MS Flashcards

1
Q

What is MS?

A

an inflammatory demyelinating disorder of the CNS

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2
Q

What is significant about the plaques in MS?

A

disseminated in time and place

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3
Q

What sex has most common incidence of MS?

A

Female 3:1

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4
Q

What are the 4 clinical courses of MS?

A

Relapsing Remitting
Primary Progressive
Progressive relapsing
Secondary Progressive

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5
Q

Describe relapsing remitting MS?

A

flare ups followed by asymptomatic phases

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6
Q

Describe the clinical course of primary progressive MS?

A

constantly worsening gradually over a period of time

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7
Q

Describe the clinical course of progressive relapsing MS?

A

constant gradual progression combined with flare ups and partial remission

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8
Q

Describe the clinical course of secondary progressive MS?

A

asymptomatic + flare ups and then gradual progression.

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9
Q

What category of dysfunction do symptoms such as hypertonia, spasticity and weakness come under?

A

pyramidal dysfunction

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10
Q

Which eye condition is commonly seen in MS?

A

optic neuritis

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11
Q

Is optic neuritis painless or painful visual loss?

A

Painful

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12
Q

What is an RAPD?

A

relative adherent pupillary defect

a medical sign observed during the swinging-flashlight test whereupon the patient’s pupils constrict less (therefore appearing to dilate) when a bright light is swung from the unaffected eye to the affected eye

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13
Q

Which sensory modalities are affected in dorsal column loss?

A

proprioception

vibration

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14
Q

What common sensory symptoms are seen in MS>

A

pain
paraesthesia
numbness
trigeminal neuralgia

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15
Q

What category of disorders encompasses symptoms such as ataxia, intention tremor, nystagmus, past pointing, pendular reflexes and dysdiadokinesis?

A

cerebellar dysfunction

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16
Q

Which component of the pathway is involved in internuclear ophthalmoplegia?

A

medial longitudinal fasciculus

17
Q

What drug can be given to combat fatigue in MS?

A

amantadine

18
Q

What drug can be given to combat fatigue in MS patients who feel sleepy?

19
Q

What is the diagnostic criteria for MS?

A

at least two episodes suggestive of demyelination - disseminated in time and place

20
Q

What is the best scan to diagnose MS?

21
Q

What is seen in CSF of MS patients?

A

oligoclonal bands

22
Q

What medications are used in acute MS exacerbations?

A

oral/IV steroids depending on severity

23
Q

What medications can be used to treat spasticity?

A

baclofen
tizanidine
Botox
(intrathecal baclofen/phenol)

24
Q

What treatments can be given for sensory symptoms of MS? e.g. pain, numbness, paraesthesia

A
anti-convulsant - gabapentin 
antidepressant - amitriptyline 
TENS 
acupuncture 
lignocaine infusion
25
Which medications can be used to treat detrusor hypersensitivity?
anti-cholinergics - oxybutynin
26
What first line disease modifying therapy is used in MS patients?
``` interferon B glitiramer acetate (copaxone) tecfedira ```
27
What second line disease modifying therapy is used in MS patients?
monoclonal antibodies - tysabri, lemtrada fingolimod
28
What third line disease modifying therapy is used in MS patients?
mitoxantrone
29
what is PML?
progressive multifocal leukoencephalopathy
30
Which virus causes PML?
JC virus
31
What is the underlying factor that allows development of PML?
disease modifying drugs and immunomodulation
32
Which organ does mitoxantrone damage in a dose-dependent fashion?
the heart