red flags

Question 1

what are signs of infection? (vitals - temp, BP, pulse, respiratory rate)

Answer 1

• Temp > 100.4 F
• BP > 160/95 mmHg
• Resting Pulse > 100/min
• Resting Respiration > 25/min

Question 2

for patients with nonspecific low back pain - diagnostic imaging (Should or Should Not) be obtained?

Answer 2

Should Not

Question 3

for patients with low back pain with severe or progressive neurologic deficits - diagnostic imaging (Should or Should Not)be obtained?

Answer 3

Should

Question 4

for patients with low back pain when serious underlying conditions are suspected on basis of history and physical exam - diagnostic imaging (Should or Should Not) be obtained?

Answer 4

Should

Question 5

Red flag symptom: Pain is (intermittent or constant)?

and (related or unrelated) to position or movement

Answer 5

constant, unrelated to movement

Question 6

Red flag symptom: Severe (day or night) pain (related or unrelated) to movement

Answer 6

night, unrelated to movement

Question 7

Red flag symptom: Recent unexplained weight loss (or gain) > # lb

Answer 7

10 lb

Question 8

Red flag symptom: History of (direct blunt or indirect) trauma

Answer 8

direct blunt

Question 9

Red flag symptom: Appearance?

Answer 9

acutely ill, generalized weakness or malaise

Question 10

Red flag symptom: Abdominal pain – especially radiation into…

Answer 10

groin, hematuria

Question 11

Red flag symptom: Bowel or Bladder…

Answer 11

dysfunction/Saddle anesthesia

Question 12

Red flag symptom: nvolving genitals

Answer 12

Sexual dysfunction, Recent menstrual irregularities

Question 13

These symptoms refer (from or to) low back:
cancer
compression fracture
sacral stress fracture

Answer 13

from

Question 14

These symptoms refer (from or to) low back:
acute spondylolisthesis
ankylosing spondylitis
central sensitization

Answer 14

from

Question 15

These symptoms refer (from or to) low back:
vertebral infection
cauda equina

Answer 15

from

Question 16

These symptoms refer (from or to) low back:
aneurysm
vascular claudication

Answer 16

to

Question 17

These symptoms refer (from or to) low back:
kidney stone
gastrointestinal
genital pathologies

Answer 17

to

Question 18

key features & recommended imaging: new onset low back pain with history of cancer

Answer 18

cancer, MRI

Question 19

key features & recommended imaging:
age >50yr
unexplained weight loss
failure to improve after 1 month

Answer 19

cancer, lumbosacral plain radiography

Question 20

key features & recommended imaging:
older age
history of osteoporosis
use of corticosteroids

Answer 20

compression fracture, lumbosacral plain radiography

Question 21

key features of compression fracture

Answer 21

older age, history of osteoporosis, use of corticosteroids

Question 22

key features of cancer

Answer 22

age >50yr, unexplained weight loss, failure to improve after 1 month, history of cancer

Question 23

key features:
Fever
IV drug use
Recent infection

Answer 23

Vertebral infection, MRI

Question 24

key features: Vertebral infection

Answer 24

Fever
IV drug use
Recent infection

Question 25

key features: Cauda equina syndrome

Answer 25

Urinary retention motor deficits at multiple levels fecal incontinence saddle anesthesia

Question 26

``` key features: Urinary retention motor deficits at multiple levels fecal incontinence saddle anesthesia LMN and/or UMN signs unilateral or bilateral ```

Answer 26

Cauda equina syndrome, MRI

Question 27

key features: Younger age <40yo (typically young adult male, hunched posture) Morning stiffness Improved with exercise Alternating buttock pain Awakening due to back pain during second half of night

Answer 27

Ankylosing spondylitis (form of arthritis, inflame spinal joints, bones are fusing), AP pelvis plain radiography

Question 28

key features: Ankylosing spondylitis

Answer 28

Younger age <40yo (typically young adult male 20-30s, hunched posture) Reduced lateral mobility Morning stiffness Improved with exercise Alternating buttock pain Awakening due to back pain during second half of night

Question 29

key features: progressive motor weakness

Answer 29

Severe progressive neurological deficits, MRI

Question 30

key features: Severe progressive neurological deficits

Answer 30

progressive motor weakness

Question 31

5 types of cancer that commonly metastasize to the spine

Answer 31

Prostrate, Thyroid, Breast, Lung, Kidney | “PT Barnum Loves Kids” or PB Lead Kills The

Question 32

``` Key features: • Injection drug use • Urinary infection • Indwelling urinary catheter • Skin infection • Fever Percussion tenderness ```

Answer 32

Infective spondylitis

Question 33

Key features: • Age > 50 • Trauma Corticosteroid use

Answer 33

Compression fracture

Question 34

``` Risk factors: recent infection recent surgery of injections immunocompromised - prolonged oral steroid use drug use sexual contact diabetes ```

Answer 34

spinal infection

Question 35

``` Presentation: fever nigh sweats, pain worsening despite care tenderness over spinous process (not sensitive or specific) ```

Answer 35

spinal infection