L35 Patho of MS Flashcards

(34 cards)

1
Q

common sxs of MS (theres a ton)

A

visual problems
numbness
fatigue
motor weakness
gait problems
pain
spasticity
dizziness/vertigo
sexual dysfunction

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2
Q

main virus thought to be involved in developing MS

A

epstein barr virus

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3
Q

through what mechanism does the epstein barr virus cause MS?

A

molecular mimicry

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4
Q

True or False: Genetics play an important role in the development of MS

A

True

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5
Q

what are the 3 different types of MS

A

Relapsing-remitting MS (RRMS)
Secondary progressive MS (SPMS)
Primary Progressive MS (PPMS)

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6
Q

Relapse Remitting MS (RRMS)
- involves ….
- multifocal areas…
- initial sxs ….
- most cases….

A
  • involves relapse of neurological dysfunction lasting weeks or months and affecting the brain, optic nerves and/or spinal cord
  • multifocal areas of damage are revealed by MRI in the white matter
  • initial sxs disappear, but less remission with each relapse
  • most cases of RRMS eventually enter SPMS
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7
Q

Secondary Progressive MS (SPMS)
- characterized by ______
- involves ______

A
  • less inflammation than RRMS
  • involves slowly progressive neurological decline and CNS damage, with little remission
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8
Q

Primary Progressive MS (PPMS)
- resembles ___
- Mean age ____

A
  • resembles SPMS at initial stage
  • of onset is alter than RRMS bc inflammatory episodes of RRM S surpass the symptomatic threshold
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9
Q

know the figure on slide 8/20

A

okay i will be sure to go take a look at it

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10
Q

what is CIS?

A

Clinically isolated syndrome
- initial episode of neurologic sxs lasting >24 hours
- inflammation and demyelination in optic nerve, cerebrum, cerebellum, brainstem or spinal cord
- most cases progress to MS

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11
Q

What does the progressive phase of MS involve?

A

cytodegeneration (loss of myelin, axons, oligodendrocytes) and occurs with a similar rate in different forms of MS

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12
Q

what is the overall clinical presentation of MS determined by?

A

combo of underlying degeneration and the host’s immune reaction to it

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13
Q

first step autoimmune phase of MS

A
  • antigens released from CNS or cross-reactive foreign antigens are presented to B and T cells in the lymph nodes
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14
Q

Degenerative phase of MS (2 things)

A
  • CNS damage is triggered by activated B and T cells or by other insults such as stroke or infection
  • antigens released from damaged sites in the CNS further prime immune cells in the periphery
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15
Q

T or F: the degenerative phase triggers MS

A

F, it is unclear which phase does it

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16
Q

second step autoimmune phase of MS

A
  • B and T cells with high-affinity receptors for these antigens are expanded and migrate to CNS cites where they re-encounter and are activated by their target ligands
17
Q

third step autoimmune phase MS

A
  • activated B and T cells then carry out immune fxns at the CNS sites
18
Q

autoimmune responses in MS:
what activates T cell responses in the peripheral lymphoid tissue?

A

dendritic cells

19
Q

autoimmune responses in MS:
what allows for activated B and T cells to proliferate and infiltrate the CNS?

A

a4-integrin mediated binding and penetration of the BBB

20
Q

autoimmune responses in MS:
what happens to B cells that re-encounter their specific antigen in the CNS?

A

they mature to plasma cells and release IgG antibodies that target the antigen on expressing cells

21
Q

autoimmune responses in MS:
what do T cells do during this part lol

A

interact with their target ligands presented by oligodendrocytes, neurons, or microglia on MHC molecules

22
Q

autoimmune responses in MS:
T cell activation results in _______ and ________, leading to damage in myelin sheath

A

cytokine release and macrophage stimulation

23
Q

demyelinated regions can be. repaired via _____?

A

remyelination (no shit)

24
Q

remyelination involves the recruitment of ____ to the lesion and the differentiation of these cells into myelin-producing ____________

A

OPCs and oligodendrocytes

25
why does remyelination typically fail in MS?
lack of OPCs or a failure of OPCs to differentiate
26
what is astrogliosis?
the invasion and propagation of astrocytes, resulting in irreversible formation of gliotic plaques or scars
27
demyelination is the loss of what two things?
myelin and oligodendrocytes
28
what does demyelination result in?
activation of microglia and astrocytes
29
what do activated microglia and astrocytes release?
pro-migratory factors and mitogens that recruit OPCs to the lesion and stimulate their proliferation
30
what eliminates myelin debris?
macrophages
31
what do recruited OPCs do?
differentiate into oligodendrocytes
32
what is the key step where remyelination fails in MS?
OPC differentiation
33
T or F: myelin sheath formed after remyelination is identical to its original form
F, they are thinner and shorter
34
3 treatment options for Guillain-Barre syndrome
ventilation plasmapheresis IV immunoglobulin administration