Flashcards in Multiple Sclerosis Deck (30):
MS occurs d/t what? (Meaning what type of immune problem)
The autoimmunity in MS is targeting what?
The myelin in the CNS (brain and spinal chord)
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
4. colder regions
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)
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?
What is the most common viral trigger for MS?
EBV (Ebstan Bar Virus)
Are there other triggers for MS?
Yes, other viral triggers
The Patho of MS....
what is occuring to the brain and spinal chord?
Demylination of the neurons
The demylination of the neurons then causes immune and inflammation damage, this damage presents as what?
D/t the placques forming, this leads to what to happen to the conduction system?
Full patho sequence....
Demylination of neurons in brain /spinal chord --> inflammation / immune damage (placques) --> poor conudction
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
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
What are a few common ares targeted in the autoimmunity disorder MS? (5)
1. Optic nerve
2. Periventricular Region
4. Spinal Chord
5. Brain stem
Will demyelinated neurons be affected in MS?
No. Only the myelinated neurons
Will motor and sensory neurons be affected?
D/t the inflammation that occurs from the targeting of the myelin, what 2 cells are infiltrated in placques?
What are these placques (that are infiltrated with lymphocytes) reffered to as?
Can you see these patches through medical imaging?
What do the Mnfts of MS vary d/t? (2)
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
Explain the chronic exasberation and remission:
after remission = relapse, worse than before
Abnormal sensations (including numbing, tingling, pins and needles)
Why is there a decrease in the muscle strength?
Involves the neuromuscular junction, without stimulation the muscle wont work, it will then atrophy
What are the 3 things involved in the Dx of MS?
1. Hx and presentation
2. MRI for placques
3. CSF (looking for proteins)
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
What is the treatment for MS?
1. Acute Relapse:
2. To slow down progression:
1. Steroids: lessen the exasberation
2. Methotrexate, Interferon, symptomatic
immunomodulatory and antiofolate medication
Why would methotrexate being an antifolate medication cause to happen?
Inhibits folic acid action (DNA synthesis / cell division)