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NBME 16 Answers

nbme16/Block 2/Question#34 (reveal difficulty score)
A 30-year-old woman comes to the physician ...
Oligodendrocytes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1780)
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This woman's history is characteristic of multiple sclerosis (FA2020 p 523) which is a demyelinating disorder of the CNS. Oligodendrocytes make up the myelin sheathes in the CNS and are attacked in multiple sclerosis.

This is MS because:

  • Acute optic neuritis is characteristic (painful loss of vision)
  • Pyrimidal tract demyelination with spasticity and weakness is characteristic
  • Oligoclonal banding in CSF and T2 weighted lesions in white matter on MRI are diagnostic

Even if you did not get MS from the stem, the white matter lesions point you to specifically myelinated lesions, and the oligodendrocytes make up myelin sheaths in the CNS.

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