SOLVED787

A 45 year old woman comes to the clinic because of back pain. She has a history of breast cancer that was first diagnosed 4 years ago. Her primary tumor was 2.3 cm in size and she had only one axillary lymph node that was positive for malignancy. She elected to have a mastectomy, and she received adjuvant chemotherapy for 6 months. Her tumor was negative for hormone receptors. She was in her usual state of health until about 2 months ago, when she began to notice intrascapular back pain. She initially attributed it to a “pulled muscle” because she was weight lifting and exercising at a local health club. However, over the last 3 days the pain has increased in intensity particularly when she lies down, and she has noted weakness in her legs, so she came to the YNHH Emergency Department. She denied any fever, night sweats, weight loss, or headache. Physical exam reveals a thin woman in NAD. VITAL SIGNS: T 98.8, P100, R 14, BP 135/76, O2 sat 98% on RA. SKIN: warm dry, normal turgor. LN: no palpable cervical, supraclavicular, axillary or inguinal adenopathy. HEENT: conjunctivae normal, oropharynx benign, TMs normal, sinuses nontender, fundi benign.
SCIENCE
HEALTH SCIENCE
NURSING

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