INFLAMMATORY DEMYELINATING DISORDERS

Question 1

MYELIN IN CNS is Formed by

MYELIN in PNS is FORMED BY

Answer 1

⭐ OLIGODENDROCYTES

⭐ SCHWANN CELLS

Question 2

Junction of MYELIN sheath of CNS and PNS is known as

Answer 2

OBERSTEINER-REDLICH ZONE

Junction of CNS and PNS

Question 3

T ➕ B cell disorders
➕
Subacute to Chronic
➕
Autoimmune; ♀️ > ♂️
➕
OLIGODENDROCYTES and ASTROCYTES affected

Answer 3

INFLAMMATORY DEMYELINATING DISORDERS of CNS

Question 4

DISRUPTION OF BLOOD BRAIN BARRIER by VEGF is seen in

Answer 4

INFLAMMATORY DEMYELINATING DISORDERS of CNS

VEGF A is produced by ASTROCYTES
⬇️
Injury to ENDOTHELIAL CELLS

Question 5

ANTIBODY in INFLAMMATORY DEMYELINATING DISORDERS of CNS

Answer 5

anti-MOGP
(Myelin OLIGODENDROCYTE Glycoprotein)

Question 6

INFLAMMATORY DEMYELINATING DISORDERS of CNS

Answer 6

1. Multiple Sclerosis
2. Neuromyelitis Optics Spectrum disorders
3. ADEM : Acute Disseminated Encephalomyelitis

Question 7

Diseases MIMICING: INFLAMMATORY DEMYELINATING DISORDERS of CNS
🧠⚡ S²CG⚡

Answer 7

1. SLE
2. Sarcoidosis
3. Chronic GVHD

Question 8

NON-INFLAMMATORY DEMYELINATING DISORDERS of CNS

Answer 8

Osmotic DEMYELINATION Syndrome
Central Pontine Myelinosis

Question 9

CHARCOT’S TRIAD Seen in

⭐ NEUROLOGY 🧠⚡ SIN⚡
⭐ BILIARY 🧠⚡intermittent FJP ⚡

Answer 9

CHARCOT’S TRIAD OF MULTIPLE SCLEROSIS

S-staccato speech
I-intentional tremors
N-nystagmus

CHARCOT’S TRIAD in ACUTE CHOLANGITIS

✨ Fever
✨ Jaundice
✨ Pain

Question 10

Chronic/ Subacute (3-4 wks)
➕
♀️, Young 20-40 yrs
➕
PAINFUL VISUAL LOSS
➕
Sensory > > Motor
➕
Paresthesia / Hypoesthesia / Unpleasant SENSATION

Answer 10

Multiple Sclerosis

Question 11

Symptoms that Rule out MS
🧠⚡ DUNES HR⚡

Answer 11

1. 8th Cranial Nerve Involvement ➡️ Deafness
2. Peripheral Neuropathy
3. Uveitis, Sclera Involvement
4. Retinal involvement
5. Severe HIGHER Mental Function Involved
6. Encephalopathy

Question 12

Multiple Sclerosis involves

Answer 12

1. Cortical
2. Subcortical
3. Brainstem
4. Spinal Cord

Question 13

Pathology in MS

Answer 13

DEMYELINATION
⬇️
AXONAL ATROPHY
⬇️
NEURONAL LOSS
⬇️
CORTICAL ATROPHY

Question 14

Most important target in MULTIPLE SCLEROSIS

Answer 14

⭐ Myelin BASIC Protein: attacked by T cells

✨ Myelin OLIGODENDROCYTE Glycoprotein MOGP : Attacked by antibody

Question 15

HLA Association of MS

Answer 15

HLA DR-B1 15:O1
HLA DR2

Question 16

Types of MS

Answer 16

Question 17

⚡⚡ MOST COMMON TYPE OF MS

Answer 17

Relapsing-Remitting

Question 18

EYE INVOLVEMENT IN MS

Answer 18

1. OPTIC NEURITIS: U/L, ASYMMETRICAL, PAINFUL, RETROBULBAR PAIN, ANTERIOR VISUAL FIELD AFFECTED
2. PENDULAR NYSTAGMUS
3. B/L INO ➕ B/L TRIGEMINAL NEURALGIA
4. PSEUDO-BULBAR INVOLVEMENT

Question 19

✨ U/L ASYMMETRICAL, PAINFUL VISUAL LOSS, RETROBULBAR PAIN ➕, ANTERIOR VISUAL FIELD AFFECTED ➕ BETTER RESPONSIVE TO Tx

✨ B/L SYMMETRICAL, PAINLESS VISUAL LOSS, POSTERIOR VISUAL FIELD AFFECTED ➕ LESS RESPONSIVE

Answer 19

⭐ MS

⭐ NMO

Question 20

Causes of OPTIC NEURITIS

Answer 20

Question 21

🧑🏻‍⚕️ Clinical Features of OPTIC NEURITIS

Answer 21

Question 22

History of PERSISTANCE OF AFTER IMAGE Characteristic feature of

Answer 22

RETROBULBAR NEURITIS
ASSOCIATED with MULTIPLE SCLEROSIS, NMO

Question 23

Typical vs Atypical Optic Neuritis

Answer 23

Typical ON : DUE TO: DEMYELINATING DISORDERS

Atypical ON: DUE TO: other causes

Question 24

Which type of OPTIC NEURITIS is NOT ASSOCIATED WITH MULTIPLE SCLEROSIS

Answer 24

Neuro-Retinitis

Question 25

Paroxysmal Convergence Spasm Phenomenon

Answer 25

Typical but RARE symptom of MS CAUSED DUE TO: abnormal excitation in DEMYELINATED PLAQUES

Question 26

McDonald's Criteria used for

Answer 26

Multiple Sclerosis

Question 27

McDonald's Criteria

Answer 27

Dissemination in TIME: 2 Clinical/Radiological Attacks, 1 month apart Dissemination in SPACE: Involvement of 2 Site, 2 attacks = MS

Question 28

Lesion Site of MS

Answer 28

1. Juxtacortical / Cortical 2. Peri ventricular 3. Brainstem 4. Spinal Cord 5. Infra tentorial 6. Cerebellar

Question 29

Gold STANDARD TEST FOR MS

Answer 29

IEF(Isoelectric focussing) and Immunofixation (IgG)

Question 30

CSF Finding in MS

Answer 30

1. IgG ⬆️ > 90 % 2. IgG Oligoclonal Bands

Question 31

Peri ventricular lesion

Answer 31

MS

Question 32

💊💉 MANAGEMENT of ACUTE ATTACK of MS

Answer 32

High DOSE IV Methyl Prednisolone (500mg-1mg for 3 continuous days) No tapering

Question 33

💊PREVENTION OF ATTACKS OF MS 🧠⚡ ANTI-FOG⚡

Answer 33

Disease modifing therapies ➕ Steroids ✨ Injectable IFN beta, Glatiramer acetate ✨ Infusibles Natalizumab, Alemtuzumab ✨ Oral drugs Fingolimod, Teriflunomide

Question 34

Natalizumab is Monoclonal Antibody against

Answer 34

Alpha 4 Integrin USE: MS

Question 35

ALEMTUZUMAB is Monoclonal Antibody against

Answer 35

anti CD 52 USE: MS

Question 36

Most preferred DRUG in Remission management in MS

Answer 36

Teriflunomide

Question 37

Ocrelizumab is Monoclonal Antibody against

Answer 37

CD20 USE: Primary Progressive MS

Question 38

ONLY DRUG used for PRIMARY PROGRESSIVE MS

Answer 38

Ocrelizumab

Question 39

Acute ATTACK of MYELITIS (Long Segment Lesion) ➕ OPTIC NEURITIS PAINLESS ➕ Disabling disease with NORMAL MRI

Answer 39

NMO

Question 40

Autoantibodies seen in NMO

Answer 40

Anti-Aquaporin 4

Question 41

💊💉 MANAGEMENT of NMO

Answer 41

Steroids ➕ PLASMA EXCHANGE Poor Prognosis

Question 42

Anti-MOG antibodies SPECTRUM (Myelin OLIGODENDROCYTE Glycoprotein)

Answer 42

1. ADEM 2. ISOLATED OPTIC NEURITIS (INCLUDING CRION) 3. Aquaporin 4 antibody negative NMO 4. ISOLATED MYELITIS

Question 43

POST-INFECTIOUS/ POST-IMMUNIZATION ➕ CHILD ➕ ENCEPHALOMYELITIS (Altered Sensorium) ➕ Quadriplegia

Answer 43

ADEM

Question 44

DIAGNOSTIC FEATURES OF ADEM on MRI

Answer 44

Fluffy White Matter Hyperintensities

Question 45

💊💉 BEST MANAGEMENT of ADEM

Answer 45

IVIG

Question 46

SPEED OF CONDUCTION OF NERVE IMPULSE ⭐ With MYELIN ⭐ Without MYELIN

Answer 46

⭐ 70 mm/sec ⭐ 1 mm/sec