Neuroimmunology Flashcards

1
Q

What is relapsing remitting MS?

A

relapses consistent with demyelination (with or without clinical improvement), but with episodes of clinical stability in between the relapses

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2
Q

What is clinically isolated syndrome?

A

single clinical episode but no “second episode” to make a clinical diagnosis

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3
Q

What is primary progressive MS

A

Gradually progressive course from onset and do not have relapses

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4
Q

Antibody for NMO?

A

Aqua-porin 4
*located in astrocytic foot process of BBB

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5
Q

How are the relapses in NMO typically?

A

severe and may not recover completely

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6
Q

Is ADEM monophasic or polyphasic?

A

monophasic

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7
Q

How do you treat ADEM?

A

IV methylpred, if that doesn’t work then PLEX

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8
Q

Can steroids be given in pregnant lady with MS?

A

Yes, but preferably try to not use them during the 1st trimester

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9
Q

MOA of Natalizumab?

A

humanized monocloncal antibody against alpha-4 integrin
*binds to lymphocytes and prevents adherence at the endothelial surface of blood vessels –>AKA reduces entry of immunologically active cells in CNS

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10
Q

Which MS drug requires FDA approved monitoring program?

A

Natalizumab

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11
Q

MOA of fingolimoid?

A

modulator of 4/5 sphinosine 1 phosphate receptors
*superagonist at the receptor

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12
Q

MOA of Dalfampridine?

A

inhibitor of voltage sensitive potassium channels

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13
Q

What is Uhtoff’s phenomenon?

A

transient symptoms elicited by heat/exercise

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14
Q

What can Alemtuzumab cause?

A

hyperthyroidism and ITP

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15
Q

MOA of Alemtuzumab?

A

monocloncal AB that binds to CD52 which is present on B, T cells, monocytes, macrophages, NK and granulocytes

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16
Q

What studies do you need before you start Fingolimoid?

A

EKG and optho exam

17
Q

Side effects of fingolimoid?

A

macular edema and first dose bradycardia (requires 6 hr obs after 1st dose)
*bronchitis, elevated LFTs

18
Q

Which MS drug has been associated with severe varicella zoster infection?

A

fingolimoid

19
Q

Teriflunomide MOA

A

inhibits mitochondrial enzyme dihydroorotate dehydrogenase
*role in pyramidine synthesis

20
Q

Side effects of Teriflunomide?

A

diarrhea, nausea, elevated LFTs, alopecia
**TERATOGENIC, CATEGORY X