USMLE Q Bank Step 1 – 201

A 54 year old man visits his physician for evaluation of low back pain. He has a history of lung cancer and he receives a combination of radiation and chemotherapy. His back pain started 3 months ago and now he complains of numbness and tingling in his lower limbs.

What is the most likely cause of this patient’s back pain?

A- Paraneoplastic disease

B- Metastases to the vertebral column

C- Muscular spasm of paravertebral muscles

D- Primary osteosarcoma


Vertebral column is the most common site for metastases of lung cancer. Symptoms start when compression of spinal cord occurs. It causes neurological symptoms of the areas affected. Other choices are less likely associated with cancer lung.

The correct answer is B

2 thoughts on “USMLE Q Bank Step 1 – 201”

  1. All the answers are correct and they cause back pain upper or lower but metastases to the vertebrae are the most common. A great question. Thank you dr Claude

  2. How about paraneoplasm? Isn’t it a much likely cause of lower back pain, especially as there is numbness in the lower limbs?

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