MS/MND/spinal cord/muscular disorders

Question 1

Proportion of patients with relapsing-remitting MS who go on to develop secondary progressive?

Answer 1

65%

Question 2

Management of MS? (2)

Answer 2

Disease-modifying drugs e.g. Interferon beta, fingolimod

MePred 0.5g daily for flares

Question 3

What does MND never involve? (2)

Answer 3

Eye movements

Sensory nerves

Question 4

Prognosis of MND?

Answer 4

Death from ventilatory failure usually within 3-5 years after diagnosis

Question 5

Only disease-modifying drug licensed for MND?

Answer 5

Riluzole- confers a survival benefit/delays time to mechanical ventilation

Question 6

Symptom control in MND: cramps

Answer 6

Quinine (1st line)

Question 7

Symptom control in MND: spasticity

Answer 7

Baclofen, tizanidine, dantrolene, gabapentin

Question 8

Symptom control in MND: drooling

Answer 8

Propantheline, glycopyrronium bromide, amitriptyline, botox

Question 9

Symptom control in MND; dysphagia

Answer 9

Discuss parenteral feeding e.g. PEG

Question 10

Three forms of CJD?

Answer 10

Sporadic (“classical”)
Variant- (from ingestion of nervous tissue in beef with bovine spongiform encephalitis)
Familail prion disease

Question 11

Injury to the spinal cord above T1 causes?

Answer 11

Quadriplegia/tetraplegia

Question 12

Injury to the spinal cord below T1 causes?

Answer 12

Paraplegia

Question 13

Ipsilateral movement loss with contralateral pain and sensation loss?

Answer 13

Brown-Sequard syndrome

Question 14

Wasting + weakness of hands and arms, with loss of temperature + pain sensation in a “cape” distribution

Answer 14

Syringomyelia

Question 15

Inflammation of the spinal cord at a single level

Answer 15

Transverse myelitis

Question 16

Cafe-au-lait patches?

Answer 16

Type 1 neurofibromatosis

Question 17

Bilateral acoustic neuromas?

Answer 17

Type 2 neurofibromatosis

Question 18

Inheritance of NF?

Answer 18

Autosomal dominant

Question 19

First-line investigation in restless legs syndrome?

Answer 19

Serum ferritin

Question 20

Management of restless legs?

Answer 20

Dopamine agonists e.g. pramipexole, ropinorole

Question 21

Nystagmus + opthalmoplegia + ataxia

Answer 21

Wernicke’s encephalopathy