CASE 134 History: A 39-year-old woman from the Bahamas presents with spastic paraparesis and progressive pain in the lower extremities for the past 10 years. 1. What should be included in the differential diagnosis? (Choose all that apply). b. Ependymoma c. Subacute combined degeneration e. Human T-cell lymphotropic virus type I (HTLV-I)–associated myelopathy 2. Which of the following statements regarding HTLV-I infection is false? a. HTLV-I mainly infects CD4+ T cells. b. An elevated HTLV-I proviral load is the best marker of symptomatic neurologic disease. c. Maternal-child transmission via breast milk is the major mode of transmission. d. Most infected individuals develop the disease. 3. Which of the following imaging findings in the cord is most common in patients with clinical disease? a. Atrophy of the cervical cord b. Atrophy of the thoracic cord c. Increased signal in the cervical cord d. Increased signal in the thoracic cord
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