50-year-old male with a history of non-Hodgkin’s lymphoma who has been otherwise well and NED (no evidence of disease) for the past two years presents
50-year-old male with a history of non-Hodgkin’s lymphoma who has been otherwise well and NED (no evidence of disease) for the past two years presents to your office with multiple complaints. He tells you over the last three weeks he’s noticed insidious onset of low back pain which has gotten progressively worse. NSAIDs and Tylenol have not afforded him any relief. Two days ago he noticed some numbness in his pelvis and he’s had two episodes of urinary incontinence which is a new finding. Based on this information, the most appropriate next course of action is what? Question 23Select one: a. Refer him for physical therapy and continue conservative management with RICE and NSAIDs. b. Start low dose opioid analgesics such as oxycodone 5 mg po q6h prn c. Refer him for stat MRI of the spine d. Start duloxetine 30 mg po daily e. Start a muscle relaxant such as cyclobenzaprine 10 mg po tid prn
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