Demyelinating Diseases USMLE Step 1 Practice Question
A 19-year-old man with no prior neurological history experiences acute onset of paresthesias in both legs, progressive weakness, and urinary retention over 24 hours. MRI shows T2 hyperintensity spanning the entire thoracic spinal cord. CSF shows 250 WBC/μL (95% lymphocytes) and elevated protein. Which of the following findings would most strongly support a diagnosis of transverse myelitis rather than infection?
Answer choices
- ANegative bacterial and viral cultures
- BPresence of oligoclonal bandsCorrect answer
- CGray matter involvement on MRI
- DElevated CSF glucose
- EAbsence of fever
- FPositive aquaporin-4 (AQP4) antibodies
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