Reply To My Peers Reply to my peers Please see attachments Peer 1 the patient is a 45 years old male truck driver who complain of two weeks of sharp,

Reply To My Peers Reply to my peers

Please see attachments Peer 1

the patient is a 45 years old male truck driver who complain of two weeks of sharp,

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Reply To My Peers Reply to my peers

Please see attachments Peer 1

the patient is a 45 years old male truck driver who complain of two weeks of sharp, stabbing back pain after lifting a 10-lb box. The pain got better but worsened after he played a game. The day of the visit the pain was at its worst. The patient has diabetes that is well controlled, hypertension, that is fair controlled and hyperlipidemia that is also fair controlled. Patient has no history of past surgical history and his work involves lifting heavy things 4 hours in a day. he is married and is father to two daughters.
Currently, the patient is on Metformin 1000 mg PO twice daily, Glyburide 10 mg PO twice daily, Amlodipine 2.5 mg PO daily, Lisinopril 40 mg PO daily, and Simvastatin 40 mg PO daily. He has no allergies to medication.
It is important to take the vital signs of the patient including temperature, pulse, respiratory rate, blood pressure, weight, and body mass index. Physical examination also involves inspection of the posture, contour, and symmetry, also, one needs to check for palpation, gait, stoop test, and range of motion. Also, one needs to conduct back exam when the patient is standing and seated as well as pulmonary and cardiovascular exam. Other needs to be on deep tendon reflexes, muscle strength, modified version of the straight leg raise (SLR) test and neurological exam.
First differential diagnosis is lumbar strain which is the most common cause of acute lwo back pain in adults and pain radiate down one or another leg. The pain is worse after periods of immobility and with particular movement (depending on where the strain is). The second one is disc herniation that may have acute or sub-acute presentation, may be precipitated by a sudden injury and the pain is often worse when the hips are flexed as in sitting. The location of pain depends on the level of the herniation. The third is degenerative arthritis that is common as people age, and has more insidious onset.
The patient can receive conservative therapy for acute low back pain that include pharmacologic therapy, local therapy, and ensuring that the patient remains active. If the conservative therapy is not effective then the pain should be referred to a spine surgeon for surgical consultation.
References

Family medicine 10: 45-year-old male with low back pain. (n.d.). South University College of Nursing and Public Health Graduate Online Nursing Program. https://southu-nur.meduapp.com/document_set_document_relations/30230

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