skip to main content

Multiple Sclerosis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateNeurologyMultiple SclerosisRACP Adult Medicine

A 30-year-old woman presents with acute vision loss in her right eye with pain on eye movement. Fundoscopy shows a swollen optic disc. MRI brain shows periventricular white matter lesions and an enhancing right optic nerve. What is the most appropriate acute treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — IV methylprednisolone 1 g daily for 3–5 days

This presentation is consistent with optic neuritis as a first presentation of multiple sclerosis (MS). Acute treatment is IV methylprednisolone 1 g daily for 3–5 days, which hastens visual recovery but does not change the final visual outcome. Oral prednisolone alone was associated with increased relapse risk in the Optic Neuritis Treatment Trial. Disease-modifying therapy should be discussed.

Reference: eTG – 2025 – Neurology; MS Research Australia – 2023 – MS Clinical Guidelines