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302 > Case of paralysed person > Flashcards

Case of paralysed person Flashcards

1
Q

definition of MS?

A

chronic immune mediated CNS disease

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2
Q

how many people is MS affecting?

A

2 million

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3
Q

who does MS usually affect?

A

female predominance age 20-40

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4
Q

increased risk association with MS?

A

low vit D/ exposure UVB
EBV infection in past
obesity/ smoking
HLA DRB1
HLA-A

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5
Q

pathology of MS?

A

multifocal neuroinflammation plaques in white matter peri venular , subcortical and grey matter

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6
Q

molecular level of MS?

A

infiltrating lymphocytes mainly T cells,
axon degeneration gliosis and oligodendrocyte damage

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7
Q

how is MS first triggered

A

peripheral t cells become reactive, cross reactivity foreign antigens to CNS antigens carried in lymphatic system.
Activate macrophages and glia

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8
Q

how would a MS brain look macroscopically?

A

white matter loss- corpus callosum
hydrocephalus
volume loss global atrophy

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9
Q

what happens to bbb?

A

vasoactive molecules make the brain more leaky

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10
Q

what happens after some time?

A

remyelination via the oligodendrocyte precursor cells by myelin is thinner

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11
Q

how does GM to WM differ

A

GM lesions have less b/t cells or macrophage, seeding of inflammatory cells

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12
Q

what causes MS damage?

A

inflammatory demyelination (new T2 lesions/ or clinical relapse) and progressive neurodegeneration(atrophy/disability markers worsen irrespective of relapse activity)

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13
Q

scale for MS to assess mobility?

A

expanded disability status scale

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14
Q

SPMS?

A

less relapse favour progression but new plaques on MRI
PIRA>6-12 months

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15
Q

e

A

IFNbeta siponimod

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16
Q

PPMS?

A

predominant progression from onset
typically spastic paraparesis or sensory cereballar ataxia

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17
Q

radiologically isolated syndrome?

A

MRI abnormaties without clinical signs
40% will develop MS

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18
Q

Clinically isolated syndrome

A

symptoms lasting more than a day, demyelination optic neuritic

19
Q

what is macdonald criteria?

A

s

20
Q

how to diagnose MS?

A

at least 1 clinical relapse corresponding to one demyelinating MRI lesion

21
Q

differential diagnosis of MS?

A

ADEM, NMOSD, sarcoidosis,SLE

22
Q

what can you find in MS investigations?

A

oligoclonal bands positive

23
Q

LMN signs

A

weakness, reduced reflexes, reduced tone flaccidity

24
Q

UMN signs

A

increased brisk reflexes, increased tone,

25
Q

where does the cell body of lmn sit?

A

anterior horn of grey matter

26
Q

upper motor neurons cause?

A

paraplegia

27
Q

if lmn lesion ask?

A

is sensation affected

28
Q

if sensation is normal then?

A

NMJ, muscle

29
Q

if sensation is abnormal then?

A

root, nerve, neuropathy

30
Q

upper motor lesion investigation?

A

mri

31
Q

if NMJ and muscle affected?

A

check for Myasthenia gravis and electrodes

32
Q

in spinal cord lesion what is affected?

A

flaccidity/ hypotonia at that level- LMN
upper motor neurons - weakness spasticity distal to the lesion

33
Q

T1 vs T2?

A

fluid is bright on T2, and black on T1

34
Q

demyelination on MRI is?

A

white matter lesions typically

35
Q

biomarkers of acute neuroinflammation?

A

t1 lesions with contrast enhancement

36
Q

ring enhancing lesion on MRI could indicate?

A

brain abscess

37
Q

what can you see in MS?

A

perpendicular lesions to ventricles, discrete (can draw around)

38
Q

spinal cord lesions are usually?

A

dorsal, lateral eccentric

39
Q

what is a precursor of MS?

A

transverse myelitis

40
Q

tumefactive MS?

A

incomplete ring, peripheral enhancement

41
Q

acute disseminated encephalomyelitis?

A

multiple lesions all over, patient very sick flu like illness

42
Q

neuromyelitis optica?

A

demyeliniation long spinal cord lesion affects optic nerve too

43
Q

MS differentials?

A

aging- a white dot per decade is normal
vascular- fluffy
ms- dorsal fingers

302 (24 decks)

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