NORCET 5 Prelims - Sept 2023 (Shift-2)
Medical & Surgical Nursing
Easy
Early sign of Pott's spine?
Appeared in: NORCET 5 Prelims - Sept 2023 (Shift-2)
Explanation
- Pott's spine, or spinal tuberculosis, is a destructive infection of the vertebrae caused by Mycobacterium tuberculosis.
- The most common and earliest presenting symptom is localized back pain, which is often insidious in onset and persistent.
- This pain is due to the inflammatory process and bone destruction within the vertebral body.
- Other signs, such as fever, neurological deficits, or spinal deformity, typically appear later in the disease course.
Why Other Options Were Wrong
- Option A: Spinal cord sepsis is a severe, advanced complication resulting from the spread of infection and abscess formation, not an early sign.
- Option C: While the pain of Pott's spine is typically exacerbated by movement, the fundamental early sign is the presence of back pain itself, which can also occur at rest.
- Option D: Nausea and vomiting are non-specific gastrointestinal symptoms and are not characteristic of spinal tuberculosis.
Related Visual
- Visual 1: MRI of the Spine - An MRI image showing vertebral body destruction, disc space narrowing, and a pre-vertebral abscess, which are classic findings in Pott's spine. This helps visualize the underlying pathology causing the pain.
- Visual 2: Diagram of Disease Progression - A flowchart illustrating the stages of Pott's spine, from early vertebral infection and back pain to the late-stage formation of a gibbus deformity and potential spinal cord compression.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Early clinical manifestations of Pott's spine (tuberculous spondylitis) as background academic context rather than a clinical decision trigger.
- Early diagnosis is critical. In patients with persistent back pain, especially in TB-endemic regions like India, a high index of suspicion for Pott's spine can prevent severe complications like spinal deformity (gibbus) and permanent paralysis.
- Nurses play a key role in assessment. A thorough pain assessment (location, character, duration, aggravating/relieving factors) and screening for constitutional symptoms (fever, night sweats, weight loss) are vital for early detection.
- What if? If a patient with known Pott's spine suddenly develops urinary incontinence and leg weakness, this indicates acute spinal cord compression (a neurological emergency). The priority shifts from medical management to urgent surgical consultation for decompression to prevent permanent paralysis.
How to Approach the Question
- First, identify the keywords in the question: 'early sign' and 'Pott's spine'. This directs you to focus on the initial manifestation of the disease.
- Recall that Pott's spine is a form of tuberculosis affecting the spine, which is a chronic, progressive infection.
- Evaluate the options in the context of disease progression. An infection in the bone (osteomyelitis) will cause localized inflammation and pain as an initial symptom.
- Consider the severity of the other options. 'Spinal cord sepsis' is a systemic and severe condition, making it a late complication.
- 'Pain with movement' is a descriptor of the pain, not the sign itself. The sign is the pain.
- 'Nausea and vomiting' are not specific to a spinal infection.
Concept Tested & Keywords
- Concept Tested: Early clinical manifestations of Pott's spine (tuberculous spondylitis).
- Stem keywords: Pott's spine, early sign
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Negative lead-in flag: false
Question ID
QlIZ1gVBFh2Q8g9vjAzs7s
Practise the full NORCET 5 Prelims - Sept 2023 (Shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Sensorineural Function Questions
- Which ophthalmic diagnostic test measures the Intraocular pressure?
- Look at the image and tell which of the following is incorrect combination:
- Identify the following instrument in image:
- 100 mL fluid is given to patient and patient's CVP is 3 mm Hg, then what is the next intervention?
- How to tie ET tube to adult patient to prevent bedsore?
- What sound is heard when percussing a distended bladder?
- Which test would be done to check balance in a patient with ataxia?
- Identify the condition:
- In the emergency you have 4 patients. By prioritizing your management plan, which patient's problem will you address first?:
- Neurological assessment GCS scale component includes?
More NORCET 5 Prelims - Sept 2023 (Shift-2) Questions
- A doctor ordered 0.45% normal saline with 50 ml/hr by microdrip set then what is drop per minute?
- In which of the following type of poisoning bluish line on gums seen?
- How many Anatomical regions are present in abdomen?
- Which is a preferred Foley catheter size used in adult female?
- A client was admitted with rib fractures and a Pneumothorax, which were sustained as a result of a motor vehicle accident. A chest tube was placed on…
- After a tonsillectomy, a child begins to vomit bright red blood. The nurse would take which initial action?
- A nurse is assessing a malnourished adolescent who has been consuming a vegan diet. For signs of which specific vitamin deficiency should the nurse a…
- A client is admitted to the emergency room with symptoms of delirium tremens. After admitting the client to a private room, the priority nursing inte…
- In which of the following consists with Charcot's triad, EXCEPT?
- The nurse is going to take perineal anus examination in a woman who had normally delivered a new born 2 days before. The nurse should place the woman…