Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NMSK Exam 2: Neuro > 3. MS > Flashcards

3. MS Flashcards

1
Q

What is Multiple Sclerosis?

A

Autoimmune demylination of the CNS (brain and SC) at multiple sites in the CNS over space and time that causes periods of exacerbations and remissions of symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Multiple Sclerosis

Symptoms (7)

A
  • Can cause any neurological sign. Common ones are
      1. Paresthesias (tingling)
      1. Optic neuritis (pain and vision loss)
      1. Urinary problems/ Bladder dysfunction: spastic bladder and overflow incontinence
      1. Gait disturbances
      1. Dysarthria (slow and slurred speech)
      1. Hemiparesis (weakness on 1 side of body)
    • Transverse myolitis?!?!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 4 major types of MS?

In order from MC => LC

A
  1. Relapsing and remitting (45-50%)
  2. Secondary progressive (begin with relapsing and remitting type and still have some relapses)
  3. Primary progressive
  4. Benign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Secondary progressive MS patients begin their disease process as which form?

A

Relapsing remitting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When/who is MS most diagnosed in?

A

W 20-30; but often diagnosed from 15-50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is M.S affected by geographic region?

A
  • ↑ risk depending on where you live before 14 YO:
  • More common in
    • Temperate regions (Minneapolis, NY)
      Less common in
    • Tropical regions (FL, Miami
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The course of Multiple Sclerosis is most favorable in whom?

A
  1. Women
  2. Earlier onset (in 20s)
    1. *However, if really young (i.e., adolescent/early adult; 15YO) = unfavorable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which test can confirm the diagnosis of MS?

A

No single test can be used. Many tests are done:

  1. MRI of the head and CT of the spine
  2. Multimodality evoked potentials (SSEPs, VEPs, BAER)
  3. Lumbar puncture of CSF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do you see on MRI of the head and CT of spine in MS patient?

A
  1. MULTIPLE Ovoid lesions of high signal on T2WI in periventricular white matter and spinal cords
  2. Acute lesions may enhance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do you see in CSF in MS patient?

A
  1. Oligoclonal bands
  2. ↑ IgG index/synthesis rate
  3. ↑ proteins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes M.S?

A
  • Unknown:
    • Genetic susceptability
    • Childhood event sensitizes immune system to attack CNS myelin ==> adult event triggers the disease (viral infection or post-partum period)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Only approved drug for patients with the Multiple Sclerosis: Primary Progressive type + relapsing forms of the disease?

A

Ocrevus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Disease modifying drugs for M.S (slow the progression and ↓ amount and severity of exacerbations

A
  1. IFN (interferons)
  2. Glatirimer Acetate
  3. Dimethyl Fumarate
    • mabs
    • mod
    • mide
  7. FINGOLAMOD?!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment of acute exacerbation in MS?

How does this affect the exacerbation?

A
  • 1 gram of IV high-dose corticosteroid (methylprednisolone) for 3-5 days tapered with oral prednisolone
    • ↓ length of exacerbation, but does not change the outcome.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If patient has an acute exacerbation of M.S and cannot tolerate steroids, what is another treatment?

A
  1. ACTH (Acthar gel)
  2. IVIg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is M.S diagnosed over space and time?

A

Multiple lesions over space and time

17
Q

What is a DDx of Multiple Sclerosis?

A

1. Clinicallly Isolated Syndrome (CIS): monofocal episode or multifocal episode

18
Q

What is a monofocal episode of Clinically Isolated Syndrome (CIS)?

A

Person experiences a single neurologic sign/symptom that’s caused by a single lesion (1 episode/1 time)

(i.e., optic neuritis in one eye)

19
Q

What is a multifocal episode of Clinically Isolated Syndrome (CIS)?

aka

A

Acute Disseminated Encephalomyelitis (ADEM)

  • Person experiences more than one sign/symptom caused by lesions in more than one place (i.e., optic neuritis in one eye plus hemiparesis) one time.
20
Q

When CIS patients have multiple demyelinating lesions on MRI, they have a __________% chance of developing MS within several years?

A
  • 60-80%
  • *High risk
21
Q

When CIS patients do not have multiple demyelinating lesions on MRI, they have a ______% chance of developing MS within several years

A
  • 20%
  • *Low risk
22
Q

What are some conditions which can mimic MS?

A
  1. Autoimmune disease: SLE w/ cerebritis or CNS vasculitis or Polyarteritis Nodosa w/ transverse myelitis
  2. Devic’s disease (neuromyelitis optica)
  3. B12 deficiency
  4. Lymphoma or leukemia w/ CNS involvement
  5. Spinocerebellar ataxias
  6. Infections: HIV, West Nile, HTLV-1, CMV, Lyme disease, Syphillis
  7. Granulomatous disease (sarcoidosis)
  8. Metachromatic leukodystrophy, adrenomyeloleukodystrophy
23
Q

tx for management of spasticity in patients with MS?

(symptom-management drugs, NOT disease-modifying)

A
  1. Baclofen (oral or intrathecal)
  2. Tizanadine
  3. Diazepam
  4. Carbamazepine
  5. Botox injections
  6. Dantrolene
24
Q

Tx of intention tremors in patients with MS?

(symptom-management drugs, NOT disease-modifying)

A
  1. Propanolol
  2. Promidone
  3. Clonazepam
25
Q

tx of urinary urgency (spastic bladder) in patients with MS?

(symptom-management drugs, NOT disease-modifying)

A
  1. Oxybutinin
  2. Detrol LA
26
Q

tx urinary retention/hesitency in patients with MS?

(symptom-management drugs, NOT disease-modifying)

A
  1. Bethanechol
27
Q

tx fatigue in patients with MS?

(symptom-management drugs, NOT disease-modifying)

A
  1. Amantadine
    • afinil
  3. Bupropion
  4. Methylphenidate
  5. Pemoline
  6. XRCISE
28
Q

What is Devic’s Disease (aka?)?

A
  • Devic’s Disease (NMO: Neuromyelitis Optica):
    • Variant/different entity of M.S that is characterized by inflammation and demyelination of the optic nerve and SC (often LONG segments of SC), but spares the brain
29
Q

Fairly sensitive and specific test to diagnose Devic’s disease (aka NMO)?

A

Aquaphorin 4 antibodies in blood and CSF

30
Q

What is the general treatment for Devic’s Disease (aka NMO)?

A
  1. Steroids and/or plasma exchange (plasmapheresis)
  2. Followed by: immunosupression (i.e., azothiaprine, mycophenolate mofetil, or rituxumab)
31
Q

Why is it important to differentiate if MS or Devic’s Disease?

A

More aggressive, but treatable

NMSK Exam 2: Neuro (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions