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WorksheetsMS-Quiz1
Total questions: 15
Worksheet time: 30mins
Which of the following events is considered the initiating factor in the pathogenetic cascade of multiple sclerosis?
accessing of central nervous system by autoreactive lymphocytes
breakdown of blood-brain barrier
development of astrocytic scars
development of confluent demyelinated areas in white and gray matter
Which of the following factors is believed to be protective against multiple sclerosis?
Epstein-Barr nuclear antigen 1 (EBNA1)
HLA-A*02
HLA-DRB1*1501
low exposure to ultraviolet light
Which of the following factors is believed to increase the risk for developing multiple sclerosis?
chewing tobacco
drinking alcohol
smoking cigarettes
use of nicotine gum or patches
Which of the following elements should be sought first when attempting to confirm a diagnosis of multiple sclerosis?
dissemination in space
evidence of a typical syndrome
oligoclonal bands in CSF
radiographic evidence consistent with multiple sclerosis
A patient is referred after one episode of apparent optic neuritis. Imaging shows enhancement of the optic nerve, a juxtacortical lesion, and a lesion in the spinal cord. Examination of the CSF shows oligoclonal bands. Which of the following elements of the diagnostic criteria for multiple sclerosis have been met?
dissemination in space and dissemination in time
dissemination in space only
dissemination in time only
neither dissemination in space nor dissemination in time
Which of the following patient scenarios is most consistent with a diagnosis of clinically isolated syndrome?
no symptoms of multiple sclerosis (MS); findings of an MRI performed for another indication fulfill imaging criteria for MS
no symptoms of MS; MRI performed for another indication shows lesion consistent with MS that does not fulfill imaging criteria for MS
single episode of optic neuritis; findings on MRI fulfill imaging criteria for MS
single episode of optic neuritis; MRI shows lesion consistent with MS that does not fulfill imaging criteria for MS
Which of the following patient factors is most strongly linked with the development of progressive multiple sclerosis?
age
level of vitamin D
number of lesions on MRI
number of previous relapses
Which of the following definitions describes progressive solitary sclerosis?
evolution of a single radiologic lesion such that it fulfills imaging criteria for multiple sclerosis (MS)
progression from a solitary lesion to multiple lesions
progressive MS for which the only antecedent is the detection of a single radiologic lesion that fulfills imaging criteria for MS
single attack of MS
In patients with relapse of multiple sclerosis, which of the outcomes of corticosteroid therapy is most reasonable to expect?
hastening of recovery in a patient with disabling relapse
hastening of recovery in a patient with mild relapse
improvement in disease outcome in a patient with disabling relapse
improvement in disease outcome in a patient with mild relapse
A patient presents with a mild to moderate relapse of multiple sclerosis. Which of the following characteristics suggests that this patient is an appropriate candidate for treatment with oral steroids at home?
ability to walk without a cane
comorbid diabetes mellitus
high risk for falls
history of plasma exchange
A patient with a severe relapse of multiple sclerosis shows no evidence of recovery at the conclusion of a 5-day course of IV corticosteroids. Which of the following treatment approaches is most appropriate?
completion of a second course of steroids
injection of adrenocorticotropic hormone (ACTH) gel
performance of plasma exchange
wait of 1 to 2 additional weeks to allow steroids to take effect
Which of the following characteristics is a risk factor for highly aggressive multiple sclerosis?
female sex
first relapse 1.5 years after initial attack
onset before 40 years of age
white ethnicity
Which of the following agents used to treat aggressive multiple sclerosis is an antibody to CD52?
alemtuzumab
natalizumab
ocrelizumab
rituximab
Which of the following drugs used to treat aggressive multiple sclerosis has been associated with B-cell lysis syndrome?
alemtuzumab
cladribine
natalizumab
ocrelizumab
The original application for approval of the drug cladribine was withdrawn because of concern about an increase in which of the following events?
development of Graves disease
development of malignancies
reactivation of hepatitis B virus
reactivation of herpesvirus
