4th Year MS Flashcards
what two parts of life can make MS improve?
pregnancy
postpartum
6th CN presentations
internuclear ophthalmoplegia
conjugate lateral gaze disorder
what is internuclear ophthalmoplegia?
problems with eyes moving together
what is conjugate lateral gaze disorder?
affected eye does not abduct
common presentations of MS
optic neuritis
partial transverse myelitis
what is Lhermitte’s sign?
electric shock down cervical spine with neck flexion
what is Uhthoff’s phenomena?
worsening of symptoms with heat e.g. bath
what is a previous episode of optic neuritis characterised by?
pale disc on fundoscopy
can have RAPD
LP result
CSF has high protein and oligoclonal bands
what are oligoclonal bands?
immunoglobulins that aggregate on electrophoresis
classifying relapsing and remitting course
active
not active
worsening
not worsening
what does loss of vision need urgent treatment with?
steroids
what criteria is used to disseminate in time and space?
MacDonald criteria
what does MacDonald criteria use?
symptoms
MRI imaging
symptoms need to be in the absence of fever
management options for the demyelinating process
beta-interferon (beta-IFN) and glatiramer acetate
monoclonal antibodies
tecfidera (dimethyl fumarate)
rituximab
what is beta-IFN and glatiramer acetate?
injectable disease-modifying agents
examples of monoclonal antibody therapies
alemtuzumab
natalizumab
risk in alemtuzumab
stroke
arterial dissection
adverse in use of monoclonal antibody therapies
reactivation of JC virus causing progressive multifocal leukoencephalopathy (PML)
what does PML cause?
white matter lesions in the brain with no remyelination
what is ocrelizumab used for?
slows progression of PPMS
when is rituximab used?
CD20, b cells given every 6 months on the ward
