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Neurology Year 3 > Lower Back Pain > Flashcards

Flashcards in Lower Back Pain Deck (18)
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1

General Red Flag symptoms

Failure to improve after 4-6 weeks of therapy
Unrelenting night pain
Pain at rest
Progressive motor or sensory defect

2

What are some red flags that indicate cancer could be a cause?

Age >50
Unintended weight loss
History of cancer
Pain at night or in recumbency

3

What are some red flags that could indicate an infection?

Fever
Chills
Recent infection
Immunosuppression
IV drug use
Foreign travel
Poor dental health

4

What are some indicators the pain could be from a fracture?

Age >50
Osteoporosis
Trauma
Chronic steroid use

5

What are some indicators it could be Cauda Equina Syndrome?

Bilateral sciatica
Saddle Paraesthesia
Urinary incontinence
Leg weakness
Decreased anal tone

6

What are some indicators it could be a AAA?

Age >60
Abdominal Pulsating Mass
Pain at rest
history of drinking and smoking

7

When is a Plain X Ray used?

Young man to check for Ankylosing Spondylitis in SI joint
Elderly to check for vertebral collapse

8

When is a CT used?

Where MRI is contraindicated
Foreign body, Trauma, Implant

9

When is an MRI used?

Good for soft tissues
Red flag neurological symptoms

10

When is a radionucleotide bone scan used?

Shows an increased bone turnover

11

What conditions would show an increased bone turnover?

Fractures
Osteomyelitis
Pagets
Metastesis
Ankylosing Spondylitis

12

When are SPECT or PET scans used?

Suspected Metastatic disease

13

In metabolic causes of back pain what substances are unusual in the laboratory tests?

Alkaline Phosphatase
Ca2+
PO4+

14

In metastatic causes what abnormalities would show up in the labatory tests?

PSA
Acid phosphatase

15

What is the baseline of pharmacological treatment in lower back pain?

NSAIDs to enable mobility

16

Why is maintaining exercise despite lower back pain so important?

It is key to maintain mobility as prevent seising up and improves pain tolerance

17

What is the short term pharmacological management for serious pain?

Opiates

18

What is long term pharmacological management for serious pain>

Tricyclic Anti Depressants
Amitriptyline