A 55-Year-Old Man with a History of Chronic Low Back

question 481

Multiple Choice

A 55-year-old man with a history of chronic low back pain comes to the physician with a 3-week history of progressive right shoulder pain and a 1-week history of worsening lower back pain.  He has tried several over-the-counter medications without significant relief.  He smokes 2 packs daily and consumes alcohol occasionally.  A chest x-ray reveals a right superior lobe mass.  Which of the following additional findings, if present, would indicate a worse prognosis requiring urgent intervention?

• A)Asymmetric upper-extremity deep-tendon reflexes
• B)Right hand muscle atrophy and weakness
• C)Right lower-extremity hyperreflexia
• D)Pupil size asymmetry and asymmetric palpebral fissures
• E)Streaky hemoptysis and weight loss

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Definitions:

Dysfunction

In sociology, a component of society that may disrupt the social system or reduce its stability.

Social Life

The part of an individual's time that is spent interacting with others in informal or structured social settings.

Sociologist

A scientist who specializes in sociology, focusing on the systematic study of social behavior and societal structures.

Organization

A group of people structured systematically to achieve specific goals or perform tasks.