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Neuro/Psych Exam > Demyelinating Diseases > Flashcards

Demyelinating Diseases Flashcards

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1
Q

What are some risk factors for developing MS?

A
  1. Being born in the North (Vit. D)
  2. Age 20-40
  3. Female
  4. Family Hx
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2
Q

What are 3 common presentations of MS?

A
  1. Optic Neuritis
  2. Intranuclear Ophthalmoplegia
  3. Transverse Myelitis
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3
Q

What is Optic Neuritis?

A

Acute Demyelination of the Optic Nerve (usually ant to chiasm so affects only 1 eye)

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4
Q

What condition presents as progressive monocular vision loss that appears as though looking through dirty dish water and has color desaturation?

A

Optic Neuritis

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5
Q

What should you do if a patient has Optic Neuritis?

A

Get an MRI

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6
Q

What will be seen on PE of Optic Neuritis?

A

Afferent Pupillary Defect (may still be present after sx)

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7
Q

What is intranuclear ophthalmoplegia?

A

A lesion in the brainstem that –> impaired horizontal gaze with failure of MEDIAL gaze when looking AWAY from the lesion

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8
Q

What condition results from a disconnect between the Abducens Nucleus and the Occulomotor Nucleus?

A

Intranuclear Ophthalmoplegia

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9
Q

Which eye will you see Nystagmus in with Intranuclear Ophthalmoplegia?

A

The good Eye

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10
Q

What is Transverse Myelitis?

A

Demyelination of the Spinal Cord

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11
Q

What condition could result in hemi sided weakness, sensory defects and bowel/bladder dysfunction?

A

Transverse Myelitis

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12
Q

Which neuroimaging modality is used for visualizing new and old regions of demyelination in MS?

A

MRI with T2 Flair Sequence

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13
Q

What abnormality is seen in the CSF of MS patients?

A

Oligoclonal Banding, high IgG/Albumin Ratio and elevated IgG

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14
Q

What is the treatment for an acute MS episode?

A

High Dose IV Methylprednisolone

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15
Q

What long term treatment option for MS works by decreasing T cell migration?

A

Interferon Beta

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16
Q

What long term treatment option for MS can be rendered ineffective by smoking due to Abs that develop against the drug?

A

Interferon Beta

17
Q

What are the side effects of Interferon Beta?

A

Flu like sxs (HA, arthralgias, myalgias)

18
Q

What long term treatment option for MS works by modulating the immune system through MHC?

A

Glatiramer Acetate

19
Q

What is the indication for using Glatiramer?

A

Long term treatment of less aggressive MS

20
Q

What is the main side effect of Glatiramer?

A

Chest Tightness

21
Q

What long term treatment option for MS that sequesters lymphocytes through binding of sphigosine 1 phosphate receptors?

A

Gilenya

22
Q

What long term treatment option for MS results in significant Bradycardia and Hypotension?

A

Gilenya

23
Q

What long term treatment option for MS interferes with Pyrimidine synthesis to block proliferation of T and B cells?

A

Teriflunomide

24
Q

What are the side effects of Teriflunomide?

A
  1. TERATOGENIC ***
  2. Alopecia
  3. Hepatotoxicity
25
Q

What long term treatment option for MS targets the Nrf2 pathway involved in oxidative stress response to decrease lymphocyte levels?

A

Dimethyl Fumarate

26
Q

What long term treatment option for MS is given for very aggressive disease?

A

Natalizumab

27
Q

How does Natalizumab work?

A

Binds to Alpha 4 integrin of the BBB to prevent lymphocytes from entering the brain

28
Q

What long term treatment option for MS is associated with Progressive Multifocal Leukoencephalopathy?

A

Natalizumab

29
Q

Which demyelinating disease could present with sudden vision loss or loss of bladder function?

A

Neuromyelitis Optica (Devics)

30
Q

What lab test would indicate Devic’s Disease?

A

NMO IgG Antibody test (Ab against Aquaporin 4 Cl Channel)

31
Q

What is the treatment for Devic’s Disease?

A

Rituxumab

Neuro/Psych Exam (12 decks)

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