Low Back Pain: ABFM practice questions

6 board-style questions on low back pain in the PulseMD family medicine question bank, 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 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 evaluation
3. Order lumbar spine MRI to rule out disc herniation
4. Advise continued activity as tolerated, NSAIDs, and reassurance with expected recovery within 4-6 weeks

Sample question 2

A 42-year-old office worker presents with 3 weeks of low back pain radiating down her left posterior thigh and lateral calf to the dorsum of her foot. She reports numbness over the lateral calf and dorsal foot. On examination, she has weakness of left ankle dorsiflexion (4/5 strength), diminished sensation over the lateral calf, and a positive straight leg raise at 40 degrees on the left. Deep tendon reflexes are symmetric. Which nerve root is most likely affected?

1. S1
2. L3
3. L4
4. L5

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

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