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Block 8 Week 5 > Bloch: MS > Flashcards

Flashcards in Bloch: MS Deck (30)
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1
Q

MS is an immune-mediated disease of the (blank). It is a disease of the (blank) and axons

A

CNS; myelin

2
Q

The balance b/w the protective and (blank) response determines the net effect of the inflammatory response

A

destructive

3
Q

It has been shown that active inflammation results in both (blank) and (blank)

A

demyelination; axonal transection

4
Q

Who gets MS?
Age?
Gender?
Location?

A

women in their 20’s-50’s;

most common in Northern European ancestry and in more Northern and Southern latitudes

5
Q

T/F: The risk of MS is greater if there is a first-degree relative with MS

A

True

6
Q

How do you ultimately diagnose MS?

A

clinically!

You can use MRI and CSF to provide support

7
Q

What are the diagnostic criteria for MS?

A

dissemination in time and space; evidence that damage has occurred in at least two separate areas of the CNS at different points in time

8
Q

List some symptoms that may be associated with MS… the list is long…

A
numbness
loss of vision
pain
fatigue
trouble walking
bowel or bladder dysfunction
sexual dysfunction
depression
9
Q

What things in your work-up would increase your suspicion of MS?

A

female
age 25-40
clinically isolated syndrome (like optic neuritis or transverse myelitis)

10
Q

A first neurologic event suggestive of demyelination

A

clinically isolated syndrome (CIS)

11
Q

Individuals with a clinically isolated syndrome suggestive of demyelination are at increased risk for developing MS if this occurs

A

multiple, clinically silent lesions on MRI

12
Q

These are the two most common clinically isolated syndromes

A

optic neuritis

transverse myelitis

13
Q

In general, patterns of MS can be progressive or (blank)

A

relapsing-remitting

**55% of cases are relapsing-remitting

14
Q

What factors come into play when choosing a DMARD?

A
patient's disease course and prognostic indicators
benefits vs risks of each medication
co-morbidities
cost vs. benefits for each patient
patient's lifestyle and preferences
patient readiness
15
Q

What are some negative prognostic indicators of MS?

A
frequent, multifocal attacks
heavy MRI burden on initial scans
pyramidal involvement
ataxia
cognitive difficulties
5 year accumulation of disability
spinal progression
16
Q

new symptom or sudden worsening of old symptom lasting at least 24 hours, and usu accompanied by an objective change in neurologic finding

A

relapse

17
Q

Treatment with (blank) recommended if relapse significantly interferes with everyday functioning

A

corticosteroids

**3-5 day course of high-dose intravenous methylprednisolone
high dose oral steroids may also be used

18
Q

What symptoms of MS are readily visible?

A
spasticity
gait, balance, coordination problems
speech/swallowing problems
tremor 
weakness
19
Q

What can be used in patients with MS to promote function, comfort, independence, and conserve energy, safety and activity?

A

mobility aids, like a cane or crutches or a walker

20
Q

This causes temporary worsening of MS symptoms

A

elevation in body temperature (heat sensitivity)

**cooling strategies are beneficial during hot, humid weather, exercise, cooking

21
Q

What can happen to your bladder in MS?

A

fails to store pee; large bladder (fails to empty); dysynergic bladder; nocturia

22
Q

How can you manage the burning, irritating neuropathic pain associated with MS?

A

newer anti-epileptic drugs

23
Q

This is often under-diagnosed and undertreated in patients with MS

A

depression

24
Q

T/F: Depression and suicide are both more common in patients with MS

A

True

25
Q

T/F: Cognitive impairment is rare in MS, and only occurs in the late stages or severe MS

A

False!

26
Q

T/F: MS is a white matter disease so it doesn’t really affect brain volume, gray matter, or the cerebral cortex

A

False!

27
Q

T/F: If an MS patient can pass a brief mental status exam, they are good to go!

A

False

28
Q

T/F: Memory problems reported by MS patients are usu caused by stress, anxiety or depression

A

False

29
Q

The amount of (blank) correlates with lesion load and brain atrophy. It can occur at any time, but is more common later on. It is most likely progressive MS.

A

cognitive impairment

30
Q

What drugs are used to treat MS?

A

DMARDS like IFNb-1b or IFNb-1a