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MMLU / A 29-year-old Hispanic woman, gravida 3, para 3, comes to the office because of…

Problem

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question

A 29-year-old Hispanic woman, gravida 3, para 3, comes to the office because of recurrent low back pain during the past year. Rest and analgesics usually eradicate the pain within 2 weeks. However, the pain seems to recur every 2 to 3 months. Medical history is remarkable for gestational diabetes mellitus during her pregnancies. She takes no medications except for an oral contraceptive. She walks 3 miles daily for exercise and works as a sales representative for a computer software company. She is 165 cm (5 ft 5 in) tall and weighs 100 kg (220 lb); BMI is 37 kg/m2 . Vital signs are normal, and physical examination discloses no abnormalities. Which of the following is the most appropriate next step?

choices

  1. Administer an epidural injection of methylprednisolone
  2. Order MRI of the lumbosacral spine
  3. Order x-rays of the lumbosacral spine
  4. Recommend beginning a weight loss program

subject

professional_medicine

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