MKSAP: 29-year-old woman is evaluated during a routine follow-up examination of multiple sclerosis

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 29-year-old woman is evaluated during a routine follow-up examination of multiple sclerosis, which was diagnosed 3 years ago. The patient says she wishes to discontinue her oral contraceptive and attempt to become pregnant. She has no other personal or family medical history of note. Medications are fingolimod, vitamin D, and an oral contraceptive. On physical examination, temperature is 36.9 °C (98.5 °F), blood pressure is 100/50 mm Hg, pulse rate is 66/min, and respiration rate is 14/min; BMI is 27. A right afferent pupillary defect is noted. All other physical examination findings are normal. Besides discontinuing the oral contraceptive, which of the following is the most appropriate next step in management? A. Advise against pregnancy B. Discontinue fingolimod C. Substitute mitoxantrone for fingolimod D. Substitute teriflunomide for fingolimod Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Neurology OB/GYN Source Type: blogs