demyelinating diseases

Question 0

cause of MS

Answer 0

unknown- more inc ertain families- due to HLA Dr2

Question 1

MS

Answer 1

multople inflammatory white matter lesions separated in space and time

Question 2

Ms is an an immune attack on

Answer 2

oligodendroglia

Question 3

single episode

Answer 3

cannot be diagnosed as MS-clinically isolated syndrome

Question 4

patients with only one single location of damage

Answer 4

cannot be diagnosed with MS

Question 5

4 tpyes of MS

Answer 5

relapsing remitting
secondarily progressive
primary progressive
rapidly progressive

Question 6

MS often affects

Answer 6

optic nerves
dorsal columns
corticospinal tract
cerebellar pathways
medial longitudinal fasiculus
spinal trigem tract
control of bladder

Question 7

Lhermitte’s sign

Answer 7

electric sensation down back and/or legs with neck flexion- irritation of cervical spinal cord sensory tracts

Question 8

MS does NOT

Answer 8

damage neuron cell bodies
–does not result in LMN damage, c nerve nuclei dmage, damage to peripheral nerves

does not produce aphasia or effect memory cog until late

Question 9

MRI shows

Answer 9

T2 hyperintensities in periventricular distribution in most

Question 10

CSF shows

Answer 10

oligoclonal bands and elevated IgG

Question 11

only MRI can show

Answer 11

whether lesions are isolated in time and space

Question 12

relapsing remitting

Answer 12

1st incidence clinically isolated- like clinical neuritis

w/ each recurring episode, some increasing disability with a cumulative deficit

Question 13

secondary progressive

Answer 13

starts out like relapsing remitting but then begins an upward slope of increasing neuro deficit in between the definite episodes

more aggressive, less responsive to treatment

Question 14

primary progressive MS

Answer 14

no distinct episode of symptoms and no sudden onset

MRI and clinical over course of illness both by clinical picture

Question 15

progressive relapsing

Answer 15

combo of progressive dsiability from beginnging with some relapses and remissions

Question 16

delay between onset of symptoms and diagnosis

Answer 16

3.5 years

Question 17

MS attac

Answer 17

actication helper T cells–>attracted to and adhere to blood vessels of BBB–>breakdown BBB and invaid–>encounter antigens of CNS and reactivate and attack CNS myelin

Question 18

fda approved treatment

Answer 18

high dose steroids-acute attack, doesnt alter course

chemo drugs- harsh effect (such as cardiomyopathy with mitoxantrone)

Question 19

natalizumab

Answer 19

recently approved, black box warning for causing progressive multifocal leukencephalohy–screen for JC virus antibodies

Question 20

B interferon

Answer 20

modulates t cell and b cell fx
decreases expression of matrix metalloproteinases
reverses BBB disruption and alters expression of a number of cytokines

Question 21

glatiramer acetate

Answer 21

probs functions as an altered peptide ligand for the major histocompat complex class II molecules

stimulates reg t cells that have a propsensity for CNS migraton that may suppress immune rxn in cns