NR 511 Quiz

A 42-year-old professional golfer complains of chronic back pain for many years. His workup reveals that it is not the result of a degenerative disc problem. His back “goes out” about twice per year, and he is out of work for about a week each time. Which of the following should the clinician advise? Consider changing careers to something less physical. Start on a daily low-dose narcotic to take away the pain. Make an appointment with a neurosurgeon for a surgical consultation. Begin a planned exercise program to strengthen back muscles. In this case, the patient may benefit from a regular planned exercise program to strengthen his back muscles and attempt to reduce the probability of future episodes of back pain. A 49-year-old female presents with low back pain radiating into the right leg,. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further? Compression fracture. Herniated nucleus pulposus. Question 1 1 / 1 pts Bedrest. Question 3 1 / 1 pts Question 4 1 / 1 pts Osteoarthritis. A plain x-ray will not show a herniated nucleus pulposus or a muscle strain. It will show spondylolisthesis, scoliosis, osteoarthritis, and spinal stenosis. Note that x-rays of the spine are not indicated in low back pain unless the cause of the pain is thought to be bony in origin or traumatic in nature or there is a need to rule out systemic disease. In assessing the skeletal muscles, the clinician turns the patient’s forearm so that the palm is face up. This is called: Pronation. Supination. Abduction. Eversion. Turning the forearm so that the palm is up is called supination. A conservative approach is recommended in the initial approach to the management of low back pain. Which of the following would be an appropriate treatment plan for a 32- year-old obese male (BMI 33) diagnosed with an acute lumbar strain? A slipped capital femoral epiphysis (SCFE). Question 5 1 / 1 pts Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Epidural Steroid Injections (ESI). Surgery. It has been proven that rest has little to no effect on the resolution of LBP. Patients should do whatever activities are tolerable. Almost 90% of cases resolve within 1 to 6 weeks thus the initial management should include non-pharmacologic (massage, heat, etc.), pharmacological (NSAIDs, short term use of muscle relaxants) and activity. Surgery and ESI are not indicated in the initial management of LBP.