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% Document Info
\author{bee.f (bee.f)}
\pdfinfo{
  /Title (5002-case-6.pdf)
  /Creator (Cheatography)
  /Author (bee.f (bee.f))
  /Subject (5002 Case 6 Cheat Sheet)
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        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{5002 Case 6 Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{bee.f (bee.f)} via \textcolor{DarkBackground}{\uline{cheatography.com/180201/cs/38630/}}}
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\noindent
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}bee.f (bee.f) \\
  \uline{cheatography.com/bee-f} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 23rd February, 2024.\\
   Updated 11th May, 2023.\\
   Page {\thepage} of \pageref{LastPage}.
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  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
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\begin{document}
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\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Case}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{- 38 y.o.\{\{nl\}\}- Episodic LBP for 7 yrs.} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Pain, onset, character}}\{\{nl\}\}- LB / pelvic region\{\{nl\}\}- 2-3/10 best\{\{nl\}\}- 6-7/10 worst\{\{nl\}\}- Ache \& sharp w/ bending} \tn 
% Row Count 4 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{AF}}\{\{nl\}\}- Pain during 3rd trimester \& postpartum w/ all 4 pregnancies\{\{nl\}\}- Housework \& picking up children} \tn 
% Row Count 7 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{RF}}\{\{nl\}\}- Rest \& periodic chiro\{\{nl\}\}- SMT (spinal manipulation technique) \& STW (soft tissue work) techniques} \tn 
% Row Count 10 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Extra}}\{\{nl\}\}- Asthma since childhood - concerned its getting worse (worried there's dampness in house)\{\{nl\}\}- Smokes 20/day for 20 years\{\{nl\}\}- Takes OCP (oral contraceptive pill)} \tn 
% Row Count 14 (+ 4)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Psychosocial factors}}\{\{nl\}\}- Can't read / write well \& blames this on getting the MMR vaccine\{\{nl\}\}- Children aren't vaccinated\{\{nl\}\}- Husband passed away last year} \tn 
% Row Count 18 (+ 4)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{System review}}\{\{nl\}\}- Non-productive cough in the mornings} \tn 
% Row Count 20 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Physical Examination Findings}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Observations}}\{\{nl\}\}- Appears pale + underweight\{\{nl\}\}- Nicotine stains on hands + fingers\{\{nl\}\}- Slightlower crossed posture\{\{nl\}\}- Levoconvex Tx scoliosis} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{ROM}}\{\{nl\}\}- Levoscoliosis (apex T6)\{\{nl\}\}- {\bf{AROM Lx:}} flexion \& extension - slight limitation at end range w/ discomfort around LS junction\{\{nl\}\}- Small rib hump seen on forward flexion} \tn 
% Row Count 8 (+ 4)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Palpations}}\{\{nl\}\}- QL trigger points\{\{nl\}\}- Glute med, max TTP} \tn 
% Row Count 10 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Clinical tests}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Kemps:}}\{\{nl\}\}- {\bf{Purpose:}} assess Lx spine facet joint pain\{\{nl\}\}- {\bf{Findings:}} L reproduces POC at LS junction; R -ve} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{SLR:}}\{\{nl\}\}- {\bf{Purpose:}} identifies impairment in disc anatomy or nerve root irritation\{\{nl\}\}- {\bf{Findings:}} 70° bilat. w/ tight hamstrings} \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Slump's:}}\{\{nl\}\}- {\bf{Purpose:}} detect altered neurodynamics or neural tissue sensitivity\{\{nl\}\}- {\bf{Findings:}} Negative (-ve)} \tn 
% Row Count 9 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{SI springing:}}\{\{nl\}\}- {\bf{Purpose:}} diagnose joint dysfunction\{\{nl\}\}- {\bf{Findings:}} mild LBP R\textgreater{}L} \tn 
% Row Count 11 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Faber's:}}\{\{nl\}\}- {\bf{Purpose:}} diagnose hip pathology by attempting reproducing pain\{\{nl\}\}- {\bf{Findings:}} mild LBP R\textgreater{}L; no restrictions of hip range} \tn 
% Row Count 14 (+ 3)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Thigh thrust:}}\{\{nl\}\}- {\bf{Purpose:}} provocation of SIJ\{\{nl\}\}- {\bf{Findings:}} mild LBP R\textgreater{}L} \tn 
% Row Count 16 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Gaenslens:}}\{\{nl\}\}- {\bf{Purpose:}} diagnose SIJ lesion, pubic symph. instability, L4 nerve root lesion\{\{nl\}\}- {\bf{Findings:}} mild LBP R\textgreater{}L} \tn 
% Row Count 19 (+ 3)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Sacral base compression:}}\{\{nl\}\}- {\bf{Purpose:}} diagnose hip pathology\{\{nl\}\}- {\bf{Findings:}} mild LBP} \tn 
% Row Count 22 (+ 3)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{SIJ compression \& distraction:}}\{\{nl\}\}- {\bf{Purpose:}} SIJ sprain or dysfunction\{\{nl\}\}- {\bf{Findings:}} no pain} \tn 
% Row Count 25 (+ 3)
% Row 9
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{McGills test:}}\{\{nl\}\}- assess radiographic Lx instability\{\{nl\}\}- {\bf{Findings:}} LBP on part 1, decreased pain on part 2 (positive = Lx-pelvic instability)} \tn 
% Row Count 29 (+ 4)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Active SLR:}}\{\{nl\}\}- {\bf{Purpose:}} assess Lx-Sx nerve root irritation\{\{nl\}\}- {\bf{Findings:}} LBP on part 1, decreased pain on part 2} \tn 
% Row Count 32 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Discussion}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Working Dx}}\{\{nl\}\}- Chronic LBP w/ associated Lx \& pelvic functional instability} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Psychosocial}}\{\{nl\}\}- Pt's circumstances changed dramatically the past year after husband's death\{\{nl\}\}- Now reliant on social support\{\{nl\}\}- Her \& her 3 children had to move due to lack of social housing\{\{nl\}\}- Difficulty reading \& writing\{\{nl\}\}- On medication for depression \& anxiety} \tn 
% Row Count 8 (+ 6)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Communication}}\{\{nl\}\}- Don't talk to pt about tardiness / psychology} \tn 
% Row Count 10 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Other}}\{\{nl\}\}- Chronic pain usually psychosocial\{\{nl\}\}- Scoliosis not related to complaint but may be to some of the findings} \tn 
% Row Count 13 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Learning outcomes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Dx of LBP:}}\{\{nl\}\}- {\bf{Muscle strain:}} pain, stiffness, \& soreness\{\{nl\}\}- {\bf{Herniated disc:}} pain, numbness, \& tingling in LB, buttocks, \& legs\{\{nl\}\}- {\bf{OA:}} pain, stiffness, \& loss of mobility\{\{nl\}\}- {\bf{Spinal stenosis:}} pain, numbness, \& weakness in LB, buttocks, \& legs\{\{nl\}\}- {\bf{Spondylolisthesis:}} LB pain, numbness, \& stiffness, as well as numbness \& tingling the legs\{\{nl\}\}- {\bf{Fibromyalgia:}} widespread pain, including the LB\{\{nl\}\}- {\bf{Inflammatory arthritis:}} inflammation \& pain} \tn 
% Row Count 10 (+ 10)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Scoliosis:}}\{\{nl\}\}⏺ {\bf{{\emph{Definition:}}}}\{\{nl\}\}- Spine curvature - mild or severe\{\{nl\}\}- Can affect all ages\{\{nl\}\}- Most commonly diagnosed in children \& adolescents\{\{nl\}\}⏺ {\bf{{\emph{Types:}}}}\{\{nl\}\}- {\bf{Idiopathic:}} most common \& cause is unknown\{\{nl\}\}- {\bf{Congenital:}} present at birth \& caused by abnormal spinal development\{\{nl\}\}- {\bf{Neuromuscular:}} caused by neuromuscular disorder (e.g. cerebral palsy or muscular dystrophy)\{\{nl\}\}- {\bf{Degenerative:}} caused by degeneration of the spinal discs \& joints in the spine (usually seen in adult \textgreater{}65y.)\{\{nl\}\}⏺{\bf{{\emph{Symptoms:}}}}\{\{nl\}\}- Depend on severity\{\{nl\}\}- Mild: asymptomatic\{\{nl\}\}- Severe: back pain, fatigue, uneven shoulders \& hips, \& difficulty standing or sitting up straight\{\{nl\}\}⏺ {\bf{{\emph{Treatment:}}}}\{\{nl\}\}- Depends on severity \& age\{\{nl\}\}- Mild: may not require treatment, or manual therapy\{\{nl\}\}- Severe: bracing or surgery} \tn 
% Row Count 28 (+ 18)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Management of this pt:}}\{\{nl\}\}- {\bf{Pain management:}} NSAIDs, cognitive behavioural therapy (CBT), acupancture, manual therapy, electrotherapies\{\{nl\}\}⏺ {\bf{Physical therapy:}} improve strength, flexibility, stability, core strength, posture, \& overall mobility\{\{nl\}\}- {\bf{Manual therapy:}} spinal manipulation or mobilisation (relieve pain \& improve mobility), soft tissue therapy to relive muscle tension \& improve ROM\{\{nl\}\}- {\bf{Psychosocial interventions:}} cognitive-behavioural therapy (CBT) to reduce anxiety \& depression related to pain\{\{nl\}\}- {\bf{Bracing:}} in severe cases provides support to the affected area\{\{nl\}\}- (Surgery only in severe cases)} \tn 
% Row Count 42 (+ 14)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Learning outcomes (cont)}}  \tn
% Row 3
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Impact of yellow flags present:}}\{\{nl\}\}- Prolonged recovery\{\{nl\}\}- Increased disability: psychosocial factors can affect their ability to cope w/ pain \& perform ADLs\{\{nl\}\}- Increased healthcare utilisation\{\{nl\}\}- Work-related issues: more economic burdens than this pt already has\{\{nl\}\}- Chronic pain: yellow flags are more likely to develop chronic pain (psychosocial factors can contribute to the development of long-term pain conditions)} \tn 
% Row Count 9 (+ 9)
% Row 4
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Consider other health concerns present in this pt:}}\{\{nl\}\}- Non-productive cough: likely due to smoking\{\{nl\}\}- Smoking 20 (30?) cigarettes / day for 20 years\{\{nl\}\}- Unvaccinated\{\{nl\}\}- Underweight \& pale: iron-deficiency, malnutrition, chronic stress, or depression} \tn 
% Row Count 15 (+ 6)
% Row 5
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Relationship between depression \& LBP:}}\{\{nl\}\}-{\bf{Shared biological mechanisms:}} common biological pathways (e.g. abnormalities in the CNS), that contribute to the development \& maintenance of both conditions\{\{nl\}\}- {\bf{Psychosocial factors:}} chronic pain can lead to -ve psychosocial consequences (e.g. social isolation, reduced physical activity, \& poor quality of life), which can contribute to depression\{\{nl\}\}- {\bf{Stress:}} chronic stress is linked to development \& exacerbation of both depression \& chronic pain\{\{nl\}\}- {\bf{Behavioural factors:}} pts w/ chronic pain may adopt maladaptive comping strategies (avoidance), which can lead to a -ve spiral of pain, disability \& depression\{\{nl\}\}⏺ LBP \& depression interact in complex ways \& treatment has combination of pharmacological \& psychosocial interventions (CBT)} \tn 
% Row Count 32 (+ 17)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Learning outcomes (cont)}}  \tn
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Changes needed to make w/ clinical procedures \& consent to support this pt:}}\{\{nl\}\}- Holistic approach\{\{nl\}\}- Pt-centred care\{\{nl\}\}- Informed consent\{\{nl\}\}- Multidisciplinary team\{\{nl\}\}- Screening for depression} \tn 
% Row Count 5 (+ 5)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Other tests that should be done:}}\{\{nl\}\}- {\bf{Respiratory exam:}} non-reproductive cough, likely due to smoking\{\{nl\}\}- {\bf{Wardell sign:}} how much of the pain is psych. related} \tn 
% Row Count 9 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}