#january2020mccqe1
A 65-year-old man is evaluated in the emergency department for a 3-day history of gradually worsening low back pain and fever.
On physical examination, temperature is 38.0°C (100.4°F); other vital signs are normal. General examination, including neurologic examination, is normal. MRI of the spine shows enhancement of the L3-L4 end plates and inflammation of the disk space. No epidural enhancement or paravertebral collections are seen. The patient is hospitalized.
Which of the following is the most appropriate next management step?
(A) Begin ceftriaxone
(B) Begin nafcillin
(C) Obtain blood cultures
(D) Obtain bone biopsy
A 65-year-old man is evaluated in the emergency department for a 3-day history of gradually worsening low back pain and fever.
On physical examination, temperature is 38.0°C (100.4°F); other vital signs are normal. General examination, including neurologic examination, is normal. MRI of the spine shows enhancement of the L3-L4 end plates and inflammation of the disk space. No epidural enhancement or paravertebral collections are seen. The patient is hospitalized.
Which of the following is the most appropriate next management step?
(A) Begin ceftriaxone
(B) Begin nafcillin
(C) Obtain blood cultures
(D) Obtain bone biopsy
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