Multiple Sclerosis

Expanded Disability Status Scale 

• Measures the current level of disability to benchmark and monitor changes in multiple sclerosis

1. Which of the following is TRUE regarding types of MS? 

a) Primary progressive MS is the most common type

b) Starting medications after a clinically isolated syndrome (CIS) will prevent MS

c) 30% of relapsing-remitting cases will convert to secondary progressive MS after 10 years

d) None of the above are true

2. All of the following are correct regarding DMT therapy in MS EXCEPT

a) DMT should be started on diagnosis of RRMS

b) Siponimod is the only DMT indicated for active PPMS

c) DMT may be initiated if there are 2 + brain lesions detected upon CIS 

d) DMT can be held in CIS if the patient is monitored closely 

3. All of the following are signs/symptoms of MS EXCEPT

a) Bladder dysfunction

b) Optic neuritis

c) Depression

d) All of the above may occur in MS

4. A patient presents with newly diagnosed RRMS. They have been prescribed dimethyl fumarate 240 mg po BID. The patient expresses they have new onset diarrhea since starting their prescription. Which of the following would be the MOST appropriate recommendation to manage their symptoms? 

a) Increase fluid intake 

b) Psyllium 1 tbsp po BID 

c) Discontinue dimethyl fumarate

d) a + b 

5. Which of the following is FALSE regarding therapeutic management of MS? 

a) Onset of action with glatiramer acetate is 3 months

b) High dose prednisone is the treatment of choice for acute exacerbations of MS

c) Alemtuzumab is highly efficacious DMT, but its toxicity limits its use as first-line DMT

d) DMTs do not treat existing MS symptoms