answer 18

urgent; rheumatologist

Question 19

_________ _________ is a “Do Not Want To Miss” condition in any young adult with low back pain

Answer 19

ankylosing spondylitis

Question 20

What condition is indicated?

Berlin Criteria- ≥2 =… 3, 4-6
88% probability

70% sensitive

AM stiffness

P! with rest AND relief with exercise

Awakening with LBP during 2nd half of night

Alternating buttock P!

Answer 20

Ankylosing Spondylitis

Question 21

What condition is indicated?

IBP Criteria (≥ 4 = 80% sensitive /72% specific)

< 40 yrs. of age

Gradual onset

Relief with exercise

No change with rest

Night P! with improvement getting up

Answer 21

Ankylosing Spondylitis

Question 22

What are some PT Rx with Ankylosing Spondylitis?

Be sensistive to _____ in patients with AS diagnosis

______ prevention

Gentle ______, ______ therapy, and ______ considering fragility

Postural ________

Answer 22

trauma

fall

ROM; manual, MET

education

Question 23

Name some complicated conditions that may occur with Ankylosing spondylitis?

Answer 23

Osteoporosis

Fractures

Stenosis

Fusion in an upright or MORE often forward bent position

Cardiopulmonary disorders

Question 24

__________ is a reproductive gland below the bladder that aids sperm function

Answer 24

prostate

Question 25

An american man is at risk for what condition with these factors? Age and ethnicity Genetics Chemical exposure High fat, red meat diet Obesity Alcohol consumption

Answer 25

prostate cancer

Question 26

________ cancer is ONLY in biological males and typically > _____ years of age

Answer 26

Prostate; 65

Question 27

What cancer is the 2nd MOST common cancer and death in American men?

Answer 27

Prostate

Question 28

Prostate cancer is typically more _______ americans

Answer 28

African

Question 29

Pathogenesis of prostate cancer: _______ gland cells infiltrate the prostate

Answer 29

disorganized

Question 30

With prostate cancer, they typically have ________ P!

Answer 30

lumbopelvic

Question 31

With prostate cancer, men can have what two dysfunctions?

Answer 31

bladder; sexual

Question 32

Prostate cancer is more a _______ tumor

Answer 32

metastatic

Question 33

Men after the age of ______ should get Prostate Specific Antigen (PSA) screening yearly

Answer 33

55

Question 34

______ _______ muscle training has an overall benefit for bladder dysfunction

Answer 34

Pelvic floor (PFMT)

Question 35

Prostate cancer is an _______ MD referral

Answer 35

urgent

Question 36

__________ is toxicity to pancreas cells

Answer 36

pancreatitis

Question 37

With pancreatitis, the _________ bille refluxes into pancreas and causes ________ and possible ________

Answer 37

gallbladder inflammation fibrosis

Question 38

With pancreatitis there is a sharp ______ upper quadrant P! that radiates to the _______ region

Answer 38

right; thoracolumbar

Question 39

With pancreatitis, it can worsen by _____ meals or drinking ______ due to difficult digestion

Answer 39

fatty; alcohol

Question 40

With pancreatitis what position relieves the symptoms?

Answer 40

knees closer to the chest

Question 41

With pancreatitis, the patient could become ______ or yellowed and experience ______ and vomitting

Answer 41

jaundiced; nausea

Question 42

With pancreatitis, Grey-Turner sign indicates....?

Answer 42

swollen flanks

Question 43

With pancreatitis, Cullen sign indicates...?

Answer 43

swollen umbilicus

Question 44

With pancreatitis, it could progress to ______ S&S and vital/mental status changes

Answer 44

infection

Question 45

With pancreatitis, it may lead to scarring in the _______ region and be unmodifiable to JM's

Answer 45

thoracolumbar

Question 46

With pancreatitis, it is an _______ and possible _______ MD referaal depending on severity

Answer 46

urgent; emergent

Question 47

________ are weakening's in a vessel wall

Answer 47

aneurysms

Question 48

What is the MOST common site for an aneurysm?

Answer 48

aorta

Question 49

Abdominal aortic aneurysm is more common in biological ______

Answer 49

males

Question 50

With Abdominal aortic aneurysms it is increasing frequency due to ______ populations

Answer 50

aging

Question 51

These are risk factors for what condition? Smoking > 50 yrs. of age Biological male Vascular diseases i.e., atherosclerosis and collagen disorder- weakens vessel walls Genetics- family hx of AAA

Answer 51

AAA

Question 52

What are the 3 etiologies for AAA?

Answer 52

trauma vascular disease infection

Question 53

Pathogenesis of AAA? Weakening of ______ in vessel walls

Answer 53

elastin

Question 54

Clinical manifestation S&S with AAA: Often ________ MOST often _____ and possibly _______ and flank P!, especially with activity Searing, ripping, or tearing back or abdominal P! that stops all _______ (may indicate rupture)

Answer 54

asymptomatic LBP; abdomen activity

Question 55

What would you observe MOST likely with AAA?

Answer 55

abdominal heartbeat

Question 56

Palpation with AAA: ___-______ palpable mass (≥ 3cm) that pulses; typically just _____ of midline from umbilicus

Answer 56

non-tender left

Question 57

With AAA you would hear a ______ auscultation sound over AA

Answer 57

bruit

Question 58

With AAA there will be absent or _______ pulses elsewhere

Answer 58

diminished

Question 59

With AAA it is a “Do Not Want To Miss”condition and is an ________ referral *MOST die before getting to a hospital

Answer 59

EMERGENCY