Multiple Sclerosis Flashcards

1
Q

what are 3 characteristics of MS?

A

immune-mediated
demyelinating
central nervous system

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2
Q

what will be seen in histological exams of MS lesions? (3)

A

T cells
B cells
macrophages

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3
Q

what is the pathogenesis of MS?

A

focal demyelinated plaques with inflammation, gliosis, and axonal damage in the CNS

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4
Q

where are focal demyelinated plaques most commonly seen? (4)

A

optic nerves
spinal cord
brainstem
cerebellum

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5
Q

phase in which activated mononuclear cells destroy myelin and oligodendrocytes, macrophages pick up and degrade myelin, and myelin fragments turn into protein and lipids

A

active plaques (acute phase)

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6
Q

phase in which gliosis develops and demyelinated axons traverse glial scar tissue

A

inactive plaque (burned out stage)

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7
Q

what is the relative afferent pupillary defect or Marcus Gunn pupil?

A

affected pupil will dilated in response to direct light

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8
Q

an MS attack duration must be at least ____ hours and cannot have ____ or ____

A

24
fever
infection

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9
Q

what are the 3 most common symptoms of an initial attack?

A

sensory disturbances
motor weakness
visual complaints

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10
Q

what is the most common form of MS?

A

relapsing-remitting

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11
Q

a steady deterioration of MS

A

secondary progressive

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12
Q

symptoms of MS steadily progress from the onset, leading to early disability

A

primary progressive

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13
Q

what will a lumbar puncture with CSF show?

A

oligoclonal bands made of IgG

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14
Q

what are the 2 parts of the McDonald Criteria?

A

dissemination in space (2 or more regions affected)

dissemination in time (attacks at diff times)

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15
Q

characterized as a first attack OR the patient does not report symptoms but plaque is seen on imaging

A

Clinically Isolated Syndrome (CIS) / Radiographically Isolated Syndrome (RIS)

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16
Q

what should be done in the case of a CIS/RIS?

A

repeat MRI in 6-12 months

17
Q

what is the diagnostic of choice for MS?

A

MRI of brain or spinal cord

18
Q

what is the goal of treatment for MS?

A

partial recovery from exacerbations

19
Q

what is the treatment for acute exacerbations of MS?

A

IV methylprednisolone x 5 days (or high dose oral steroids)

20
Q

what treatment can reduce the frequency of attacks in MS? (3)

A

interferon injections
glatiramer acetate injections
dimethyl fumarate

21
Q

what can we add if a patient has continued exacerbations while on interferon? (2)

A

antibodies:

natalizumab
alemtuzumab

22
Q

what is the treatment for severe or progressive MS?

A

immunosuppressive therapy

Rituximab

23
Q

what can be done for severe relapses of MS or if patient is unresponsive to steroids?

A

plasmapheresis

24
Q

what can be completed by the patient to determine the index of clinical disability of their MS?

A

expanded disability status scale

25
Q

what is the prognosis of MS?

A

life reduced by 7-14 years

26
Q

half of deaths are related to MS complications, such as: (4)

A

infection
respiratory disease
cardiovascular disease
suicide