Questions and Answers
PART X · QUESTIONS
1. Changes associated with aging that can contribute to low back pain include all the following except
a. Muscle spasm
b. Narrowing of disc spaces
c. Decreased water content of intervertebral discs
d. Decreased flexibility of lumbar curve
View Answer
1. The correct answer is a. Muscle spasm is usually a consequence of strain, overuse, or injury.
2. Mrs. L., your neighbor, is 62 years old, 5′ 3″ tall, and weighs approximately 160 lbs. She is complaining of low back pain. She cannot identify any precipitating factor but she reports having had “back problems” off and on for years. It ordinarily goes away on its own if she “takes it easy.” She reports sometimes taking acetaminophen or ibuprofen, which helps. This time, however, she says her back has been bothering her for the last 2 months and is present most of the time, although it gets worse when she’s been more active. She mentions that she just took a week off and “stayed in bed the entire time.” When she returned to her normal activity yesterday, her back pain came right back and may even be a little worse. What is the most appropriate response?
a. “You probably have a slipped disc. You should make an appointment to be seen by your primary care provider to have some tests done.”
b. “Back pain is commonly associated with aging. You could try one of the nutritional supplements from the health food store.”
c. “Lots of times exercises and weight loss help back problems. I’d recommend that you join a gym and try to lose 25 to 30 lbs.”
d. “Staying in bed for a week may have caused your muscles to become weaker. You should see your primary care provider to check your back and suggest some exercises and other things that can help you.”
View Answer
2. The correct answer is d. Postural muscles lose strength at approximately 3% per day with bed rest. A referral is indicated for appropriate diagnosis and treatment. The other options contain inappropriate suggestions or incorrect information.
3. Most low back pain is due to which of the following?
a. Vertebral fractures
b. Herniated intervertebral discs
c. Muscle sprain/strain
d. Obesity
View Answer
3. The correct answer is c. This is the most common cause, usually due to deconditioning or overuse. Answers a and b are less common sources of back pain; d is sometimes a contributing factor.
4. Degenerative disc disease commonly occurs in whom?
a. Those with a poor dietary calcium intake
b. Those with a narrowing of the spinal canal
c. People as they age
d. In athletes, particularly African-American males
View Answer
4. The correct answer is c. Degenerative disc disease results from fibrosis and thinning of the nucleus pulposus associated with aging.
5. What is the basic pathophysiology underlying osteoporosis?
a. An imbalance between osteoclastic and osteoblastic activity
b. An increase in osteoblastic activity
c. A decrease in osteoclastic activity
d. Impaired calcium absorption that leads to a decrease in osteoclastic activity
View Answer
5. The correct answer is a. It is a disturbance in the balance between osteoclastic and osteoblastic activity, from a variety of causes, and results in osteoporosis. The other choices are incorrect or incomplete.
6. Which of the following is an appropriate response for you to make to a 40-year-old woman who is interested in learning what she can do to decrease her risk for osteoporosis?
a. “You should take hormones to replace estrogen once you reach menopause.”
b. “If you do not have risk factors in your history, you probably don’t need to do anything special.”
c. “Weight-bearing exercises and an adequate intake of calcium and vitamin D are important factors in preventing osteoporosis.”
d. “Osteoporosis is inevitable, so there’s nothing much you can do to prevent it.”
View Answer
6. The correct answer is c. Weight bearing helps increase osteoblastic activity. Vitamin D is needed for calcium absorption, which is necessary for new bone formation. The other choices are incorrect because estrogen replacement is not recommended for all women, and all older women are at some degree of risk and should modify their lifestyle and/or diet as indicated.
7. Which of the following medications may contribute to iatrogenic osteoporosis?
a. Steroids
b. Thyroid hormones
c. Heparin
d. NSAIDs
View Answer
7. The correct answer is a. Long-term use of glucocorticoid hormones can commonly cause osteoporosis; the others do not.
8. Which of the following statements about osteoporosis in men is true?
a. Osteoporosis is less significant in men because their bones are more dense.
b. Demineralization in men begins in the late 70s or early 80s.
c. Men do not get osteoporosis because it is an estrogendependent disorder.
d. Men have fewer vertebral compression fractures than women because they have less trabecular bone.
View Answer
8. The correct answer is a. Bones in men are denser and thicker than those of women. The other choices are incorrect because demineralization in men begins in the late 60s, and men do get osteoporosis and vertebral compression fractures.
9. What provides tensile strength?
a. Compact bone
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
