ABIM Exam Review Practice Question of the Week: Reviewing Multiple Sclerosis

Below is a question directly from Knowmedge’s Internal Medicine Board (ABIM) exam QVault:


All of the following may be attributed to multiple sclerosis except:


A. Dementia

B. Spasticity

C. Blurry vision

D. Lack of ipsilateral adduction to a contralateral gaze

E. Hyperreflexia





Multiple sclerosis (MS) is a disease that results from demyelination of white matter in the brain and spinal cord. MS can present as a variety of neurological complaints including:

● Bladder or bowel dysfunction

● Weakness

● Spasticity

● Hyperreflexia

● Paresthesias

● Optic neuritis

● Intranuclear ophthalmoplegia


Choice D (Lack of ipsilateral adduction to a contralateral gaze) describes intranuclear ophthalmoplegia. If the patient is told to look to the left side, the right eye needs to adduct. If it is unable to adduct, then a right medial longitudinal fasciculus (MLF) lesion is likely present. The neurological conditions that cannot be attributed solely to MS include aphasia, seizures, and choice A (Dementia).


The best imaging study to diagnose MS is an MRI of the brain that will show an increased T2 signal and decreased T1 signal.


You can see all the previous ABIM Exam Review Questions of the Week at the Knowmedge Blog. You can find also additional topics and questions directly from the Knowmedge Internal Medicine ABIM Board Exam Review Questions QVault.

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