Demyelinating Diseases USMLE Step 1 Practice Question
A 41-year-old woman presents with acute paraplegia and a sensory level at T8. Two weeks later, she develops bilateral optic neuritis. Vital signs show BP 128/82, HR 88, RR 16, temperature 37.2°C, SpO2 98% on room air. MRI reveals a longitudinal myelitis extending over 3 spinal segments without brain lesions. Serum aquaporin-4 antibody testing is positive. Which of the following is the most likely diagnosis?
Answer choices
- AAcute disseminated encephalomyelitis
- BTransverse myelitis with coincidental optic neuritis
- CSpinal cord compression with secondary inflammation
- DMultiple sclerosis
- ENeuromyelitis optica spectrum disorderCorrect answer
- FParaneoplastic myelopathy with anti-NMDA receptor antibodies
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