M1-2 Reading Guide 4

Question 1

What does the Roland-Morris Disability Questionnaire assess?

Answer 1

physical, emotional and social impact on quality of life

Question 2

What does knowing irritability help us do?

Answer 2

plan whether to perform a full or limited exam

Question 3

SINSS =

Answer 3

Severity
Irritability
Nature
Stage
Stability

Question 4

What are the characteristics of red flag night pain?

Answer 4

• Awakens patient at night consistently
• difficulty returning to sleep
• may need to get up and walk around
• most intense pain at night
• unable to explain cause/source of pain

Question 5

What are the characteristics of nigh pain associated with MSK problems?

Answer 5

• Infrequently awakens at night usually due to position
• able to return to sleep quickly
• usually better with rest
• sx relieved by change of position and easy return to sleep

Question 6

What are the flags?

Answer 6

• red
• orange
• yellow
• blue
• black

Question 7

What are red flags?

Answer 7

signs of serious pathology

• cauda equina syndrome
• fx
• tumor

Question 8

What are orange flags?

Answer 8

psychiatric sx

• clinical depression
• personality disorder

Question 9

What are yellow flags?

Answer 9

factors we should monitor in case of a need for immediate referral

Question 10

What are some psychological examples of yellow flags we look for?

Answer 10

• beliefs, appraisals, and judgement (indication of poor tx outcome, delayed return to work)
• emotional responses (worry, fears, anxiety)
• pain behavior (including coping strategies)

Question 11

What are blue flags?

Answer 11

perception about the relationship between work and health

• Belief that work is too onerous and likely to cause further injury
• belief that workplace supervisor and workmates are unsupportive

Question 12

What are black flags?

Answer 12

system or contextual obstacles

• Legislation restricting options for return to work
• conflict with insurance staff over injury claim
• overly solicitous family and health care providers
• heavy work with little opportunity to modify duties

Question 13

Which flag types may assist in identifying pts at risk of poor prognosis?

Answer 13

• yellow

- blue

Question 14

What about the hx (current and previous episodes) would make you think it may be non-MSK in nature?

Answer 14

• recent
• sudden onset for no apparent reason
• cycle nature (gets worse, better, then worse again)