Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the initial treatment for cord compression?

1. Dexamethasone

2. Prednisone

3. Ibuprofen

4. Acetaminophen

The correct answer is: Dexamethasone

The initial treatment for cord compression is dexamethasone due to its potent anti-inflammatory properties, which help reduce edema around the spinal cord. When there is compression caused by conditions such as tumors, trauma, or other causes, inflammation can exacerbate the compression, leading to worsening neurological deficits. By administering dexamethasone, the goal is to quickly decrease this inflammation and improve the clinical status of the patient, potentially restoring neurological function or preventing further deterioration. This approach is especially crucial in acute scenarios where prompt intervention can impact the outcome significantly. Other medications listed, like prednisone, are corticosteroids but have a slower onset of action compared to dexamethasone and are typically not the first choice in acute settings. Ibuprofen and acetaminophen are analgesics that may help with pain management but do not address the underlying issue of inflammation and edema associated with cord compression. Therefore, dexamethasone stands out as the most appropriate initial treatment in this context.