Approach to back pain Quiz: Ace Your Exams
Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!
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A 65-year-old man with a history of type 2 diabetes and peripheral vascular disease presents to the emergency department with a three-week history of persistent lower back pain. The pain is described as constant, worse at night, and it does not improve with over-the-counter analgesics. Six weeks ago, the patient underwent a lumbar epidural corticosteroid injection for treatment of left lower extremity radicular pain. Temperature is 38°C (100.4°F), pulse is 94/min, respiratory rate is 20/min, blood pressure is 146/94 mmHg, and oxygen saturation is 99% on room air. There is spinal tenderness to palpation, erythema, and swelling at L3 and L4. The pain worsens with hyperextension or flexion of the spine. There are no neurological deficits. Laboratory results are shown below. Human immunodeficiency virus (HIV) test results and blood and urine cultures are pending. A spinal X-ray shows degenerative changes but no acute pathology. Which of the following is the best next step in management?
| Laboratory value | Result |
| Hemoglobin | 14 g/dL |
| Leukocyte count | 13,100/mm3 |
| Platelet count | 450,000/mm3 |
| Creatinine | 0.9 mg/dL |
| Erythrocyte sedimentation rate (ESR) | 77 mm/hr |
| C-reactive protein | 15 mg/L |
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