 |  NBME form1, q2. thanks
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| Author | 11 Posts |
Perhaps
Forum Elite
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Posts: 162
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A 57-year-old woman with breast cancer comes to the physician because of increasing neck pain over the past 3 days. She has fallen frequently because of muscle weakness. Vital signs are within normal limits. Examination shows hyperreflexia of all extremities. There is tenderness over the cervical spine. Serum calcium level is 11 mg/dL. X-ray films show metastases to the cervical spine. Which of the following is the most appropriate next step in management?
A) Application of a soft cervical collar
B) Physical therapy
C) Mithramycin therapy
D) Tamoxifen therapy
E) Spinal cord decompression and cervical stabilization
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| shumaila
Forum Elite
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E?
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| GDS2008
Forum Elite
Topics: 9
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Based on elimination, I would go for E) SPinal cord decompression and cervical stabilization
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| humbty
Forum Elite
Topics: 24
Posts: 135
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I took A. We would need further diagnostic tests (MRI or CT) before going to OR I would say. To secure her spine during that A.
But I m not sure.
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| GDS2008
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But soft collar is of no use when it comes to securing the spine??
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| humbty
Forum Elite
Topics: 24
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Is a soft colar really soft? I m no specialist in collars. I thought even a soft collar stabilizes.
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| HighHopes
Forum Senior
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Posts: 165
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I answered E,
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| GDS2008
Forum Elite
Topics: 9
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soft collars are very soft and they are not recommended for spine stabilization
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| achilles
Forum Guru
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i'll go for E too.
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| Perhaps
Forum Elite
Topics: 61
Posts: 162
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Thanks a lot!
Maybe E then
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| frank100
Forum Guru
Topics: 48
Posts: 586
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E. only one that explains 4 extremity neurologic manifestations, and itīs approach
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