DrVirgo
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Mid lumbar back pain, anxious pale diaphoretic, BP norm., tachycardic, degenerative disc disease, and calcifications anterior to the vertebral bodies. B. Herniation of nuceus pulposus
or…F. Ruptured Aortic Aneurysm. (I think B)
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| dr_arc
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ans F = ruptured aortic aneurysm,
age grp, severe back pain, diaphoretic pt with a droping bp , lack of neurological findings or SLR that would sugges a disc problem, support the answerm
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| DrVirgo
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His BP is pretty normal...
And how do you explain the calcifications on the vert. bodies and teh degenerative disc disease if the answer is Ruptured AAA?
I still think its B. Herniation...
anyone know why he has calcifications? due to..........?
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| robin082006
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F
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| dr in trouble
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Now i am in favour of RAA---sorry but i didnt read the qs carefully b4. The calcifications are quiet normal at this age d/t degenerative disc disease.
Degenerative disc disease refers to a syndrome in which a compromised disc causes low back pain. Lumbar degenerative disc disease usually starts with a torsional (twisting) injury to the lower back, such as when a person rotates to put something on a shelf or swing a golf club. However, the pain is also frequently caused by simple wear and tear on the spine.
Despite its rather dramatic label, degenerative disc disease is fairly common, and it is estimated that at least 30% of people aged 30-50 years old will have some degree of disc space degeneration, although not all will have pain or ever receive a formal diagnosis. In fact, after a patient reaches 60, some level of disc degeneration is deemed to be a normal finding, not the exceptionFortunately, over time the pain from lumbar degenerative disc disease usually decreases, rather than becoming progressively worse. This is because a fully degenerated disc no longer has any inflammatory proteins (that can cause pain) and usually collapses into a stable position eliminating the micro-motion that generates the pain
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| DrVirgo
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Any other thoughts on this one?
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| mytime
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F. coz his symptoms, are pre-shock, is BP is normal, but how much longer????? He has reflex tachycardia, hence the BP is trying to be ok. SO AAA.
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| DrVirgo
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mytime wrote:
F. coz his symptoms, are pre-shock, is BP is normal, but how much longer????? He has reflex tachycardia, hence the BP is trying to be ok. SO AAA.
Ok, thats probably right, but reflex tachycardia even BEFORE the hypotension??
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| sherry39
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DISCITES....ANKYLOSING SPONDYLITES...CAUSING AORTIC REGURG
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| mildus
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Maybe he maintains his BP temporarily by tachycardia. He is pale - possibly due to compensatory vasoconstriction and bleeding, and is diaphoretic due to sympathetic activation.
X-ray findings of degenerative spine disorders don't correlate well with clinical findings, i.e. patient can be asymptomatic and have significant x-ray changes and vice versa.
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| Vietnamese
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sherry39 wrote:
DISCITES....ANKYLOSING SPONDYLITES...CAUSING AORTIC REGURG
Great idea.
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| peter90036
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calcif plaque on aorta
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| drhouse
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Herniated disc could be the ans.
anxiety n diaphoresis can be explained by pain lead to sympathetic discharge.
BP is normal so no chances of ruptured aortic aneurysm...
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| lq2006
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F
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| drhouse
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what is the ans Dr.virgo??
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