2011 Med 2

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  1. What are the red flags of back pain? Name 6.
    • Cauda equina syndrome features e.g. urinary retention, neuro Sx
    • Trauma (significant)
    • Weight loss
    • Hx of cancer
    • Aged 50+
    • IVDU
    • Corticosteroid use
    • Pain that's worse when lying down
    • Fever
  2. Back pain - How would you investigate this man (likely herniated disc)?
    • Conservative for the first 3 weeks IF NO RED FLAG.
    • Then do spinal XR +/- MRI
  3. Back pain - Name 5 elements of management.
    • Reassurance: majority settle, 10% need surg
    • Pain control: heat, exercise, spine manipulation (less evidence)
    • FU: GP r/v, and refer if symptomatic after 4-6 weeks
    • Surgery (if severe or progressive)
  4. Back pain - Describe the surgery for herniated disc.
    • Surgery indications:
    • Severe or progressive neurological deficit OR
    • Leg pain > back pain, +ve straight leg raise test, no response to Tx for 4-6weeks AND imaging shows a lesion
    • If indicated: discectomy or endoscopic microdiscectomy
Card Set:
2011 Med 2
2011-06-03 02:16:23
Back Pain sciatic

Back Pain, sciatic
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