Pre Tutorial 4 - Back Problem (Datin Vasanthie)

A 46-year-old man presents with a 6-week history of leg and back pain. The pain is often made worse by sitting. On examination, there is weakness of left hip abduction and left foot drop. The GP suspects a prolapsed disc. Which of the following nerve roots is most likely to have been affected?

• L5

• S1

• L4

• L3

A 47-year-old man presents with severe lower back pain which has been progressively worsening over the last 6 days. On examination, there is tenderness over the lumbar region, and has persistent pyrexia. Imaging shows evidence of discitis in the region of L4. What is the most likely causative organism?

• Staphylococcus aureus

• Mycobacterium tuberculosis

• Staphylococcus epidermidis

• Haemophilus influenzae

A 55-year-old man presents with a gradual onset of back pain over the past 8 months. The back pain is worse on activity and walking causes bilateral pain and weakness in his calves. The back pain is relieved by sitting or leaning forward. What is the most likely diagnosis?

• Spinal stenosis

• Lumbar Spondylosis

• Spondylolisthesis

• Epidural abscess

A 25-year-old athletic male presents with lower back pain and intermittent leg pain, especially after physical activity. Imaging reveals anterior displacement of one vertebra over another. What is the most likely diagnosis?

• Lumbar spondylosis

• Spondylolisthesis

• Compression fracture

• Spinal stenosis

A 14-year-old girl is referred for a scoliosis screening during a school health check. The physical examination reveals an abnormal curvature of the spine. What is the most common type of scoliosis in adolescents?

• Congenital scoliosis

• Neuromuscular scoliosis

• Degenerative scoliosis

• Idiopathic scoliosis

A 50-year-old male presents with severe lower back pain, saddle anesthesia, and bowel and bladder incontinence. What is the most likely diagnosis?

• Spinal Stenosis

• Acute Prolapsed Intervertebral Disc

• Spondylolisthesis

• Cauda Equina Syndrome

A 45-year-old female presents with numbness and weakness in her right arm, with reflex changes. Hoffman's sign is positive. Which term best describes her condition?

• Radiculopathy

• Peripheral neuropathy

• Polymyalgia rheumatica

• Myelopathy

A 68-year-old female presents with a history of multiple vertebral fractures after minor falls. She is concerned about her bone health. What is the most appropriate imaging for her?

• MRI

• X-ray

• CT scan

• DEXA scan

A 55-year-old male presents with chronic lower back pain and stiffness. You suspect lumbar ankylosing spondylitis. Which of the following physical examinations would be most appropriate to assess for the above diagnosis?

• Lumbar range of motion assessment

• Thomas test

• Spurling's test

• Straight leg raise test

A 40-year-old male presents with back pain, fever with chills and rigors, and weight loss. Imaging reveals a paravertebral abscess and destruction of the vertebral bodies. What is the most likely diagnosis?

• Tuberculosis of the spine (Pott's disease)

• Spondylolisthesis

• Osteomyelitis

• Lumbar abscess