A 35-Year-Old Man Comes to the Office with a 5-Day

question 1079

Multiple Choice

A 35-year-old man comes to the office with a 5-day history of back pain, which began as he was carrying heavy boxes while moving to a new apartment.  Since then, he has had sharp pain in the low back radiating to the posterior aspect of the left calf and foot.  The patient has no associated bladder or bowel incontinence.  Vital signs are normal.  BMI is 38 kg/m².  Examination shows intact motor strength, deep tendon reflexes, and light touch and pinprick sensation in the lower extremities.  Anal reflex and perineal sensation are normal.  Lifting the left leg to 70 degrees with the knee held straight causes burning pain radiating from the low back to the left foot.  Which of the following is the best next step in management?

• A)MRI of the lumbar spine
• B)Nerve conduction studies
• C)Supervised exercise program
• D)Surgical decompression
• E)Trial of nonsteroidal anti-inflammatory drugs
• F)X-ray of the lumbar spine

---

Definitions:

Yield-To-Maturity

The expected total yield on a bond when held to its maturity date, stated as a yearly percentage.

Coupon Rate

The interest paid annually on a bond, indicated as a percentage of its face value.

Annually

Occurring once every year, often used to describe events or measurements that are taken or occur once per year.

Maturity

In finance, maturity is the time at which the principal amount of a bond, loan, or other debt instrument becomes due and payable.