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Year 2 neuro exam 2 > Demyelination, Cohen > Flashcards

Flashcards in Demyelination, Cohen Deck (61)
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1

presenting Sx of MS

visual loss, diplopia, dysarthria, ataxia, paralysis, sensory loss, bladder and sexual dysfunction
loss of cognitive abilities

2

type of destruction in MS

myelin destruction in oligodendrocytes
axons destroyed

3

age onset MS

late 20s
female >M

4

gender prognosis MS

male worse prognosis

5

geography Ms

north equator more common

6

twin studies MS

more common in monozygotic than dizygotic

7

HLA MS

DR15
D3 D4

8

pathology MS

T cell mediated against CNS myelin
inflammation
some B cells
macrophages!
cytokines and chemokines

9

what cytokines and chemokines are released in MS

INF beta and gamma

10

tyeps of courses of MS

benign MS
relapsing remitting
secondary chroni
primary progressive

11

majority MS is what pattern

relapsing remitting

12

course of benign MS

small number of mild attacks and regain full function eventually

13

why are legs affected more in MS than arms

more myelin

14

what amount of attacks in first few years of MS suggests poor prognosis

>1 attack/year

15

life expenctancy shortage in MS patients

5-10 years

16

Kurtzkes rule

90% disability in MS occurs within 10 years initial dx

17

Common Sx in first attack of MS

visual loss or double vision
weakness
paresthesia

18

Dx of MS

easier when patients have 2+ attacks of CNS dysfunction
MRI! old and new lesions
LP!!! most specific b/c oligoclonal bands

19

What shows recent area demyelination in CNS

MRI with gadolinium enhancement

20

Optic neuritis

sudden loss vision in one or both eyes
painful
lose pupillary reaction

21

what causes optic neuritis

swelling of nerve
very painful

22

Marcus Gunn reaction or Pupillary afferent defect

when flashlight quickly moved form normal eye to affected eye and seems to dilate

23

disc in optic neuritis

pallor
yellow coloring

24

what to give to patient with optic neuritis

IV corticosteroids

25

patients with optic neuritis tend to develop

MS

26

Signs of internuclear ophthalmoplegia

adduction cannot reach medial edge
abductin goes part way with nystagmus
b/l

27

location lesion of internuclear ophthalmoplegia

damage to medial longitudinal fasciculus in brain stem linking CN VI with contra CNIII

28

causes of internuclear opthalmoplegia

MS
or brainstem stroke

29

Diagnostic criteria MS

2+ attacks in brain or spinal cord at 2+ times

30

MRI findings in MS

9+ hyperintense T2 lesions with 1+ gadolinium enhancing lesion
1+ lesion of cerebellum or brain stem
3+ periventricular lesions