Review Quiz

Which of the following is true regarding multiple sclerosis (MS).

  1. MS is a disease involving the peripheral nervous system affecting the axons of lower extremities first.
  2. MS is a chronic inflammatory disease, caused by an autoimmune response, resulting in degeneration of myelin sheath in the CNS.
  3. MS is a disorder of the CNS caused by the Varicella-zoster virus.
  4. Exacerbation of MS causes damage to the cell body (soma) of sensory neurons.

You are treating a patient experiencing an exacerbation of MS. Which lab value would you expect to find?

  1. Elevated CSF immunoglobulin G (IgG)
  2. Elevated Vitamin D levels
  3. Critically low hemoglobin and hematocrit
  4. Positive hepatitis B surface antigen screen

A patient newly diagnosed with MS has arrived at your clinic. Which of the following is most likely to be true regarding this patient?

  1. The patient is a 45-year-old male with a positive family history of MS.
  2. The patient is female and recently had a bacterial infection not treated with antibiotics.
  3. The patient is a 30-year-old female presenting with relapsing remitting episodes of recurrent neurological symptoms.
  4. The patient is male IV drug user presenting with flu-like symptoms.

What is the best treatment for a patient experiencing an acute MS exacerbation?

  1. Corticosteroids, such as methylprednisolone, to promote a swift recovery.
  2. Penicillin, an antibiotic, to treat the infection.
  3. Vitamin D supplement to promote a positive progression.
  4. Oseltamivir, an antiviral, to prevent viral replication.

You suspect your patient is experiencing symptoms of MS. The patient has never been diagnosed with MS, you have taken a thorough history and have ruled out other diagnoses. The last 3 months your patient has had 2 separate episodes of asthenia (atypical muscle weakness) along with brainstem symptoms lasting more than 24 hours. What is your next step to confirm diagnosis?

  1. Order a brain MRI to assess for plaques and tangles.
  2. Obtain serum ammonia levels, a head CT to rule out hemorrhage, and admit the patient to the hospital for further testing.
  3. Diagnosis can be confirmed from the provided information.
  4. Order a brain MRI to assess for demyelinating plaques and obtain a CSF sample to measure the IgG index.

A patient diagnosed with Spinal MS is most likely to present with which of the following symptoms?

  1. Memory problems and vision changes.
  2. Ataxia and weakness in extremities.
  3. Rapid onset of severe headache and tachycardia.
  4. Bladder and bowel problems.