skip to main content

Relapsing-remitting multiple sclerosis relapse — SCE Neurology MCQ

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

HardMultiple sclerosisRelapsing-remitting multiple sclerosis relapseSCE Neurology

A patient with multiple sclerosis develops new optic neuritis and myelitis symptoms over four days but is febrile with nitrite-positive urine. MRI also shows an enhancing cord lesion. What should occur before relapse corticosteroids?

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

Reveal the answer and explanation

Correct answer: A — Assess and treat the active infection, with neurological reassessment

The best answer is “Assess and treat the active infection, with neurological reassessment”. Infection can worsen old deficits and makes corticosteroids hazardous; an enhancing lesion may represent relapse, but infection should be managed first unless an exceptional emergency dictates otherwise. “Give high-dose steroids immediately without addressing infection” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Escalate disease-modifying therapy during sepsis” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Diagnose primary progressive multiple sclerosis” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Perform brain biopsy” is a credible alternative elsewhere, but it fails the decisive discriminator in this case.

Reference: NICE NG220 multiple sclerosis recommendations: https://www.nice.org.uk/guidance/ng220/chapter/Recommendations