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NB > Autoimmunity: Multiple Sclerosis > Flashcards

Autoimmunity: Multiple Sclerosis Flashcards

1
Q

MS: Potential molecular mimicry with myelin basic protein?
Mention the pathogens.

A
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2
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A
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3
Q

Diagnose

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4
Q

what do you see

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5
Q

Treatment of MS relapses?

A
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6
Q

What to keep in mind when treating MS relapses with Methylprednisolone? (4 points)

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7
Q

DISEASE MODIFYING DRUGS role in treating MS? (4 points)

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8
Q

Therapies to prevent relapses?

Mention 3 examples, their routes and their doses.

A
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9
Q

Mechanism of action for Glatiramer actetae?

A
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10
Q

Advantages of Glatiramer actetae?

A

• Regulates immune system

• Reduces relapse rate by 30%

• No effect on primary progressive MS

• No trials in secondary progressiveMS

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11
Q

Natalizumab mechanism of action?

A

• Recombinant, humanized antibody

• Binds to alpha-4 integrin on the immune cells and prevent their migration into the CNS via the blood brain barrier

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12
Q

Dosage and route of Natalizumab?

A

Given once per month intravenously

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13
Q

Advantages of Natalizumab? (3 points)

A

Advantages
• Reduces relapse rate by 68%
• 80-90% reduction in new MRI lesions
• Reduces rate of disability progression by 42%

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14
Q

What is Teriflunomide?
-Mechanism
-Effectiveness
-Indications

A
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15
Q

Main side effects of Teriflunomide? (5 points)

A

-slight thrombocyte and leukocyte reduction
- gastrointestinal symptoms
-hepatic impairment
-reversible hair thinning
-peripheral neuropathies and acute uric acid nephropathy

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16
Q

Mechanism of action for Dimethyl fumarate (Tecfidera)?

A

-amplification of Th2 responses

-Has antioxidative and immunoregulatory effects

-Modulation of the differentiation of antigen presenting cells.

17
Q

Comment on the Effectiveness of Dimethyl fumarate (Tecfidera)

A

Effectiveness: reduction of relapse rate by approx. 50% vs. placebo

18
Q

Indication to use Dimethyl fumarate (Tecfidera)?

A

RRMS

19
Q

Main side effects for Dimethyl fumarate (Tecfidera)?

A

gastrointestinal side effects, flush and lymphopenia.

20
Q

The first oral FDA approved drug for relapsing form of MS?

A

Fingolimod (Gilenya)

21
Q

Mechanism of Fingolimod (Gilenya)?

A

Mechanism : Binds to SP1 receptor on lymphocyte , the receptor becomes internalized and it causes the lymphocyte to be sequestrated in lymphoid tissue.

22
Q

Comment on the effectiveness of Fingolimod (Gilenya)?

A

reduction in the rate of relapses by approx. 55% vs. placebo

23
Q

Indications of Fingolimod (Gilenya)?

A

RRMS

24
Q

Main side effects of Fingolimod (Gilenya)?

A

-VZV reactivation
-PML cases
-basal cell carcinoma
-transient bradycardia
-macular edema
-haemophagocytic syndrome.

25
Q

Identify the drug: ‘A monoclonal antibody binds to CD 20 a cell expressed on B cells and depletes B cell through antibody dependent cell mediated cytotoxicity.’

A

Ocrelizumab (Ocrevus)

26
Q

What is Ocrelizumab (Ocrevus)?

A

A monoclonal antibody binds to CD 20 a cell expressed on B cells and depletes B cell through antibody dependent cell mediated cytotoxicity.

27
Q

Comment on the Effectiveness of Ocrelizumab (Ocrevus)?

A

-Reduction in relapse rate of approx. 46-47% vs. IFN, reduction in disability progression by 24%

28
Q

What is Alemtuzumab?

A

• Alemtuzumab: Is a humanized monoclonal antibody directed against CD52 which depletes lymphocytes.

29
Q

Indication to use Alemtuzumab?

A

Indication: RRMS with at least two relapses over the past two years during at least six months of immunomodulatory therapy or untreated patients have suffered a very high rate of relapse.

30
Q

Drugs to reduce spasticity in MS?

A

Baclofen and diazepam can reduce spasticity.

31
Q

How are bladder symptoms in MS patients treated?

A

Bladder symptoms can be treated with anticholinergic drugs.

32
Q

How do we treat neuropathic pain in MS patients?

A

Cannabis - Sativex (cannabidiol+ tetrahydrocannabinol) symptomatic relief of neuropathic

NB (87 decks)

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