Demyelinating Diseases USMLE Step 1 Practice Question
A 45-year-old man with a 10-year history of relapsing-remitting MS presents with progressive leg weakness, spasticity, and bladder dysfunction over 3 years without distinct relapses. Vital signs: BP 145/92, HR 88, RR 16, temperature 37°C. Brain and spinal cord MRI demonstrate multiple T2 hyperintense lesions with spinal cord atrophy. CSF analysis shows no oligoclonal bands. He denies recent vision changes. Which disease course best describes his condition?
Answer choices
- APrimary progressive MS
- BBenign MS
- CProgressive-relapsing MS
- DSecondary progressive MSCorrect answer
- ERelapsing-remitting MS with superimposed acute relapse
- FClinically isolated syndrome with demyelinating features
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