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Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 2/Question#7 (reveal difficulty score)
A 32-year-old woman comes to the physician ...
Interferon beta therapy ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: neuro

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submitted by โˆ—step_prep(148)
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  • Young woman presenting with neurological symptoms separated in time and space, including Lโ€™hermitteโ€™s sign (electric-like sensation with neck flexion) and optic neuritis (unilateral painful vision changes/loss) with a brain MRI showing multifocal, ovoid subcortical white matter lesions in a periventricular distribution most consistent with multiple sclerosis
  • Key idea: Multiple sclerosis is treated chronically with immunosuppressants, but an acute MS flare (such as this patient) should be treated with glucocorticoids, interferon beta or plasmapheresis

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spiroskeet  This patient is currently asymptomatic, which is why treatment for her should be IFN-ฮฒ (or glatiramer or natalizumab). If she still had symptoms of an acute MS exacerbation, treatment would consist of corticosteroids (i.e., dexamethasone/methylprednisolone). If symptoms persist in spite of steroids, she should undergo plasmapheresis. +22



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