Question

a 35 year old athlete presents to your office complaining of low back pain that came on yesterday during heavy lifting. patient states that the pain radiates into his legs immediately after performing deadlifts. based on the mechanism of injury and the patient’s complaint, what is the initial step you should take? a) test for lower extremity muscle strength b) test for lower extremity deep tendon reflex c) ask about any changes to his bowel and/bladder movement d) ask about changes in mood or behavior

Explanation:

The patient has low - back pain radiating to legs after heavy lifting. Changes in bowel and bladder function can indicate serious spinal cord or nerve root injury. This should be ruled out first as it is a medical emergency. Muscle strength and deep tendon reflex tests are important but secondary. Mood or behavior changes are not relevant to the immediate injury mechanism.

Answer:

c) Ask about any changes to his bowel and/bladder movement