Multiple Sclerosis

Question 1

Dosing of steroids of MS

Answer 1

IV methyprednisolone for 3-5 days then oral 60-80 mg tapering to lower over 12-20 days period

Question 2

What is the issue with long term administration of interferon

Answer 2

Development of antibodies

Question 3

Route of IFN-B

Answer 3

Subcutaneous

Question 4

Treatment for spatic bladder in MS

Answer 4

Propantheline

Oxybutinin

Question 5

This is a copolymer I that mimics action of MBP

Answer 5

Glatiramer

Question 6

Postural tremor in MS can be treated by

Answer 6

INH with pyridoxine

Question 7

What can be given to ameliorate the flu like symptoms by administration

Answer 7

administer steroids

Question 8

Adverse effects of Glitaramer I

Answer 8

Flushing
Chest tightness
Palpitation
Anxiety

Question 9

Dose of steroids that proven to have reduction of disability as well as degree of brain atrophy on T1W1

Answer 9

Methylprednisolone 1g/d for 5 days over 5 years

Question 10

What is the mechanism of action of fingolimod

Answer 10

This is an oral drug that interfere with egress of lymphocytes from lymphnode

Question 11

Clinical benefit of Natalizumab

Answer 11

reduction in the mRI lesion and reduces relapse

Question 12

What trial compare alemtuzumab to interferon in MS

Answer 12

CAMMS223 Trial investigators

superior than interferon

Question 13

Route of IFN-B-1a

Answer 13

Intramuscular

Question 14

What is the mechanism of action of Rituximab

Answer 14

B-cell depleting monoclonal antibody that targets CD20 lymphocytes

Question 15

How is Alemtuzumab given

Answer 15

5 consecutive days annually

Question 16

Adverse effect of fingolimod

Answer 16

lymphophenia
Bradycardia
AV block
macular edema
Herpes infection
Elevated liver function test

Question 17

Advantage of natalizumab

Answer 17

Once monthly dosing and lack of acute side effects

Question 18

Adverse effect of Rituximab

Answer 18

lymphoma

Question 19

This medication can hastened the attacks of optic neuritis

Answer 19

Steroids

Question 20

Percentage of antibody development

Answer 20

30% - daily
18% - alternate use
5% - weekly
2% - one year use

Question 21

Adverse effect of Alemtuzumab

Answer 21

ITP and autoimmune thyroiditis

Question 22

Severe disabling tremor can be managed surgically by:

Answer 22

ventrolateral thalamotomy

Question 23

This is a nonglycosylated bacterial cell product within amino acid sequence

Answer 23

IFN-B-1B

Question 24

What is the condition observed in patient undergo plasma exchange to rapidly clear natalizumab to reverse PML

Answer 24

Immune reconstitution inflammatory syndrome (IRIS)

Question 25

IRIS can be ameliorated by

Answer 25

Steroids

Question 26

Fatigue in MS can be given

Answer 26

Amantadine Modafinil Premoline Dextroamphetamine

Question 27

Monoclonal antibodies

Answer 27

Natalizumab Alemtuzumab Rituximab

Question 28

AFFIRM study

Answer 28

Natalizumab, 68% reduction of relapse 80% reduction of T2 lesion 96% reduction in gadolinium enhancing lesion

Question 29

Steroids hastened the optic neuritis by how many months

Answer 29

6 months

Question 30

What is the management for urinary retention in MS

Answer 30

Betanechol

Question 31

pain symptoms in MS can be given

Answer 31

CBZ or Gabapentin

Question 32

Result of PRISM Study

Answer 32

IFN-B-1B delayed the progression of the disease for 9-12 months in a period of 2-3 years

Question 33

What is the mechanism of action of Alemtuzumab

Answer 33

targets CD 52 reducing the expressed B lymphoctyes and T lymphocytes for longer period.

Question 34

What is the route of administration of Glitaramer

Answer 34

SQ

Question 35

SENTINEL Study

Answer 35

Study that combined natalizumab and interferon gives better results

Question 36

What is the serious side effect of Natalizumab

Answer 36

PML

Question 37

Mechanism of action of Natalizumab

Answer 37

1. Alpha integrin antagonist - blocks lymphocytes and monocytes adhesion to the endothelial cells and their migration to vessel wall