4th Year MS Flashcards

1
Q

what two parts of life can make MS improve?

A

pregnancy

postpartum

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2
Q

6th CN presentations

A

internuclear ophthalmoplegia

conjugate lateral gaze disorder

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3
Q

what is internuclear ophthalmoplegia?

A

problems with eyes moving together

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4
Q

what is conjugate lateral gaze disorder?

A

affected eye does not abduct

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5
Q

common presentations of MS

A

optic neuritis

partial transverse myelitis

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6
Q

what is Lhermitte’s sign?

A

electric shock down cervical spine with neck flexion

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7
Q

what is Uhthoff’s phenomena?

A

worsening of symptoms with heat e.g. bath

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8
Q

what is a previous episode of optic neuritis characterised by?

A

pale disc on fundoscopy

can have RAPD

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9
Q

LP result

A

CSF has high protein and oligoclonal bands

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10
Q

what are oligoclonal bands?

A

immunoglobulins that aggregate on electrophoresis

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11
Q

classifying relapsing and remitting course

A

active
not active
worsening
not worsening

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12
Q

what does loss of vision need urgent treatment with?

A

steroids

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13
Q

what criteria is used to disseminate in time and space?

A

MacDonald criteria

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14
Q

what does MacDonald criteria use?

A

symptoms
MRI imaging
symptoms need to be in the absence of fever

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15
Q

management options for the demyelinating process

A

beta-interferon (beta-IFN) and glatiramer acetate
monoclonal antibodies
tecfidera (dimethyl fumarate)
rituximab

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16
Q

what is beta-IFN and glatiramer acetate?

A

injectable disease-modifying agents

17
Q

examples of monoclonal antibody therapies

A

alemtuzumab

natalizumab

18
Q

risk in alemtuzumab

A

stroke

arterial dissection

19
Q

adverse in use of monoclonal antibody therapies

A

reactivation of JC virus causing progressive multifocal leukoencephalopathy (PML)

20
Q

what does PML cause?

A

white matter lesions in the brain with no remyelination

21
Q

what is ocrelizumab used for?

A

slows progression of PPMS

22
Q

when is rituximab used?

A

CD20, b cells given every 6 months on the ward