A. T lymphocytes B. B lymphocytes C. Dendritic cells D. Natural killer cells

A. Initiate disease-modifying therapy with alemtuzumab. B. Wait until he has progressed to definite MS and then initiate disease-modifying therapy with glatiramer acetate (GA) or interferon β. C. Initiate disease-modifying therapy with GA or interferon β now to delay the transition from CIS to MS. D. Initiate treatment with fingolimod or teriflunomide.

A. Interferon β, glatiramer acetate B. Glatiramer acetate, fingolimod C. Natalizumab, dimethyl fumarate D. No medications are FDA-approved to treat patients with CIS

A. Only about 10% to 20% of patients with MS have significant problems with treatment adherence. B. Warming medication before self-injection may help to relieve some of the discomfort. C. Patients who self-inject glatiramer acetate should be instructed to massage the injection site before and after injection. D. Frequent use of “drug holidays” is a good way to help patients remain adherent to MS medications.

A. MS is a disease of myelin and is not known to cause axonal loss. B. Axonal loss occurs from the early stages of the disorder and is associated with long-term progression of neurologic impairment. C. Axonal loss has been described in patients with early MS, but it is generally believed to be clinically unimportant. D. Axonal loss occurs only after many years of chronic CNS inflammation.

A. Oligoclonal banding on a lumbar puncture can definitively diagnose patients with MS. B. A diagnosis of MS cannot be confirmed without the use of MRI scans. C. A diagnosis of CIS is used to indicate a single episode suggestive of CNS demyelination in a patient who does not meet the full diagnostic criteria for MS. D. Only about 10% of patients with CIS ever progress to definite MS.

A. Approximately 90% of patients with MS will require ambulatory assistance within 10 years. B. Patients with MS generally have either a relapsing-remitting course or the progression of long-term disability. Most patients do not progress from the relapsing form of the disease to the progressing form. C. Patients who smoke have been shown to have a lower rate of progression from CIS to definite MS. D. Vitamin D deficiency has been associated with an increased risk of MS and with greater disease activity in those diagnosed with MS.

A. CNS inflammation B. Axonal loss and neurodegeneration C. Pain and spasticity D. Depression and fatigue

A. Autoimmune reactions B. Elevated liver function tests C. Severe skin rash D. Postinjection reaction

A. Natalizumab B. Fingolimod C. Teriflunomide D. Alemtuzumab