AQUIFER: Family Medicine 10: 45-year-old male with low back pain
ACTUAL CASE STUDY QUESTIONS AND ANSWERS (100% GUARANTEED)
You are working with Dr. Lee
... [Show More] today. She hands you a triage note from the nurse regarding your next patient, Mr. Payne:
Forty-five-year-old white male truck driver complaining of two weeks of sharp, stabbing back pain. The pain was better after a couple of days but then got worse after playing softball with his daughter. This morning his pain is so bad that he had trouble getting out of bed.
Dr. Lee provides you some background information about low back pain.
TEACHING POINT
Low Back Pain Prevalence, Cost, & Duration
Low back pain (LBP) is the fifth most common reason for all doctor visits. In the U.S., lifetime prevalence of LBP is 60% to 80%. The direct and indirect costs for treatment of LBP are estimated to be $100 billion annually. Fortunately, most LBP resolves in two to four weeks.
Dr. Lee continues: "There are many causes for LBP. For presenting symptoms that have a broad differential diagnosis, I find it helpful to think of systems of etiologies in which diseases or conditions can be categorized."
TEACHING POINT
Common Causes of Back Pain
Musculoskeletal (MSK) and Non-MSK Causes of Back Pain MSK Causes
Axial:
Degenerative disc disease
Facet arthritis
Sacroiliitis
Ankylosing spondylitis
Discitis
Paraspinal muscular issues
SI dysfunction
Radicular:
QUESTION 1
Dr. Lee tells you: "Working from such a broad list is difficult. Having a shorter list of working diagnoses will help you conduct a more focused initial history and physical exam. What are the three most common causes of back pain?"
Select all that apply.
The best options are indicated below. Your selections are indicated by the shaded boxes.
A. Degenerative joint disease
B. Disc herniation
C. Kidney stones
D. Lumbar strain
E. Pyelonephritis
F. Spinal stenosis
SUBMIT
Answer Comment
The correct answers are D, B, A.
QUESTION 2
Before you meet Mr. Payne, you pause to consider the relevant history to gather for back pain. What questions should you include in your history that would help you narrow your differential diagnosis?
Select all that apply.
The best options are indicated below. Your selections are i [Show Less]