[CLMD] Multiple Sclerosis [Hon]

Question 1

What is the definition of M.S.?

Answer 1

“A disorder of the brain and spinal cord characterized by a tendency for periods of increasing and decreasing symptoms and signs (flares and remissions) which result from loss of nerve tract insulation (myelin) at multiple sites in the CNS”

Question 2

What are the most common neurologic symptoms observed in M.S. patients?

Answer 2

Paresthesias

Gait disturbance

Weakness

Visual loss

Urinary difficulty

Dysarthria

Hemiparesis

Question 3

What are the 4 types of MS? (In order of prevalence)

Answer 3

Relapsing remitting

Seconary progressive

Primary progressie

Benign

Question 4

What is the typical age of diagnosis with MS?

Answer 4

20s and 30s

Question 5

What is the single test that can confirm the diagnosis of MS?

Answer 5

HA! There isn’t one! Muah haha hahah.

There are multiple studies tha can be used to help make the diagnosis

Question 6

MS is a disorder of the…

CNS or PNS?

Answer 6

CNS

Question 7

What causes MS?

Answer 7

Unknown

Question 8

What is a potential THEORY of the development of M.S.?

Answer 8

Childhood event or illness that sensitizes the immune system to attack CNS myelin followed by an adult event triggering the disease process

Question 9

Which gender is more affected by M.S.?

Answer 9

Women

Question 10

Generally, earlier age of diagnosis of MS is considered:

Answer 10

Favorable prognosis

(EXCEPT when the pt is 15ish)

Question 11

This will be a test question:

What do you expect to see in the Lumbar puncture for CSF analysis of an MS patient?

Answer 11

Oligoclonal bands &/or increased IgG index/synthesis rate

Question 12

What imaging studies are used to make the diagnosis of MS?

Answer 12

MRI of the head

C & T spine

Question 13

Overall, MS is dianosed by…

Answer 13

Multiple lesions over space and time

Question 14

What are the types of drugs used for maintenance in MS?

Answer 14

Interferon drugs

Glatirimer acetate

Dimethyl fumarate

Anything that ends in -mab (e.g.daclizumab)

Question 15

What is the ONLY drug to be approved for primary progressive MS (PPMS)?

Answer 15

Ocrevus

Question 16

In general, the medications listed before were used for what form of MS?

Answer 16

Relapsing forms of MS

Question 17

How do you treat an acute exacerbation in MS?

Answer 17

HIGH dose corticosteroids

(1 gram IV daily for 3-5 days)

Question 18

What is a clinically isolated syndrome (CIS)?

Answer 18

Event of neurolgic symptoms occurs ONE TIME

Question 19

What is a monofocal episode?

Answer 19

Person experiences a single neurologic sign or symtpom that is caused by a single lesion

Question 20

What is a multifocal episode?

Answer 20

AKA Acute disseminated encephalomyelitis ADEM

Person experiences more than one sign of symptom caused by lesions in more than one place

(eg. optic neuritis in one eye plus hemiparesis)

Question 21

What are the (6) symptoms that are managed with drugs?

Answer 21

Spasticity

Intention tremor

Urinary urgency

Urinary retention/hesitancy

Painful dysesthesias

Fatigue

Question 22

What is devic’s disease?

aka?

Answer 22

AKA = Neuromyelitis optica (NMO)

Characterized by inflammation and demyelination of optic nerves and spinal cord with relative sparing of brain

Different from MS; SPARES THE BRAIN

Question 23

What is the treatment for devics?

Answer 23

Steroids &/or plasma exchange followed by immunosuppression