neurology > MULTIPLE SCLEROSIS > Flashcards

MULTIPLE SCLEROSIS Flashcards

(45 cards)

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1
Q

what is MS

A

AUTOIMMUNE DISEASES ; DEMYLINATION

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2
Q

AGE OF ONSET MS

A

15- 50 BUT PEAK 20 -40

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3
Q

WHO IS AFFECTED THE MOST IN MS

A

FEMALE MORE THAN MALE ; RATIO ; 2;1

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4
Q

RACE OF MS

A

HIGHER IN CAUCASIANS

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5
Q

CAUSES OF MS

A

UNKNOWN
THEROY
GENETICS ; FEMALE
GENES ENDING FOR [ HLA DR2]ENVIROMENTAL FACTORS ; INFECTIONS ;, EBV , HHV6
VIT D DEFEINCY ; HIGHER RATES IN NORTHEN AND SOUTH POLES

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6
Q

CLINICAL PRESENTATION OF MS

A

1.MENTALITY DYSFUNCTION ; DEPRESSION , EUPHORIA , COGNITIVE IMPAIREMENYT
1.SPEECH DYSFUNCTION ; STACCATO , SLURRED , SCANNING
3. CRANIAL NERVE INVOLVEMENT ; 3,2 , 7 ,8
MOTOR DYSFUCNTION ; PARAPAREISIS
SENSORY DYSUNCTION ; PARATHESIA
LHERTHMEN SIGN
CEREBELLAR DYSFUNCTION ; ATAXIA
AUTONOMIC DYSFUNCTION ‘SEXUAL DYSFUCNTION
URGENCY [ MOST COMMON BLADDER FEATUERS]
BOWEL DYSFUNCTION
EPILSEY RARE
UTHOFF PHENOMENA

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7
Q

investigations for ms

A

MRI
CSF FOR OLIGOCLONAL BANDS
VEPS
fundus examination ;pallor of the optic disc

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8
Q

ms diagnosis use MC DOLAND CRITERIA

A

1, dissemenation in space
2. dissemenation in time

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9
Q

disseminated space

A

perventricular
juxtacortical
infratentorial
spinal cord

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10
Q

what tool used to asses severity of MS

A

EDSS [ expanded disability status scale]
MS functional [ cognitive , hand function , ambulation of distance and ambulation of speed]

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11
Q

dd of MS

A

ADEM
TRANSVERE MYELITIS
BECHEST DISEASE
scaroidosis
neuromylitis optica [devic disease]
HIV
NEUROSYPHILIS
VITAMIN B 12 DEFECIENCY
SPINAL CORD NEOPLAS E.G [EPEDYMOMAS]
vascuilitc disease as SLE , PAN

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12
Q

what is transvere myelitis

A

acute inflammation that affecting spinal cord can affect one or more than one segement ; commonly affect thoracic segements

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13
Q

causes of transverse myelitis

A

idiopathic
infection ; HS ,HZ EBV , INFLEUNZA
BACTERIAL INFECTION AS TB , SYPHILIS , DIPTHERIA
AFTER VACCINATion
and may be asoociated with vascilits
iatrogenic and toxic ; psot lumbar , iv heroin
demylineation with MS

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14
Q

what is the clinical presentation of MS ?

A

shock stage ;
flaccid paraplegia and most important sensoy lost below level of the lesion all sensation is lost
and may have sphincteric problem as retention of urine with over flow
recovery stage ; as spastic paraplegia and loss all of senstation below level of the lesion
sphinceteric ;percipetency of micturation

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15
Q

what investigations done for TM

A

CSF
MRI ; USED TO SPOT AREAS OF INflammation

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16
Q

treatment of TM

A

Symptomatic treatment
steroid

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17
Q

what is devic disease or neuromylitis optic ?

A

itis optic neuritis with myleitis

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18
Q

NMO common in which speicies

A

japanes

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19
Q

investigations for devic disease

Study These Flashcards
A

MRI for brain normal and spinal cord
lesion in spinal is lage extensive can take 3 segemnts or more
vep
csf ; NMO IgG [ AQUAA 4 ] [key]. oligclonal band

20
Q

prognsosi of devic disease

Study These Flashcards
A

poor receovery between attacks

21
Q

treatment of devic disease

Study These Flashcards
A

plasma pherisis

22
Q

what is ADEM ?

Study These Flashcards
A

autoimmune disease in CNS sudden inflammation and emylination in brain and spinal cord

23
Q

causes of ADEM

Study These Flashcards
A

POST infection ., vaccine

24
Q

clinical presentation of ADEM

Study These Flashcards
A

it is single event of demylination that occur more in children and adolesecent
FAHM [ fever common]
visual problems , seizuers [ common]
weakness
irritability
confusion
drowzzines
coma

25
how to differntiate between MS vs ADEM
ADEM ; CHILDREN AND ADOLESECNT AND it is only one attack , that have FAHNM , SEZIEURS , EMNGISM DCL WHILE MS ; it is relapsing - remitting disease , common in adult more in female . no seizuers , fever
26
what investigation for ADEM
MRI FOR BRAIN AND SPINAL CORD VEP CSF ; high WBCS AND PROTEIN
27
what is the treatment of ADEM
STEROIS TO REDUCE INFLAMMATION IVIG TO BIND AND NEUTRALIZE AUTO ANTIBODIES MAY IN SEVERE CASES DO PLASMA EXCHANGE
28
what is sarcoidosis
is is multisystem inflammatory disease
29
common in which race
female , afrocarribean
30
sarcoidosis coomon site affected
hilar lymphnode
31
describe lesion of scarcoidosis
non caseating granuloma
32
clinical presentation of the sarcoidosis
uveitis systemic ; rash , weight loss , arthralgia specific symtpoms ; shortness of breath and coughing , tender leg nodule and vision change s
33
investigations done for sracoidosis
chest x ray ; hilar lymph node blood test ; calcium is high and ACE is high BAL [t cell in lung is high] gold standard is biopsy
34
treatment of sarcoidosis
may take steroid
35
what is bechest disease
it is multisystem recuurent inflammatory disease affect mainly turkey then asia then western countries
36
bechst diseases ?
is tis vasculitis disease
37
to diagnose behcet disease we need
oral ulcer plus 2 ; genital ulcer uveitis skin lesionas pustular , nodsum pathergy test increase in the inflammatory markers
38
what is pathery test
skin prick in the fore arm then after 2 dyas if occur red pump or pustule this is due to hypersenstivity in response to trauma this test used in ; not specific behcet disease
39
what is sle
autoimmune disorder
40
clinical presentation of sle
Afro-caribbean Skin – malar, photosens, discoid, Raynaud’s Renal – nephritis Serositis – arthritis, mouth ulcers Blood – haemolytic anaemia, ↓WCC, ↓plts Cardiac – peri-/endo-/myo-carditis Lungs – pleuritis, pleural effusions CNS – cerebral vasculitis, transverse myelitis PNS - myositis ANA, dsDNA antibodies
41
investigations fo sle
ANA and Ds DNA [ SPECIFIC] FOR SLE
42
what is sijogren disease
90% Female * Primary (Sicca syndrome) or secondary to other autoimmune disorders ( mixed connective tissue disease and rheumatoid arthritis) * Presentation : Dry eyes , Dry mouth * Arthralgia, myalgia, parotitis, periph neuropathy * CNS involvement – transverse myelitis, optic neuritis (?overlap with NMO?), cerebral vasculitis * Anti-Ro/SSA, anti-La/SSB or RF
43
specific serology for sojgren syndrome
ANTI ro /ss a anti LA /ssb or rf
44
what is cerebral vascuilits
Primary or secondary to systemic vasculitis(SLE) * Acute, subacute, may relapse-remit * Headache * Seizures * Stroke-like * Encephalopathy / cognitive deterioration / psychiatric * Movement disorders (chorea) * Systemic features - fever, night sweats, rash, weight loss, arthropathy, ↑inflammatory marker
45
what is giant cell arterits [ most common form of arteritis ]
>50y Systemic symptoms/PMR Scalp tender Visual loss (AION) [double vision ] Jaw claudication ↑ESR, ↑plts, abn LFTs Temporal artery biopsy

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