Demyelinating disorders Flashcards

1
Q

what is the most common demyelinating disorder

A

multiple sclerosis

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2
Q

what is the secondary metabolic demyelinating disorder called

A

central pontine myelinosis

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3
Q

what kind of condition is multiple sclerosis

A

autoimmune

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4
Q

are men or women more likely to get MS

A

women

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5
Q

when do people usually present with MS

A

30/40s

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6
Q

which part of Britain has the highest incidence of MS

A

Orkney

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7
Q

what deficiency is associated with MS

A

vitamin D deficiency

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8
Q

is MS a disease of white matter or grey matter

A

white matter - bc only white matter contains axons (covered in myelin sheaths)

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9
Q

what is the pathological appearance of white matter in MS

A

glassy/translucent/brown appearance

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10
Q

which inflammatory cells are present in MS (most significant one)

A

oligoclonal IgG bands

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11
Q

which eye symptom is common (20%) in MS

A

unilateral optic neuritis - painful vision loss, exacerbated by eye movements

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12
Q

what down below symptom is common in MS

A

lower urinary tract dysfunction - nocturia, urgency, incontinence

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13
Q

what motor and sensory symptoms occur in MS

A

spasticity and weakness

numbness and pain

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14
Q

can someone get pregnant if they have MS

what would happen during pregnancy

A

yes

relapses actually get better

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15
Q

what is the Uhthoff phenomenon in MS

A

symptoms get worse during increase in heat - eg during exercise or shower

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16
Q

what are the 2 types of MS

dependent on presentation

A

relapsing and remitting

progressive

17
Q

is there loss of sphincter tone in MS

A

yes

differs it from MND

18
Q

what investigation do you do for MS diagnosis

what do you see

A

MRI - see ‘white finger’s in sagittal plane

19
Q

apart from MRI, what other investigation do you do for MS

A

lumbar puncture electrophoresis - looking for oligoclonal IgG bands

20
Q

treatment of exacerbation of MS

A

PO steroids (IV and admit to hospital if bad)

21
Q

symptomatic treatment for MS if tired

22
Q

symptomatic treatment for MS if spasticity

23
Q

symptomatic treatment for MS if sensory problems eg neuropathic pain

A

amitriptyline

24
Q

symptomatic treatment for MS if lower urinary tract dysfunction

A

catheterization

25
first line disease modifying drugs for MS
interferon beta (immunoglobulins)
26
second line disease modifying drugs for MS
monoclonal antibody (esp if relapsing and remitting)
27
third line disease modifying drug for MS
mitoxantrone (esp if progressive)
28
what condition causes bilateral severe optic neuritis
neuromyelitis optica
29
what is the genetic predisposition to MS
HLA DR2 (though may be idiopathic)
30
is MS curable
no hence need disease modifying drugs to slow down disease process