A 66-Year-Old Man Is Brought to the Emergency Department with Low

question 110

Multiple Choice

A 66-year-old man is brought to the emergency department with low back and left hip pain.  The patient tripped at work and fell backwards, landing on his left side.  He has no head injury or loss of consciousness.  Medical history is unremarkable.  Blood pressure is 148/90 mm Hg, pulse is 105/min, and respirations are 18/min.  On examination, the left paraspinal lumbar area and left hip are tender to palpation.  The neurovascular examination is intact.  X-ray is obtained and is shown in the exhibit.  Which of the following is the best next step in management of this patient?

• A)Admit for nonoperative pain control and physical therapy
• B)Admit for surgical repair
• C)CT scan of the pelvis without contrast
• D)Discharge with crutches and instructions for weight bearing as tolerated
• E)Discharge with non-weight-bearing instructions and outpatient physical therapy

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Definitions:

Phlebotomy procedure

A medical procedure that involves making an incision in a vein to draw blood for testing, transfusions, or treatment for certain medical conditions.

First line

The initial, preferred treatment or intervention for a specific disease or condition.

Defense

Measures, strategies, or mechanisms employed to protect against attack, harm, or damage in military, sports, or legal contexts.

Laboratory coat

A protective garment worn to prevent contamination of clothing and skin from hazardous substances in a lab setting.