Level 2: Back Pain – Contrasting Case #2: Patient Information – NEED IMAGE

Given these changes from the original case, what is your diagnosis?

What is your diagnostic explanation?

As compared to the long case, this patient is a 60 year old female presenting with a complaint of low back pain. She appears to be in an extreme amount of discomfort.

HPI: Patient states that over the past few days she has been having low back pain. She describes the pain as a deep constant pain that does not get better. She states that the pain was mild at first, but has become increasingly difficult to ignore. She denies fevers, chills, nausea/vomiting.

PMH: No known drug allergies. Simvastatin for hypercholesterolemia. SH: 80 pack year smoking history.

Occasional Alcohol. Married. Retired. FMH: Mother had hypertension and diabetes. Father had hypertension and coronary artery disease.

ROS: No findings

PE –
VS: Height 5’5; Weight 150lb; BMI 25; HR 82; BP140/90; RR 16; 98.5F
Cardiac: S1 and S2 audible. Regular rate and rhythm. No murmurs
Lungs: Clear to auscultation bilaterally. No adventitious sounds present.
Abdomen: Pulsating mass in midline. No organomegaly present.

Tests: CT imaging indicating AAA