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+--- Thread: q_____________? - sarim (/showthread.php?tid=621276)
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q_____________? - sarim - ArchivalUser - 10-12-2011
A 60 y/o HIV positive man has had low back pain for several months.He has also noticed some "hunching' of his posture.Recently he has been having malaise, sweating and wt loss.With the exception of HIV, his past medical Hx is unremarkable.Lumbar x ray reveals collapse of the bodies of L1 and L2 and the inervertebral disk.
Lab:
RBC----------------- 4.1 million
WBC---------------- 5000
ESR ---------------- 32
Alk phosphatase-- 90 U/L
Caicium------------ 9.1
The most probable Dx?
A-Kaposi sarcoma
B-Multiple myeloma
C-Osteoporosis
D-Tuberculosis
E-Metastatic prostate cancer
0 - ArchivalUser - 10-12-2011
D ( activation of tbc)
0 - ArchivalUser - 10-12-2011
eee
0 - ArchivalUser - 10-12-2011
DD
0 - ArchivalUser - 10-12-2011
D..
0 - ArchivalUser - 10-12-2011
DDD, lumbar vertebrae TB
0 - ArchivalUser - 10-12-2011
my choice was e bcz his wbc count is still normal so his immunity is still there so that excludes tb.......
sarim correct me if i m wrong.
0 - ArchivalUser - 10-12-2011
@kardio
-But WBC differential is not given, so we can't say what's the Lymphocytes status...... i did not even notice this point though....but since he is HIV+...he is most likely Immunocompromised.
and that is what most likely reason for his T.B. Osteomylitis(Pott's Disease).
-In "Metast. Prostate Cancer"---we have "OsteoBLASTIC lesion" (not a collapse)
and Alka phosphatse will be HIGH (this pt's AP is in normal range)
-Multiple Myeloma and Osteoporosis would NOT affect the Intervertebral Disc.
Correct answer is "D"
thanks.
0 - ArchivalUser - 10-12-2011
D.Pott'dz
0 - ArchivalUser - 10-12-2011
thanx sarim i made mistake bcz of this wbc thing....n also bcz prostate ca can be osteoCLASTIC also but thats rare