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Multiple Sclerosis Flashcards

1
Q

An autoimmune disorder that causes segmental demyelination of neurons in CNS

A

Multiple Sclerosis

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2
Q

The cardinal sign of MS

A

Charcot’s Triad

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3
Q

Charcot’s Triad

A

SIN: Scanning speech, Intention tremor, Nystagmus

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4
Q

Etiology of MS

A

Idiopathic

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5
Q

6 Risk factors of MS

A

Female, 20-40 years old, Geographical pattern, Family History, Smoking, Vitamin D Deficiency

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6
Q

Hallmark of MS

A

Multifocal Plaque Formation

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7
Q

Oligodendrocytes ratio

A

1:60

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8
Q

What imaging is used to detect Multifocal Plaque Formation?

A

MRI

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9
Q

Criteria used to confirm MS

A

Mcdonald’s Criteria

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10
Q

Mcdonald’s Criteria: 2 plaques

A

Clinically definite

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11
Q

Mcdonald’s Criteria: 1 attack

A

Clinically possible

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12
Q

Mcdonald’s Criteria: 1 or 2 plaques

A

Clinically probable

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13
Q

Mcdonald’s Criteria: 1 or 2 attack

A

Clinically probable

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14
Q

Mcdonald’s Criteria: 1 plaque

A

Clinically possible

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15
Q

Mcdonald’s Criteria: 2 attack

A

Clinically definite

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16
Q

Distinct pathologic pattern: Apoptosis of oligodendrocytes

A

Type 3

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17
Q

Distinct pathologic pattern: Cell-mediated destruction of myelin sheath by T-cells

A

Type 1

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18
Q

Distinct pathologic pattern: Primary degeneration of oligodendrocytes

A

Type 4

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19
Q

Distinct pathologic pattern: Cell-mediated destruction of myelin sheath by T-cells and Immunoglobulins

A

Type 2

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20
Q

What distinct pathologic pattern has a (+) repair of oligodendrocytes

A

Type 1 and 2

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21
Q

What is the most common distinct pathologic pattern of MS?

A

Type 2: Cell-mediated destruction of myelin sheath by T-cells and Immunoglobulins

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22
Q

What is the least common distinct pathologic pattern of MS?

A

Type 4: Primary degeneration of oligodendrocytes

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23
Q

Medications that are given in patients with MS

A

Immuno-regulator medications: Interferon B

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24
Q

Four medications under Interferon B

A

Betaseron, Extavia, Avonex, Rebif

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25
Medication given during acute MS
Corticosteroid
26
MS sites of Predilection
POB CCCC: Periventricular white matter, Optic Nerve, Brainstem, Cortex, Cerebellum, Cervical SC (posterior white column)
27
What ST is present in MS?
Lhermitte Sign
28
Five clinical types of MS
Relapsing-Remitting, Secondary-Progressive, Primary-Progressive, Progressive-Relapsing, Fulminant
29
Progressive disease with little to no attacks
PPMS: Primary Progressive MS
30
Rapid progressive disease with series of attacks later in the course
Fulminant MS
31
Progressive disease with series of attacks later in the course
PRMS: Progressive Relapsing MS
32
Clinical type due to the patient not following prescribed intake of medicines
SPMS: Secondary Progressive MS
33
Exacerbating-remitting MS
RRMS: Relapsing Remitting MS
34
What is the onset symptoms of RRMS?
Sensory: paresthesia and optic neuritis
35
Poor prognosticating indicator of MS
Male, Motor onset, older onset, polysymptomatic onset, fewer MRI lesion
36
Most common clinical type of MS
RRMS
37
Least common clinical type of MS
PRMS
38
Percentage of RRMS
85%
39
Percentage of SPSM
20%
40
Percentage of PPMS
10%
41
Percentage of PRMS
5%
42
7 functional system affected in MS
Visual system, Pyramidal system, Sensory system, Cerebellar system, Brainstem, Mental System, Bowel/Bladder system
43
Four clinical manifestation under visual system
Optic Neuritis, Nystagmus, Visual Scotoma, Diplopia/Ophthalmoplegia
44
Ice pick like sensation behind eye with graying/blurring of vision that may lead to blindness
Optic Neuritis
45
(+) Dark spots in the visual field
Visual Scotoma
46
What extremity is most commonly affected in MS?
LE
47
Most common, disabling symptom of MS
Fatigue
48
Pseudo-exacerbation of symptoms due to increase body temperature
Uthoff's phenomenon
49
Fatigue exacerbates due to _____?
Worst in hot temperature
50
Pseudo-exacerbation of Uthoff's phenomenon is reversible after what time?
<24 hours
51
Most common presenting symptoms of MS
Paresthesia
52
Description of Paresthesia felt by MS
Electric-like sensation
53
What paresthesia felt in the face?
Trigeminal Neuralgia / Tic Doulourex / Paroxysmal Pain Syndrome
54
What paresthesia felt in the limb?
Paroxysmal Limb Pain / Dysesthetic Limb
55
What paresthesia felt in the trunk?
MS Hug
56
One of the most common pain complaint of patient's with MS
Headache
57
Hypersensitivity to light stimulus
Hyperpathia
58
Painful band sensation around trunk
MS Hug
59
Most common type of pain felt in MS
Paroxysmal Limb Pain / Dysesthetic Limb
60
Five cerebellar ataxia seen in MS
Dysmetria, Dyssynergia, Dysdiadochokinesia, Intention Tremor, Gait Ataxia
61
Description of gait ataxia
Drunkeness
62
Cranial nerves affected in brainstem
CN 2,5,7,8
63
Most common speech problem seen in MS with description as problem with controlling the volume
Scanning speech
64
Three mental status manifestation of MS
Dementia, Attention deficit, Memory loss
65
Most common bowel problem in MS
Constipation
66
Most common bladder problem in MS
Detrussor Hyperflexia
67
Four female sexual problems in MS
Decrease sensation, Loss of Libido, Vaginal Dryness, Difficulty in reaching orgasm
68
Four male sexual problems in MS
Decrease sensation, Loss of Libido, Difficulty in ejaculation, Impotence
69
Scale used to classify MS functional activity
Kurtzke Expanded Disability scale
70
Kurtzke: No disability
1, 1.5
71
Kurtzke: Fully ambulating without rest and assistance
4, 4.5, 5, 5.5
72
Kurtzke: Bed bound
8, 8.5
73
Kurtzke: Moderate disability
3, 3.5
74
Kurtzke: Intermittent unilateral assistance 100m
6
75
Kurtzke: Death
10
76
Kurtzke: Normal
0
77
Kurtzke: Bed ridden
9, 9.5
78
Kurtzke: Moderate d/a 1 functional system
3
79
Kurtzke: No d/a minimal sign in 2 functional system
1
80
Kurtzke: Constant bilateral assistance 20m
6.5
81
Kurtzke: Cannot walk beyond 5m
7
82
Kurtzke: Minimal disability in 2 functional system
2.5
83
Kurtzke: Unable to take few more steps
7.5
84
Kurtzke: 500m
4
85
Kurtzke: 100m
5.5
86
Kurtzke: cannot eat, talk, swallow
9.5
87
Kurtzke: can be out of bed
6
88
Kurtzke: 200m
5
89
Kurtzke: bed bound much of the day
8.5
90
Kurtzke: can eat, talk, swallo
9
91
Kurtzke: 300m
4.5
92
Score for benign MS
<3
93
Score of Malignant MS
3 or more
94
Another name of malignant MS
Marburg Disease

Neurology (14 decks)

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