Brainscape's Knowledge GenomeTM

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


See full index

Neurology > 3: Multiple Sclerosis > Flashcards

3: Multiple Sclerosis Flashcards

1
Q

Define multiple sclerosis

A

Chronic auto-immune condition characterised by demyelination of central nervous system

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

What age does MS occur

A

20-40 years

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

In which gender is MS more common

A

Female (3:1)

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

What is the stereotype for MS

A

Young Female

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

In which ethnicity is MS more common

A

White

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

What is a genetic RF for MS

A

HLADR2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are three environmental RF for MS

A
  • Infection: EBV, HHV6
  • High Latitude
  • Vitamin D Deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What infections increase risk of MS

A

EBV, HHV6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 4 types of MS

A
  • Primary progressive
  • Relapsing-Remitting
  • Secondary progressive
  • Progressive -relapsing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What. % of MS is relapsing remitting

A

85

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Explain relapsing-remitting MS

A

Attacks cause disability, then recovery in-between attacks. Individual nerve fully gains level of full function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain secondary progressive

A

Starts as relapsing-remitting and then attacks become continuous = secondary progressive

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

What is primary progressive

A

One continuous attack from the start

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is progressive-relapsing

A

Constant immune attack with worsening episodes super-imposed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a general symptom of MS

A

Lethargy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are visual symptoms of MS

A
  • Optic Neuritis
  • Marcus Gunn Pupil
  • Intranuclear ophthalmoplegia
  • Uhthoff’s phenomenon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is typically first manifestation of MS

A

Optic Neuritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does optic neuritis present

A

Loss of colour vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Uhtoff’s phenomenon

A

Visions/Symptoms MS worsen in the head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes intranuclear ophthalmoplegia

A

Damage to medial longitudinal fasiculus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Explain intranuclear ophthalmoplegia

A

(Defect right eye)

  • When looking right eye movements normal
  • When looking left. Left eye can abduct. The right eye is unable to adduct. Difference in eye position causes diplopia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What pupil is present in MS

A

Marcus gunn

23
Q

Explain marcus gunn pupil

A

RAPD:
During swinging light test.
Damage to afferent of affected eye
When shining light into affected eye will paradoxically dilate, opposed to constrict, as consensual reflex from other eye is stronger

24
Q

What are 3 sensory symptoms associated with MS

A
  • Lhermitte’s sign
  • DCP
  • Bilateral trigeminal neuralgia
25
Q

What is Lhermitte’s sign

A

Electric shock type pain down the spine on flexing the neck

26
Q

What motor symptoms are present in MS and why

A

Spastic weakness
Hyper-reflexia
Spasticity
Upgoing plantar

= due to UMN lesion

27
Q

What are other signs of MS

A
  • Urinary incontinence
  • Sexual dysfunction
  • Intellectural deterioration
28
Q

What is Devic Syndrome

A

Transverse myelitis and optic atrophy

29
Q

How does transverse myelitis present

A

Transverse myelitis (Loss Motor, Sensory and vision below lesion)

30
Q

What causes Devic syndrome

A

Anti aquaporin 4 antibodies

31
Q

What is Charles Bonnet Syndrome

A

When individual looses vision - develops very vivid hallucinations

32
Q

What is pulfrich effect

A

Unequal eye latencies - causes straight lines to appear curved. Commonly presents as disorientation in traffic

33
Q

What is argyll-robertson pupil

A

Small irregular pupils that can accommodate but do not respond to light

34
Q

What criteria is used to diagnose MS

A

McDonal Criteria

35
Q

What is required to diagnose MS using McDonal Criteria

A

Two lesions disseminated by space and time

36
Q

What is criteria for ‘attacks’

A

1h duration

30d between attacks

37
Q

What investigations are ordered for MS

A

Visual evoked potentials
MRI
LP

38
Q

What is seen on visual evoked potentials

A

Delayed transmission

39
Q

What is seen on MRI in MS

A

periventricular plaques

40
Q

What is seen on LP in MS

A

Oilgoclonal bands

41
Q

What lifestyle advice is given for MS

A

Smoking cessation
Reduce stress
Regular exercise

42
Q

What is given for acute attacks in MS

A

Oral prednisolone

43
Q

Explain oral prednisolone in MS

A

Helps reduce length of attacks it does not help an individual return to baseline

44
Q

What are 4 disease modifying therapies in MS

A
  • B-interferon
  • Glatamir acetate
  • Natalizumab
  • Fingolimod
45
Q

What is MOA of natalizumab

A

a4b1 integrin antagonist

46
Q

What is MOA of fingolimod

A

sphingosine-1-phosphate receptor modulator

47
Q

What should all patients starting natalizumab be offered before and why

A

JC virus test. As it can be re-activated on treatment with natalizumab

48
Q

What causes progressive multifocal leucoencephaloapthy

A

JC virus

49
Q

How is fatigue managed in MS

A

Amantadine

CBT

50
Q

How is spasticity managed in MS

A

Baclofen
Gabapentin

  • Botox
  • Cannabis
  • Physio
51
Q

How is bladder dysfunction assessed in MS

A

Bladder USS

52
Q

If residual volume is more than 500ml what is offered

A

Intermittent self-catheterisation

53
Q

If residual volume is less than 500ml what is offered for bladder dysfunction

A

Anti-cholinergic

54
Q

How is oscillopsia managed in MS

A

Gabapentin

Neurology (26 decks)

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