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neurology > MS > Flashcards

MS Flashcards

1
Q

What condition is defined as a infalmmatory demyelinating disease of the CNS?

A

MS

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2
Q

What causes episodic relapses of MS?

A

white matter demylenation in clinically eloquent areas

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3
Q

how long do episodic relapses last?

A

hours to days, impve over weeks, possibly back to normal

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4
Q

What are the chronic symptoms of MS

A

heat sensitivity, bowel/bladder/secxual dysfunction, pain, fatigue, mood disorders, cognitive dysfunction, gait impaired.

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5
Q

What are the 2 most common presenting sx?

A

limb sensory loss 33% and optic neuritis 16%

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6
Q

Which condition is described as the “MS hug”

A

transverse myelitis

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7
Q

Which symptom presents as spascity, sensory level, upgoing toes, and weakness?

A

transverse myelitis

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8
Q

How do you diagnose transverse myelitis?

A

MRI- T2 hyperintense enhancing lesion int he cord extends over 1-2 segments.

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9
Q

Where are the lesions usually located in transverse myelitis?

A

dorsally and eccentrically on the cord.

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10
Q

Transverse myelitis sensory loss can only occur in one limb? t/f

A

false- it can be in one or both lower extremities

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11
Q

What are the 3 symptoms of optic neuritis?

A
  1. ipsilateral eye pain 90%
  2. decreased acuity
  3. dyschromatopsia
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12
Q

How would optic neuritis be diagnosed?

A

neuro exam

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13
Q

what would you find upon neuro exam of optic neuritis?

A

RAPD and disc edema in 1/3

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14
Q

What other screening can be done to see optic neuritis/

A

MRI- shows increased T2 signal of optic nerve

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15
Q

What is optic neuritis caused by?

A

demyelination of hte optic nerve.

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16
Q

How do you diagnose diplopia?

A

exam looking at conjugate gaze, nystagmus. or MRI visualizing lesions in brainstem/cerebellar white mater.

17
Q

What are the two things needed to diagnose MS?

A

dissemination in space and time

18
Q

What are the 4 places a lesions can occur?

A

periventricular
juxtacortical
infratentorial
spinal cord

19
Q

T2 and FLAIR hyperintense require what criteria to be dissemination in time?

A

must be simultaneous enhancing lesions, or new ones that are on follow up MRI.

20
Q

FLAIR imaging is good for diagnosing which type of lesions?

A

supratentorial lesions that are periventricular. helps distinguish them from CSF>

21
Q

oligoclonal bands, elevated IgG, lymphocytes, and elevated proteins are found in what?

A

lumbar puncture.

22
Q

What is the most useful MS screen/

A

visual evoked potentials.

23
Q

What can VEPS identify?

A

increased latency showing demyelination of the optic nerve in optic neuritis.

24
Q

What is the first attack of MS called?

A

clinically isolated syndrome

25
Q

What are the 2 most common clinically isolated sydromes?

A

optic neuritis and transverse myelitis.

26
Q

Will treating the clinically isolated syndrome help improve outcome over time?

A

yes. decreases disability.

27
Q

What are teh treatments for MS?

A

IV methylprednisone or 50mg oral prednisone(higher attacks) .
- plasma exchange if steroids don’t work.

28
Q

Mild sensory attacks alwyas require treatment? t/f

A

false- they will usually not need treatment.

29
Q

treatment affects teh natural progression of the disease. t/f

A

false- it will not affect the history/progression of hte disease, but it will hasten the rate of recovery.

30
Q

Interferons are considered what type of treatment?

A

disease modifying

31
Q

What are the benefits to interferon treatments?

A

they will decrease relapse by 30%

32
Q

What are the advantages to glatiramer?

A

no regular blood monitoring

33
Q

What are the advantages to interferons?

A

less frequent injections, greater reduction in MRI lesions than glatriamer

34
Q

What are the disadvantages to interferons?

A

flu lik sx, leukopenia, elevated LFT, regular blood monitoring

35
Q

disadvantages to glatiramer-

A

most frequent injection schedule, liopatrophy at injection site. chest tightness SOB and flushing

neurology (9 decks)

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