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| * NBME 1 Bl 2 |
| | #531384 |
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34. A 67-year-old man is brought to the emergency department 4 hours after the onset of severe midlumbar back pain. He is anxious, pale, and diaphoretic. His temperature is 37.1 C (98.8 F), blood pressure is 105/65 mm Hg, and pulse is 120/min. Examination shows no other abnormalities. X-ray films of the lumbar spine show degenerative disc disease with calcifications anterior to the vertebral bodies. Which of the following is the most likely diagnosis?
A
) Aortoiliac occlusion
B
) Herniated nucleus pulposus
C
) Lumbar discitis
D
) Lumbar strain
E
) Pyelonephritis
F
) Ruptured aortic aneurysm
G
) Spinal stenosis
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| * Re:NBME 1 Bl 2 |
| #2188937 |
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BP is normal.. can it be F??.. how abt the calcifications ant to v. bodies ?, any corelation ?
still i think its F too cozz other features suggest shock ..which can only be present in ruptured aneurysm in the options given above
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| * Re:NBME 1 Bl 2 |
| #2189179 |
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BP would be normal initially,so always take pulse into count and patient so anxious,rest of all causes of back pain we don't have this much change in pulse.calcification on findings are just confusing us. |
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| * Re:NBME 1 Bl 2 |
| #2189189 |
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there is no finding on PE in abdomen,at least tenderness expected and the pt I need to think is rupturing AAA?
Don't you think thats weird? |
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| * Re:NBME 1 Bl 2 |
| #2189254 |
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but only ultrasound would confirm that.yup,they could have provided with more information.
this is rupturing abdominal aneurysm... |
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| * Re:NBME 1 Bl 2 |
| #2193394 |
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Ans F, calcifications anterior to the vertebral bodies...that is from calcification in wall of abdominal aneurysm
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