Alternative PANRE Test Question: 67 Year Old Smoker

A 67-year-old man presents with sudden onset paralysis of the lower extremities that started with acute onset of severe chest pain. He became nauseated and light headed about the same time. EKG appears normal. The chest radiograph is shown. He has smoked 1 pack/day since age 25.

What is the most appropriate initial intervention?

A. Stat head CT
B. Stat MRI of LS spine
C. Straight leg raises
D. Abdominal ultrasound
E. Immediate physician referral