Family Nurse Practitioner Exam

What condition is indicated by the quick onset of severe low back pain and a palpable soft pulsatile mass in an 80-year-old male?

1. Cauda equina syndrome

2. Acute diverticulitis

3. Adenocarcinoma of the colon

4. Abdominal aortic aneurysm

The correct answer is: Abdominal aortic aneurysm

The quick onset of severe low back pain coupled with a palpable soft pulsatile mass in an 80-year-old male strongly suggests an abdominal aortic aneurysm (AAA). In this age group, especially among males, the prevalence of AAAs is significant due to age-related vascular changes, such as atherosclerosis, which can contribute to the weakening of the aortic wall. When an AAA forms, it may not present noticeable symptoms until it becomes large or ruptures. The severe low back pain is often due to the pressure exerted by the expanding aneurysm on nearby structures. The presence of a soft, pulsatile mass indicates that there is an enlarged aorta that is noticeable on physical examination, which is characteristic of an AAA. Recognizing these signs is crucial in emergency situations, as a ruptured aneurysm can be life-threatening and requires immediate surgical intervention. Other conditions like cauda equina syndrome, acute diverticulitis, and adenocarcinoma of the colon have different presentations and would not typically present with both severe low back pain and a palpable pulsatile mass, especially in this demographic.