MS and Skeletal muscle relaxants

Question 1

MS: what are genetic risk factors?

Answer 1

Genetic risk factors

• HLA locus
• Interleukins such as IL2Ra, STAT3, and more
• Can work in tandem with environmental risk factors

Question 2

MS: Pathology?

Answer 2

Chronic inflammation of CNS which leads to large focal lesions characterized by primary demyelination with a variable extent of axonal loss. Presence of large confluent demyelinated lesions in the white and grey matter.

Question 3

MS: how to diagnose?

Answer 3

-MRI: MS is visible as whiter spots (lesions) on the image when dyed with “gaderino?”.
-Tests: Visual (brain’s response to light), (somatosensory) response to electrical pulses, (brainstem auditory) response to sounds.
-Lumbar puncture: cerebral spinal fluid is run on electrophoresis gel. Positive test can relate to MS but also other disorders.
-Medical history of the patient.
-McDonalds criteria: evidence of damage to the CNS that is disseminated in time and space. This means that showing damage has occurred at different dates and to different parts of the CNS.
Lots of diseases can mimic MS symptoms

Question 4

SMR: how do depolarizing SMR work?

Answer 4

Depolarizing NMB give a continues signal which will lead to desensitization of the receptor

Question 5

Characteristics of NMB:

Answer 5

• Rapid distribution but slower elimination
• Highly ionized
• do not cross cell membrances readily
• are not strongly bound to peripheral tissues
• Vd slightly larger than blood volume
• Duration of the blockade is strongly correlated with elimination half life.