SOLVED1021

a 47yearold female came for an initial appointment with a neurologist she was diagnosed with relapsingremitting multiple sclerosis rrms two years ago she states that she was initially diagnosed after experiencing acute blurred vision and pain in her left eye urinary incontinence and numbness in her arms and legs on several occasions her primary care physician ordered a magnetic resonance imaging mri which revealed several demyelinating lesions in the right frontal cerebral white matter as well as her cervical spinal cord she expressed that over the last year she has had acute attacks which were treated with corticosteroids by her primary care physician at this time i am prescribing interferon ifn1a 30 mcg weekly by im injection as a longterm diseasemodifying therapy based on this i suspect progressive multifocal leukoencephalopathy pml and want to perform a lumbar puncture to analyze her cerebrospinal fluid using a quantitative polymerase chain reaction pcr assay a query sent to the neurologist asked if the pml was a new diagnosis a differential diagnosis or a replacement diagnosis was this a legal query
SCIENCE
HEALTH SCIENCE
NURSING

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