A 27-year-old woman comes to the emergency department because of progressive numbness and weakness in her left arm and left leg for 2 days. During this period, she has also had urinary urgency and incontinence. Three months ago, she had blurry vision, difficulty distinguishing colors, and headache for one week, all of which have since resolved. Her temperature is 37°C (98.6°F), pulse is 78/min, respirations are 14/min, and blood pressure is 110/68 mm Hg. Muscle strength in the extremities is 3/5 on the left and 5/5 on the right. Cerebrospinal fluid analysis shows mononuclear cell pleocytosis and oligoclonal banding. Which of the following pathologic findings is most likely to be present in this patient's brain?

Question

A 27-year-old woman comes to the emergency department because of progressive numbness and weakness in her left arm and left leg for 2 days. During this period, she has also had urinary urgency and incontinence. Three months ago, she had blurry vision, difficulty distinguishing colors, and headache for one week, all of which have since resolved. Her temperature is 37°C (98.6°F), pulse is 78/min, respirations are 14/min, and blood pressure is 110/68 mm Hg. Muscle strength in the extremities is 3/5 on the left and 5/5 on the right. Cerebrospinal fluid analysis shows mononuclear cell pleocytosis and oligoclonal banding.  Which of the following pathologic findings is most likely to be present in this patient's brain?

Quizplus · Accepted Answer

Eductional Objective: Multiple sclerosis (MS) is an autoimmune demyelinating disease that results from oligodendrocyte depletion.  Within the lesions, inflammatory infiltrates of lymphocytes and macrophages are seen surrounding oligodendrocytes and myelin sheaths.  Oligoclonal bands are highly sensitive but nonspecific in patients with MS.

A 27-Year-Old Woman Comes to the Emergency Department Because of Progressive