A patient has scotoma, dysarthria, nystagmus, and bowel and bladder problems. Which diagnostic test result would lead to the conclusion that the patient has multiple sclerosis? Select all that apply. One, some, or all responses may be correct. \( \square \) Areas of increased density on the computed tomography (CT) scan \( \square \) Elevated gamma globulin present in cerebrospinal fluid (CSF) \( \square \) Decreased glucose levels noted in the CSF \( \square \) 3- to 4-mm sclerotic brain plaques seen on a magnetic resonance imaging (MRI) scan \( \square \) Elevated spinal fluid protein present in CSF \( \square \) Blood detected in CSF
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Elevated gamma globulin present in cerebrospinal fluid (CSF) is a key indicator of multiple sclerosis (MS), as it suggests an inflammatory response occurring in the central nervous system. Also, the presence of 3- to 4-mm sclerotic brain plaques seen on an MRI scan is one of the hallmark features of MS. These plaques represent areas of demyelination typical of the disease process. In addition, the presence of elevated spinal fluid protein in the CSF can also suggest MS, as this can indicate a breakdown of the blood-brain barrier and increased immunological activity. While areas of increased density on a CT scan may not typically diagnose MS, they may indicate other conditions. The other choices, such as decreased glucose levels or blood in the CSF, are not characteristic of MS and may suggest other neurological issues.