Multiple Sclerosis and other inflammatory CNS diseases Flashcards Preview

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Flashcards in Multiple Sclerosis and other inflammatory CNS diseases Deck (26):
1

What is Multiple Sclerosis?

An inflammatory demyelinating disorder of the CNS

2

What does MS usually present?

30's and 40's

3

What are some clinical features of MS?

Pyramidal dysfunction
Optic Neuritis
Sensory Symptoms
LR urinary tract dysfunction
Cerebellar and brain stem features
Cognitive impairment

4

What are the Pyramidal dysfunction?

Increased tone
Spasticity
Weakness
Extensors of upper limbs
Flexors of lower limbs

5

What are the Sensory Symptoms?

Pain
Paraesthesia
Dorsal column loss (Proprioception and vibration)
Numbness
Trigeminal neuralgia

6

What are the cerebellar dysfunctions?

Ataxia
Intention Tremor
Nystagmus
Past pointing
Pendular reflexes
Dysdiadokinesis
Dysarthria

7

Diplopia is caused by problems with which cranial nerve?

VI Palsy

8

Facial weakness is caused by a problem with which cranial nerve?

VII Palsy

9

What is Internuclear Ophthamoplegia?

Medial Longitudinal fasciculus
Distortion of binocular vision
Failure of adduction (diplopia)
Nystagmus in abducting eye
Lag

10

What drug can help with sleepiness?

Modafinil

11

What drug can help with fatigue?

Amantadine

12

What is the criteria for diagnosing MS?

At least 2 episodes of demyleniation
Dissemination in time and place
McDonald criteria

13

What tests are used to diagnose MS?

Clinical
MRI/CT
Neurophysiology
Blood tests

14

What blood tests are useful in diagnosing MS?

PV, FBC, CRP
Renal liver bone profile
Auto antibody screen
Borellia, HIV, syphilis serology
B12 and folate

15

What is the treatment for a mild acute exacerbation of MS?

Symptom control

16

What is the treatment for a moderate acute exacerbation of MS?

Oral Steroids

17

What is the treatment for a severe acute exacerbation of MS?

Admit/IV steroids

18

What are potential treatments for spasticity?

Physio
Baclofen/Tizanidine
Botulinum toxin
Intrathecal baclofen/phenol

19

Give an example of an anti-convulsant?

gabapentin

20

Give an example of an anti-depressant?

Amitriptyline

21

What drugs can help with incontinence?

Anti-cholinergics e.g. Oxybutynin

22

What are first line drugs for MS?

Interferon Beta (Avonex, Rebif, Betaseron, Extavia
Glitiramer acetate (Capaxone)
Tecfedira

23

What are second line drugs for MS?

Monoclonal antibody - Tysabri, Lemtrada
Fingolimod

24

What is a 3rd line drug for MS?

Mitoxantrone

25

What virus is positive with PML associated with TYSABRI?

JC

26

What is Uhthoff's sign?

When heat makes a demylenating disorder worse