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Flashcards in Multiple Sclerosis Deck (30):
1

MS occurs d/t what? (Meaning what type of immune problem)

Autoimmunity disorder

2

The autoimmunity in MS is targeting what?

The myelin in the CNS (brain and spinal chord)

3

1. When is the onset for MS?
2. It is 2x more likely to affect men or women?
3. What race does it mostly affect?
4. It is more prevalent in what regions?

1. 20-40 yrs
2. women
3. caucasians
4. colder regions

4

1. What is the ET of MS?
2. Is the Et clear?
3. If somebody in your first degree of relatives has MS, what does this do to your chance of developing the disorder?

1. Complex Trait (polygenic and environment)
2. No, unclear
3. 15X increase (MHC/HLA markers on cells)

5

In an autoimmunity disorder, the trigger (ex. virus or infection) causes t cells / abs to be made that have then altered the immune response. How are these abs or T cells considered to be acting?

Inappropriately

6

What is the most common viral trigger for MS?

EBV (Ebstan Bar Virus)

7

Are there other triggers for MS?

Yes, other viral triggers

8

The Patho of MS....
what is occuring to the brain and spinal chord?

Demylination of the neurons

9

The demylination of the neurons then causes immune and inflammation damage, this damage presents as what?

Placques

10

D/t the placques forming, this leads to what to happen to the conduction system?

Conduction problems

11

Full patho sequence....

Demylination of neurons in brain /spinal chord --> inflammation / immune damage (placques) --> poor conudction

12

What is occuring to the oligodendrocytes of the neurons?

If the oligodendrocyte is near where the demyelination is occurring, it will then undergo necrosis of the oligodendrocyte

13

Where is the location of the demylination (in other words, where is the demyelination targetting on the neuron?)

It varies, therefore the symptoms will be different

14

What are a few common ares targeted in the autoimmunity disorder MS? (5)

1. Optic nerve
2. Periventricular Region
3. Cerebellum
4. Spinal Chord
5. Brain stem

15

Will demyelinated neurons be affected in MS?

No. Only the myelinated neurons

16

Will motor and sensory neurons be affected?

Yes

17

D/t the inflammation that occurs from the targeting of the myelin, what 2 cells are infiltrated in placques?

Lymphocytes, macrophages

18

What are these placques (that are infiltrated with lymphocytes) reffered to as?

Sclerotic patches

19

Can you see these patches through medical imaging?

yes

20

What do the Mnfts of MS vary d/t? (2)

1. Location
2. Extent

21

What do the Mnfts of MS include? (5)

1. chronic exacberation and remission
2. Visual impairment, parasthesias, fatigue
3. Bowel / bladder dysfunction
4. Decrease muscle strength
5. Gait and coordination problems

22

Explain the chronic exasberation and remission:

after remission = relapse, worse than before

23

Define parasthesisas:

Abnormal sensations (including numbing, tingling, pins and needles)

24

Why is there a decrease in the muscle strength?

Involves the neuromuscular junction, without stimulation the muscle wont work, it will then atrophy

25

What are the 3 things involved in the Dx of MS?

1. Hx and presentation
2. MRI for placques
3. CSF (looking for proteins)

26

Proteins in the CSF can indicated what 3 things (1 or more of the following...)

1. Blood Brain Barrier been compromised
2. Autoimmune problem related to brain or CSF
3. Inflammation

27

What is the treatment for MS?
1. Acute Relapse:
2. To slow down progression:

1. Steroids: lessen the exasberation
2. Methotrexate, Interferon, symptomatic

28

Explain Methotrexate:

immunomodulatory and antiofolate medication

29

Why would methotrexate being an antifolate medication cause to happen?

Inhibits folic acid action (DNA synthesis / cell division)

30

When would interferon be given?
What does the interferon drug poses?

patients with persistant relapses
- Immunomodulatory and antiinflammatory