Clinical Approach to Multiple Sclerosis (Hon) Flashcards

1
Q

Multiple Sclerosis is a disorder of the brain and spinal cord that results from?

A

Loss of myelin at multiple sites in the CNS

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2
Q

What are the four types of MS?

A

1) Relapsing remitting
2) Secondary progressive
3) Primary progressive
4) Benign

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3
Q

Which type of MS is the most common?

A

Relapsing remitting

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4
Q

Most MS patients are diagnosed at what age?

A

20s and 30s

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5
Q

MS is generally characterized by periods of?

A

Exacerbation and remission

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6
Q

Which sex does MS affect more?

Which sex generally have a more favorable course?

Around what age does it have a more favorable course?

A

1) Women
2) Women
3) The earlier the onset (20s)

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7
Q

What studies are used to make the diagnosis of MS?

A

1) MRI

2) Lumbar puncture

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8
Q

What is found on MRI with MS?

A

Multiple ovoid lesions in the periventricular white matter and in the spinal cord

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9
Q

What is found on lumbar puncture for CSF analysis with MS?

A

Presence of oligoclonal bands &/or increased IgG

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10
Q

What role does medications have for MS?

A

Maintenance (To decrease the frequency and severity of exacerbations and slow the progression)

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11
Q

In general, MS is diagnosed by?

A

Multiple lesions over space and time

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12
Q

In general, medications for MS are used in patients with what form?

Ocrevus (ocrelizumab) is the only drug approved to treat?

A

1) Relapsing forms

2) Primary progressive MS

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13
Q

What medication is used to treat an acute exacerbation in MS?

A

Corticosteroids

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14
Q

What condition which can be either monofocal or multifocal can mimic MS?

A

Clinically Isolated Syndrome

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15
Q

A multifocal episode of Clinically Isolated Syndrome (aka Acute Disseminated Encephalomyelitis) is characterized by?

A

Patient experiencing more than one sign or symptom caused by lesions in in more than one area

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16
Q

When do Clinically Isolated Syndrome patients have a high risk of developing MS?

A

When CIS patients have multiple demyelination lesions on MRI

17
Q

Baclofen, tizanidine, diazepam, carbamazepine, Botox injections, and dantrolene can be used to manage what symptom of MS?

A

Spasticity

18
Q

Propranolol, primidone, and clonazepam can be used to manage what symptom of MS?

A

Intention tremor

19
Q

Oxybutynin and Detrol LA can be used to manage what symptom of MS?

A

Urinary urgency

20
Q

Bethanechol can be used to manage what symptom of MS?

A

Urinary retention

21
Q

Carbamazepine, oxcarbazepine, gabapentin, phenytoin, and baclofen can be used to manage what symptom of MS?

A

Painful dysesthesias

22
Q

Amantadine, modafinil, armodafinil, bupropion, methylphenidate, pemoline, and exercise can be used to manage what symptom of MS?

A

Fatigue

23
Q

Devic’s Disease aka Neuromyelitis Optica is characterized by?

A

Inflammation and demyelination of optic nerves and spinal cord with relative sparing of brain

24
Q

What antibodies in the blood and CSF can be tested for with Devic’s disease?

A

1) NMO (Aquaphorin 4)

2) MOG (Myelin Oligodendrocyte Glycoprotein)

25
Q

What is the treatment for Devic’s disease?

A

Steroids and/or plasma exchange followed by immunosuppression