A 60-year-old male with known metastatic prostate cancer presents with new-onset severe back pain, bilateral lower extremity weakness, and urinary retention. Physical examination reveals decreased rectal tone and a sensory level at T10. What is the most appropriate initial management step?

The correct answer to the question "A 60-year-old male with known metastatic prostate cancer presents with new-onset severe back pain, bilateral lower extremity weakness, and urinary retention. Physical examination reveals decreased rectal tone and a sensory level at T10. What is the most appropriate initial management step?" is Option A: Administer high-dose corticosteroids..

The other options — B) Order an immediate MRI of the entire spine., C) Schedule urgent surgical decompression., D) Initiate palliative radiation therapy. — are incorrect for this USMLE Exam Prep question. As explained above: The patient presents with classic signs of malignant spinal cord compression. Administering high-dose corticosteroids (e.g., dexamethasone) is the most appropriate initial management step to reduce e…