Demyelinating Diseases USMLE Step 1 Practice Question
A 31-year-old woman with recently diagnosed relapsing-remitting MS presents for discussion of disease-modifying therapy. Her vital signs are stable (BP 118/76, HR 82, RR 16, Temp 37.0°C, SpO2 98% on room air). Brain MRI reveals 2 T2 hyperintense lesions and 1 gadolinium-enhancing lesion. CSF oligoclonal bands are positive. She has experienced one clinical relapse in the past year with residual mild lower extremity weakness. She denies recent infections. Which therapeutic approach is most appropriate?
Answer choices
- APlasmapheresis
- BFirst-line disease-modifying therapy (interferon-beta or glatiramer acetate)Correct answer
- CImmunoglobulin infusion
- DHigh-dose corticosteroids for acute relapse only
- ENo treatment; monitor with clinical observation alone
- FAlemtuzumab as initial high-efficacy induction therapy for new MS diagnosis
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