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1. Which of the following is not currently an approved disease-modifying therapy for multiple sclerosis (as of December 31, 2017)?

A. ocrelizumab B. daclizumab C. rituximab D. dimethyl fumarate

2. A patient with MS has indicated that he only wants to be on an MS therapy that will help him to achieve "NEDA." You explain that NEDA is consistent with the goals of all MS therapies, and that NEDA means:

A. No Evidence of Disease Advancement, meaning that the patient will not advance to a secondary progressive phase (SPMS) B. Need Ended for Drug Administration, meaning that the patient has achieved drug-free remission C. No Evidence of Disease Activity, meaning no change in disability status, relapses, or MRI activity D. No Evidence of Disseminated Atrophy, with controlling neuronal damage and brain atrophy being the primary goal.

3. Which of the following MS therapies does not currently have an FDA-mandated Risk Evaluation and Mitigation Strategy (REMS) in place?

A. Fingolimod B. daclizumab C. natalizumab D. alemtuzumab

4. You are advising a patient whose MS has been well-controlled on natalizumab therapy for 18 months. You tell her that the most important factor to consider in terms of natalizumab safety is:

A. how long she has been on the therapy B. whether she has positive antibodies to JC virus C. how long she has had MS D. whether she has received other MS disease-modifying therapies

5. The economic analysis of MS drug costs in the ICER Report suggests that alemtuzumab is the most cost-effective based on relapse rate reduction. However, this agent may not be appropriate for all patients with MS because of shared decision-making principles which suggest:

A. the risk-benefit analysis and the patient's tolerance of risk must be considered B. many patients may be well controlled on other agents C. some patients have a milder disease presentation that may not warrant an "aggressive" therapy D. all of the above

6. You are counseling a patient who was used a subcutaneous injectable therapy for multiple sclerosis (MS) for 2 years but discontinued treatment on her own about 6 months ago. She now wants to switch to another therapy that is "safer and works better for her." Your next step is:

A. Determine what tolerability issues and adverse effects this patient was experiencing on her therapy B. Discuss the importance of adherence and advise her to go back on the injectable again for a few months' trial C. Advise her that the oral agents have a better safety record than the injectable therapies and help her select one D. Advise her that an IV therapy such as alemtuzumab is probably best for her MS

7. Several disease-modifying therapies are FDA-approved for use in treating relapsing remitting and secondary progressive forms of MS. Which of the following is/are indicated for use in treating primary progressive MS?

A. alemtuzumab B. natalizumab C. ocrelizumab D. all of the above

8. Data on the long-term effects of disease-modifying therapy in MS show:

A. Treatment is beneficial for the first 5 to 8 years of disease but after that there is minimal benefit to the patient. B. We don't know much about the effects of disease-modifying therapy in MS beyond the first 5 to 8 years. C. Patients treated with DMT do better in first decade of the MS disease trajectory than untreated patients, but after year 10 the disability levels of untreated and treated patients even out D. Treating early in the disease course confers a survival benefit in comparison with delayed treatment

9. Which of the following is the strongest evidence prompting a re-evaluation for a switch in therapy?

A. New MRI lesions or MS relapse, while on therapy B. Use of the current agent for more than 3 weeks without evidence of improvement. C. Known history of non-adherence D. A new agent comes to market

10. The annual cost of disease-modifying therapies for MS has increased over the past 20 years, from about $10,000 to the current:

A. $25,000 annually B. $50,000 annually C. $70,000 annually D. $100,000 annually

Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. Which of the following is not currently an approved disease-modifying therapy for multiple sclerosis (as of December 31, 2017)?

2. A patient with MS has indicated that he only wants to be on an MS therapy that will help him to achieve "NEDA." You explain that NEDA is consistent with the goals of all MS therapies, and that NEDA means:

3. Which of the following MS therapies does not currently have an FDA-mandated Risk Evaluation and Mitigation Strategy (REMS) in place?

4. You are advising a patient whose MS has been well-controlled on natalizumab therapy for 18 months. You tell her that the most important factor to consider in terms of natalizumab safety is:

5. The economic analysis of MS drug costs in the ICER Report suggests that alemtuzumab is the most cost-effective based on relapse rate reduction. However, this agent may not be appropriate for all patients with MS because of shared decision-making principles which suggest:

6. You are counseling a patient who was used a subcutaneous injectable therapy for multiple sclerosis (MS) for 2 years but discontinued treatment on her own about 6 months ago. She now wants to switch to another therapy that is "safer and works better for her." Your next step is:

7. Several disease-modifying therapies are FDA-approved for use in treating relapsing remitting and secondary progressive forms of MS. Which of the following is/are indicated for use in treating primary progressive MS?

8. Data on the long-term effects of disease-modifying therapy in MS show:

9. Which of the following is the strongest evidence prompting a re-evaluation for a switch in therapy?

10. The annual cost of disease-modifying therapies for MS has increased over the past 20 years, from about $10,000 to the current:

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Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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1. Which of the following is not currently an approved disease-modifying therapy for multiple sclerosis (as of December 31, 2017)?

2. A patient with MS has indicated that he only wants to be on an MS therapy that will help him to achieve "NEDA." You explain that NEDA is consistent with the goals of all MS therapies, and that NEDA means:

3. Which of the following MS therapies does not currently have an FDA-mandated Risk Evaluation and Mitigation Strategy (REMS) in place?

4. You are advising a patient whose MS has been well-controlled on natalizumab therapy for 18 months. You tell her that the most important factor to consider in terms of natalizumab safety is:

5. The economic analysis of MS drug costs in the ICER Report suggests that alemtuzumab is the most cost-effective based on relapse rate reduction. However, this agent may not be appropriate for all patients with MS because of shared decision-making principles which suggest:

6. You are counseling a patient who was used a subcutaneous injectable therapy for multiple sclerosis (MS) for 2 years but discontinued treatment on her own about 6 months ago. She now wants to switch to another therapy that is "safer and works better for her." Your next step is:

7. Several disease-modifying therapies are FDA-approved for use in treating relapsing remitting and secondary progressive forms of MS. Which of the following is/are indicated for use in treating primary progressive MS?

8. Data on the long-term effects of disease-modifying therapy in MS show:

9. Which of the following is the strongest evidence prompting a re-evaluation for a switch in therapy?

10. The annual cost of disease-modifying therapies for MS has increased over the past 20 years, from about $10,000 to the current:

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