Cervical spine injury — MCCQE Part 1 MCQ

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ModerateTraumaCervical spine injuryMCCQE Part 1

A 40-year-old man falls from a ladder and has midline neck tenderness but normal limb power and sensation. Which of the following is the most appropriate next step?

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Correct answer: B — Immobilise and image the cervical spine according to Canadian C-spine rule indications

Immobilise and image the cervical spine according to Canadian C-spine rule indications is the single best answer because the age, timing, examination findings and investigations in the vignette fit Cervical spine injury better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian C-Spine Rule, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian C-Spine Rule