Demyelinating Diseases USMLE Step 1 Practice Question
A 26-year-old woman with recent MS diagnosis presents with acute vision loss, optic nerve swelling on fundoscopy, and transverse myelitis. Vital signs: BP 118/76, HR 88, RR 16, Temp 37°C, SpO2 98%. Labs show normal CSF oligoclonal bands. Brain MRI reveals minimal white matter lesions despite severe neurologic deficits. Serum aquaporin-4 and MOG antibodies are negative. She experiences recurrent attacks every 2-3 months and denies systemic symptoms. Which diagnosis best explains this clinical presentation?
Answer choices
- ABehçet disease vasculitis
- BMultiple sclerosis
- CIdiopathic inflammatory demyelinating disease (seronegative)Correct answer
- DConverted autoimmune encephalitis
- ENeuromyelitis optica spectrum disorder
- FAcute disseminated encephalomyelitis (ADEEM)
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