NBME Step 2 CK Form 8 Interferon beta therapy (NBME Answers)

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submitted by ∗step_prep(148)

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Young woman presenting with neurological symptoms separated in time and space, including L’hermitte’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-β (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