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MCQ 12: Spinal Cord CompressionA 65-year-old woman with breast cancer presents with new onset back pain and bilateral leg weakness. What is the most urgent next step?A. Arrange outpatient physiotherapyB. Start oral morphine for pain relief C. Urgent MRI of the spineD. Prescribe oral steroids and dischargeE. Refer to orthopedics for routine follow-upAnswer: Urgent MRI of the spineExplanation: The symptoms suggest possible malignant spinal cord compression, a medical emergency. An urgent MRI of the spine is crucial for diagnosis and to guide treatment. Early diagnosis and management can prevent irreversible neurological damage. While pain relief is important, it should not delay imaging. Steroids may be started, but only after imaging and in conjunction with oncology input. Routine follow-up or outpatient management is inappropriate given the urgency of the situation.