The Daily PANCE PANRE Question 8

A 48-year-old nurse, with a body mass index of 31, presents for an evaluation of back pain. She relates that historically, she had a positive PPD test a year ago and did not follow-up as directed. She has recently been experiencing night sweats and coughing. An x-ray of her lumbar spine reveals osteopenia and cortical breakdown of vertebral bodies L4 and L5. Which of the following diagnosis is most suspect? compression fractures secondary to obesity degenerative joint disease Pott's disease compression fractures secondary to osteoporosis spondylolisthesis Answer: C Pott's disease Pott's disease is TB of the spine. She could have any of the other diseases, but the question states that she had a positive PPD and did not take meds...that is the clue that she has active TB in the spine. What is the definition of osteopenia?T score less than 2.5 = OSTEOPOROSIS T score (-1 to 2.4) OSTEOPENIA Know Your Content BlueprintTuberculosis is part of the NCCPA Content Blueprint Pulmonary System (12%). Read more and watch a ReelDx patient case video presentation atSmarty PANCE Tuberculosis. Note: * This is part of the Daily PANCE and PANRE in your inbox email series: 60 days of PANCE and PANRE Questions and Answers delivered directly to your inbox. It is a great and fun way to learn! If you haven't already, you can sign up for FREE by clicking Here. Help support The PA Life for FREE! This is provided as an opportunity for anyone who appreciates this email series to help support it painlessly. If you are going to be purchasing anything from Amazon.com (books, school supplies, etc.) simply start your next Amazon.com purchase by clicking here... it's a free way for you to help support the cause! Just click over to Amazon.com then, when you make your purchase, Amazon will send a portion of the proceeds to The Physician Assistant Life. The money goes toward paying for one-time and ongoing costs (like equipment, hosting, backup services, etc.). Thank you for supporting the site and keeping this content free! If you are studying for the PANCE or the PANRE I recommend thesereview books Dear Stephen, I wanted to thank you for your excellent website. I have been a physician assistant for 18 years and recently passed my panre again.   I was really nervous this time, as I have been working in the field of hematology oncology for the last four years. Prior to that I had worked in primary care.   Your daily questions, quizzes and websites reassurance was of tremendous help to me!   Keep up the good work. You are a treasure to the PA profession! 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My take away is to continue the daily questions Stephen sends out and then taking tests and researching areas I need to shore up. Thanks Stephen for a practical approach to PANRE. Gregory Bickel, PA-C The Daily PANCE PANRE Question 8 48 year-old nurse, with a body mass index of 31, presents for an evaluation for back pain. She relates that historically, she had a positive PPD test a year ago and did not follow-up as directed. She has recently been experiencing night sweats and coughing. An x-ray of her lumbar spine reveals osteopenia and cortical breakdown of vertebral bodies L4 and L5. Which of the following diagnosis is most suspect? A compression fractures secondary to obesity B degenerative joint disease C Potts disease D compression fractures secondary to osteoporosis E spondylolisthesis Answer: C Pott's disease is TB of the spine. She could have any of the other diseases; but the question states that she had a positive PPD and did not take meds...that is the clue that she has active TB in the spine. Note: * This is part of the Daily PANCE and PANRE in your inbox email series: 60 days of PANCE and PANRE Questions and Answers delivered directly to your inbox. It is a great and fun way to learn! If you haven't already you can sign up by clicking Here.