Question of the Week # 189

189) A 38 year old woman presents for follow up visit of right leg weakness. Her history is significant for episodes of diplopia and right sided weakness that recurred thrice in the last 3 months. These presentations were also associated with concomitant urinary incontinence and ataxia. Her most recent hospitalization for such an episode was three weeks ago. She was discharged after her symptoms improved upon using intravenous steroids. An MRI brain taken during the initial episode revealed multiple white matter lesions in the peri-ventricular area. Today, she feels well except for minimal weakness in her right leg. Most appropriate drug that should be administered to this patient to reduce the frequency and severity of these recurrences?

A) Methyl dopa

B) Interferon Beta

C) Methyl Prednisolone

D) Interferon Alpha

E) Intravenos Immunoglobulin ( IVIG)

10 Responses

  1. she had MS
    (IVIG )

  2. she has MS so for prevention of recurrance give beta interferon

  3. Based on MS dx its an auto immune dis. You can use steroids but there are more spesific meds to use (DMD),Interferon or relapsing tx

    Be more specific about your questions.
    They are very broad

    • It is important to read the question carefully since the question being asked may not be directly related to the stem. The question asks what reduces the frequency and severity of recurrences. It is important to understand that the steroids are used in acute attack but they do not reduce the recurrences. The questions on Step 3 are typically asked on a focused concept. Interferon Beta is the only DMD listed in the choices and is the correct answer.

  4. B

  5. bbb

  6. b

  7. I remember —MMBP

  8. sorry to say everyone is wrong here.
    multiple sclerosis is diagnosed
    Acute – prednisolone or methyl prednisoone
    prevention of relapses- ALPHA interferons 1a or 1b
    failure of alphs interferons then give NATALIZUMAB
    for spasticity give baclofen

    • Interferon beta-1a and interferon beta-1b are used to treat and control multiple sclerosis, an autoimmune disorder. This treatment is effective for reducing attacks in relapsing-remitting multiple sclerosis and slowing disease progression and activity in secondary progressive multiple sclerosis.

      https://en.wikipedia.org/wiki/Interferon#Diseases

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