nbme form 1 last one - ruma

[ArchivalUser]

39. 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

[ArchivalUser]

pls anyone answer this and the other qns that I posted...Thanks for ur help

[ArchivalUser]

I would go w/ A Initially to protect the cervical spine 1st, then proceed w/ E next

Actually even before that I would give her steroids to limit any further damage to the spine before going for additional managements

[ArchivalUser]

Palliative management, man. EE

[ArchivalUser]

e

[ArchivalUser]

good one david looks like completely missed the second part of ans EEE

But A would have been 1s if E did not mentioned cervical stabilization

[ArchivalUser]

Thanks