American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the standard treatment for a relapse of multiple sclerosis?

1. Oral prednisone

2. Intravenous methylprednisolone

3. Subcutaneous interferon

4. Intramuscular glatiramer acetate

The correct answer is: Intravenous methylprednisolone

The standard treatment for a relapse of multiple sclerosis is intravenous methylprednisolone. This course of therapy is preferred because it helps to reduce inflammation within the central nervous system, leading to improved recovery from exacerbations. Methylprednisolone works by suppressing the immune response, which is particularly beneficial during relapses when inflammatory processes are contributing to neurological symptoms. In contrast, oral prednisone is less commonly used for acute relapses because it may not be as effective as intravenous formulations and can also carry a risk of side effects associated with long-term use. Subcutaneous interferon and intramuscular glatiramer acetate are both disease-modifying therapies intended for long-term management of multiple sclerosis rather than treatment of acute relapses. These agents are effective in reducing the frequency of relapses when taken consistently over time, but they do not address the immediate need for rapid recovery during a relapse, making them unsuitable for this particular scenario.