Cannabis Flashcards
What are some environmental triggers for MS
Infection (EBV, HERV)
Vitamin D levels
Smoking
What is the major gene of MS
HLA-DR
Briefly state mechanism behind MS
Autoimmune mediated CNS confined disease of demyelination
What glial cell does MS affect
Oligodendrocyte
What is seen in a brain of somebody with MS
- MS plaques
- Mononuclear cell infilitration
- Lesions
What is meant by ‘lesions in space and time’
Space= lesions are in different places throughout the brain Time= lesions are different ages
What is the first lesion in MS associated with?
Where inflammation occurs around the blood vessel- immune system is not working
What courses can MS follow
- Relapsing and remitting
- Secondary progressive
- Primary progressive
Which course of MS can’t be treated
Primary progressive
What is second lesion in MS associated with
Demyelination
What are shadow plaques associated with
Repear
Shorter node of Ranvier and thinner myelin
What happens if you don’t remyelinate the nerve
Vulnerable to death because no myelin is very damaging to cells- fired to death
What are the earliest features of MS (pre active lesion)
Activated microglial accumulates
Alerts the vasculature
What are the features of an active lesion
Lymphocytes arrive through blood vessel
Form an acute lesion
What are the features of a chronic active lesion
Lymphocytes eat out
Active rim is present- seen on MRI
Macrophages full of lipid droplets on edge
What are the features of a chronic inactive lesion
Demyelination
Astrocytes move in and form scar- gliosis
OR oligodenrocyte precusor cells move in and form a shadow plaque
OR axonal loss/ death
What happens to ventricles in MS
They expand due to accelerated rate of nerve loss
What is main aim of treating MS
Prevent lesions from arising in the nervous system
2 approaches to treat MS
Escalation- drugs with low efficacy but low side effects, if disease still active switch to drugs with high efficacy high side effects
Induction therapy- a few treatments of highly effective drugs which you watch and monitor. After a few cycles some people don’t seem to need drugs
What happens if people accumulate damage and deficits
Start to display signs and symptoms
What are signs and symptoms due to
Conduction block
Demyelination
Loss of axons and neurons
Loss of synaptic plasticity
What are the signs and symptoms of MS
Blindness Nystagmus Fatigue Pain Tremor Spasms and spasticity Bladder problems Incontinenece Sexual problems Motor defects Cognitive defects
What signs and symptoms respond to cannabis
Pain
Spasms and spasticity
Define spasticity
Exaggerated stretch response- if you try to move the limb it will cause a spasm
