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Neurology Year 3 > Lower Back Pain > Flashcards

Flashcards in Lower Back Pain Deck (18)
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1
Q

General Red Flag symptoms

A

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

2
Q

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

A

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

3
Q

What are some red flags that could indicate an infection?

A
Fever
Chills
Recent infection
Immunosuppression
IV drug use
Foreign travel
Poor dental health
4
Q

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

A

Age >50
Osteoporosis
Trauma
Chronic steroid use

5
Q

What are some indicators it could be Cauda Equina Syndrome?

A
Bilateral sciatica
Saddle Paraesthesia 
Urinary incontinence
Leg weakness 
Decreased anal tone
6
Q

What are some indicators it could be a AAA?

A

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

7
Q

When is a Plain X Ray used?

A

Young man to check for Ankylosing Spondylitis in SI joint

Elderly to check for vertebral collapse

8
Q

When is a CT used?

A

Where MRI is contraindicated

Foreign body, Trauma, Implant

9
Q

When is an MRI used?

A

Good for soft tissues

Red flag neurological symptoms

10
Q

When is a radionucleotide bone scan used?

A

Shows an increased bone turnover

11
Q

What conditions would show an increased bone turnover?

A
Fractures
Osteomyelitis
Pagets
Metastesis
Ankylosing Spondylitis
12
Q

When are SPECT or PET scans used?

A

Suspected Metastatic disease

13
Q

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

A

Alkaline Phosphatase
Ca2+
PO4+

14
Q

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

A

PSA

Acid phosphatase

15
Q

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

A

NSAIDs to enable mobility

16
Q

Why is maintaining exercise despite lower back pain so important?

A

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

17
Q

What is the short term pharmacological management for serious pain?

A

Opiates

18
Q

What is long term pharmacological management for serious pain>

A

Tricyclic Anti Depressants

Amitriptyline