Question 1 Marks: 1

About 1/3 of the UK population suffers low back pain each year

Answer: True

Question 2 Marks: 1 

Non-NHS clinical costs for managing low back pain are greater than NHS costs

Answer: False

Question 3 Marks: 1

Over 80% of cases of acute low back pain are self limiting and resolve within 6 weeks

Answer: True

 

Question 4 Marks: 1

Low back pain accounts for 1/3 of GP workload

Answer: False

Question 5 Marks: 1

Indirect costs of low back pain are about the same as those of the UK banking bailout of 2009

Answer: True

Question 6 Marks: 1

Low back pain occurs by definition between the lower costal margins and the top of the buttocks

Answer: False

Question 7 Marks: 1

Non specific low back pain may be caused by rheumatoid arthritis

Answer: False

Question 8 Marks: 1

Tumour accounts for <1% of causes of specific back pain

Answer: True

Question 9 Marks: 1

Non specific low back pain may be classified as facet joint disease, degenerative disc disease or lumbago

Answer: False

Question 10 Marks: 1

Subacute low back pain lasts between 6 weeks and 3 months

Answer: True

Question 11 Marks: 1

A detailed history of the presentation of acute low back pain is the most reliable indicator of its cause

Answer: True

Question 12 Marks: 1

Full neurological examination is mandatory in every case of back pain

Answer: False

Question 13 Marks: 1

Weight loss is commonly seen in mechanical back pain

Answer: False

Question 14 Marks: 1

Mechanical back pain may be felt in the buttocks and thighs

Answer:True

Question 15 Marks: 1

Looking up as the patient enters the consulting room is helpful in diagnosing low back pain

Answer: True

Question 16 Marks: 1

MRI scan should be ordered where degenerate disc disease is suspected

Answer: False

Question 17 Marks: 1

Patients may feel worse following x-ray of spine for low back pain

Answer: True

Question 18 Marks: 1

X-ray of spine is associated with worsening patient depression scores

Answer: False

Question 19 Marks: 1

MRI scan leads to better patient satisfaction scores than x-ray of lumbosacral spine

Answer: True

Question 20 Marks: 1

PSA is a useful investigation in a 57 year old man presenting with new onset back pain

Answer: True

Question 21 Marks: 1

The average GP is likely to encounter cauda equina syndrome twice in a professional life

 Answer: False

Question 22 Marks: 1

Diminution of the bulbocavernosus reflex should be sought when referring a patient with suspected cauda equina syndrome

Answer: False

Question 23 Marks: 1

Loss of bladder function in cauda equina syndrome is painless and may only be detected on overflow

Answer: True

Question 24 Marks: 1

Degenerative disc disease can predispose to cauda equina syndrome

Answer: True

Question 25 Marks: 1

Lower limb weakness is not a sign of cauda equina syndrome

Answer: False

Question 26 Marks: 1 for all or 0.2 for each one selected

The following are rare causes of cauda equina syndrome

All 5 answers are correct; Varices, Surgery, Meningioma, Hydatid disease, Mycobacterium tuberculosis.

Question 27 Marks: 1 for all or 0.33 for each one selected

Evidence based treatments for acute low back pain include:

All 3 answers are correct; Advice to stay active, NSAIDs, Muscle Relaxants.

Question 28 Marks: 1 for all or 0.33 for each one selected

Treatments not shown to be effective in acute non-specific low back pain are:

All 3 answers are correct; Specific back exercise, Traction, Lumbar supports

 

Question 29 Marks: 1 for all or 0.5 for each one selected

Sciatica:

All 4 answers are correct;

  • Has smoking as a risk factor, 
  • May require elective surgery if unresolved in 6-8 weeks, 
  • Accompanies 5-10% of cases of low back pain, 
  • Improves spontaneously in 75% of cases

Question 30 Marks: 1 for all or 0.67 for each one selected

Evidence based treatments for chronic back pain include:

All 3 answers are correct; CBT, Alexander Technique, Individually designed exercise programmes

Question 31 Marks: 1 for all or 0.33 for each one selected

Treatments not recommended by the 2001 European guidelines for the management of chronic non-specific low back pain include:

All 3 answers are correct; Ultrasound, Exploratory surgery, Short wave diathermy.

 

Question 32 Marks: 1 for all or 0.33 for each one selected

Which of the following are associated with delayed recovery from back pain:

All 3 answers are correct; Belief that exercise is harmful, high expectations for treatment, High expressed emotion in family.

Question 33 Marks: 1

Over 70% of acute low back pain sufferers are pain free after 12 months

Answer:True

Question 34 Marks: 1

Half of all cases of sciatica improve within 10 days

Answer:True

Question 35 Marks: 1

Nearly three quarters of acute back pain sufferers will have more than one episode a year

Answer:True

Question 36 Marks: 1

Once back pain is present for 3 months it is likely to be present after a year

Answer:True

Question 37 Marks: 1

Attendance at higher education is associated with a lower chance of recovering from chronic non-specific low back pain

Answer: False

 

Question 38 Marks: 1

Over 80% of acute low back pain sufferers return to work within 4 weeks

Answer: True

Question 39 Marks: 1

The turning point after which a person with back pain is unlikely to return to work is four to six weeks

Answer: True

 

Question 40 Marks: 1

The temporary provision of lighter or modified duties facilitates return to work and reduces time off work

Answer: True

Question 41 Marks: 1

Shorter episodes of care and early return to work are associated with delayed recovery from back pain

Answer: False

Question 42 Marks: 1

Patients who have a multidisciplinary, holistic package of care supervised by a case manager have fewer recurrences of back pain

Answer: True