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.
Know Your Content Blueprint
Tuberculosis is part of the NCCPA Content Blueprint Pulmonary System (12%)
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