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Nevada Funeral Arranger Practice Exam

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You respond to a 72-year-old female complaining of sudden onset of severe, tearing back pain that radiates to her legs. She has a history of hypertension. Her blood pressure is 180/100 mmHg in her right arm and 140/80 mmHg in her left arm. Her radial pulses are diminished bilaterally. What is the most likely diagnosis?
Correct Answer:
Aortic dissection
Explanation:
The patient's presentation with sudden, tearing back pain radiating to the legs, a history of hypertension, and a significant blood pressure differential between arms is highly suggestive of an aortic dissection. Myocardial infarction typically presents with chest pain, not primarily back pain with unequal pulses. Pulmonary embolism would likely present with dyspnea and pleuritic chest pain. Renal colic presents with flank pain, often radiating to the groin.

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