Low Back Pain: ABFM practice questions

7 board-style questions on low back pain in the PulseMD family medicine question bank — physician-reviewed, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 58-year-old man presents with progressively worsening low back pain over the past 6 weeks. He reports unintentional weight loss of 15 pounds, night pain that awakens him from sleep, and a 40-pack-year smoking history. On examination, he has point tenderness over the L3 spinous process. Neurological examination of the lower extremities is normal.

1. Prescribe NSAIDs and schedule follow-up in 6 weeks
2. Prescribe cyclobenzaprine and recommend activity modification
3. Refer for outpatient physical therapy
4. Order MRI of the lumbar spine

Sample question 2

A 35-year-old warehouse worker presents with low back pain for 3 days after lifting heavy boxes. The pain is localized to the lumbar paraspinal muscles, worsens with movement, and improves with rest. He denies radiating leg pain, numbness, weakness, bowel or bladder dysfunction, fever, and weight loss. Neurologic examination is normal. What is the most appropriate initial management?

1. Prescribe oxycodone for pain control and strict bed rest for 1 week
2. Refer to orthopedic surgery for operative evaluation
3. Order lumbar spine MRI to rule out disc herniation
4. Advise continued activity, NSAIDs, and reassurance

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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