USMLE-Rx Step 1 Qmax Challenge #1052

Check out today’s Step 1 Qmax Question Challenge.

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USMLE-Rx Step 1 Qmax Challenge #1052A 26-year-old woman presents to her primary care physician with a 2-week history of pain in her right eye. During the physical examination, the patient is noted to have hyperemia and edema of her right optic disc. On further questioning, the patient also complains of intermittent weakness for the past several months. Neurologic examination reveals 5/5 strength in the left upper extremity, 4/5 in the right upper extremity, 4/5 in the right lower extremity, and 5/5 in the left lower extremity. She undergoes an MRI, which is shown in the image.

Which of the following cerebrospinal fluid studies would be consistent with the patient’s diagnosis?

A. Increased protein, normal WBC count
B. Increased protein, oligoclonal bands
C. Increased protein, protein 14-3-3
D. Increased WBC count, herpes simplex virus polymerase chain reaction
E. Normal protein, JC virus DNA


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7 thoughts on “USMLE-Rx Step 1 Qmax Challenge #1052”

  1. Wouldn’t oligoclonal bands be characteristic of MS? In which case we would see random opacities on MRI? If I had to guess I would say D

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