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Multiple Myeloma — UKMLA MCQ

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HardHaematologyMultiple MyelomaUKMLAMRCP Part 1PARA

A patient with known prostate cancer develops severe thoracic back pain, leg weakness and urinary hesitancy. What investigation should be arranged urgently for suspected metastatic spinal cord compression?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Urgent whole-spine MRI completed within 24 hours

B is correct. New severe spinal pain with motor and bladder symptoms in a person with cancer is an oncological emergency. NICE recommends MRI of the whole spine as soon as possible and always within 24 hours when metastatic spinal cord compression is suspected. A can miss epidural disease. C images too little and delays care. D and E do not assess acute cord compression. The patient also requires immediate specialist coordination, spinal precautions according to stability and timely corticosteroid consideration under the pathway.

Reference: NICE NG234 spinal metastases and metastatic spinal cord compression: https://www.nice.org.uk/guidance/ng234/chapter/Recommendations GMC PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map