Exam 3 -- Multiple Sclerosis Flashcards
Which gender has a higher prevalence of multiple sclerosis?
Female
What is the average age of onset of multiple sclerosis?
20-35 years
What genetic factor is associated with multiple sclerosis?
HLA-DRB1
People who live in northern latitudes have a higher risk of developing multiple sclerosis. True or false: once you have lived in a northern latitude, you carry the higher risk with you no matter where else you go.
False; your risk is thought to be associated with where you lived prior to puberty.
Fill in the blanks: in ________% of patients with multiple sclerosis, optic neuritis is the most common symptom; in __________%, it is the first symptom.
40-50% = most common symptom; 15-20% = first symptom
What is Uhthoff’s sign?
Symptoms of MS get worse with heat.
True or false: internuclear ophthalmoplegia is one of the symptoms of MS.
True.
Non-ocular symptoms of MS include muscle fatigue/weakness/spasms, numbness, tingling, pain, cognitive decline, bladder, bowel, and sexual dysfunction.
Free card.
Lhermitte’s sign, which is one of the symptoms of multiple sclerosis, involves a a radiating pain down the spine due to movement of what body part?
Neck
An MRI on a patient with MS might show what?
Plaques (demyelination and accumulation of macrophages and T cells)
A lumbar puncture on a patient with MS might contain what kind of antibodies?
IgG
True or false: the symptoms of MS are separated in time and space and are usually followed by partial or complete remission.
True.
What is the name of the set of criteria used to determine needed clinical findings for diagnosis of MS?
McDonald criteria.
MS attacks in a patient are typically reduced during what life event?
Pregnancy.
There are a few different forms of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remissing (RRMS), secondary-progressive (SPMS), and primary progressive (PPMS). Which form makes up 5-10% of cases?
PPMS
There are a few different forms of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remissing (RRMS), secondary-progressive (SPMS), and primary progressive (PPMS). Which form is progressive from the onset and involves minimal relapses?
PPMS
There are a few different forms of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remissing (RRMS), secondary-progressive (SPMS), and primary progressive (PPMS). Which form involves gradual worsening and may or may not include relapses?
SPMS
There are a few different forms of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remissing (RRMS), secondary-progressive (SPMS), and primary progressive (PPMS). Which form involves acute attacks followed by remission to normal or near-normal?
RRMS
There are a few different forms of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remissing (RRMS), secondary-progressive (SPMS), and primary progressive (PPMS). Which form is the most common?
RRMS
There are a few different forms of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remissing (RRMS), secondary-progressive (SPMS), and primary progressive (PPMS). In which form is the gender predilection equal?
PPMS
There are a few different forms of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remissing (RRMS), secondary-progressive (SPMS), and primary progressive (PPMS). Patients with which form usually progress to SPMS?
RRMS
There are a few different forms of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remissing (RRMS), secondary-progressive (SPMS), and primary progressive (PPMS). Which form usually occurs 10-20 years after the initial onset?
SPMS
There are a few different forms of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remissing (RRMS), secondary-progressive (SPMS), and primary progressive (PPMS). Which form has a later age of onset and has a worse prognosis?
PPMS
There are a few different forms of multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remissing (RRMS), secondary-progressive (SPMS), and primary progressive (PPMS). Which form involves minimal progression, at the beginning?
RRMS
IV methylprednisolone can be used for an acute attack of MS. You can use oral prednisone, but only if which symptom is absent?
Optic neuritis.
What is the most effective medication for MS?
Natalizumab infusion
Injection therapy for MS is safer than infusion therapy, but less effective. Name a few injectable MS medications.
Interferon beta (Avonex, Rebif, Betaseron, Plegrity), Glatiramer
Oral therapy for MS is the most convenient, but is less effective than infusion and injection therapies. What drug is the most commonly used oral MS drug?
Dimethyl fumarate (Tecfidera)
Some medications can be used to manage the symptoms of MS. Which medication helps improve walking speed?
Dalfamiridine
Some medications can be used to manage the symptoms of MS. Which medication helps with fatigue?
Amantadine. This is also a drug used for Parkinson’s.
Some medications can be used to manage the symptoms of MS. Which medication is for anti-convulsion and is also the drug of choice for general seizures?
Valproate
Male patients with PPMS have the worst prognosis.
Free card.
What percent of untreated patients with MS develop significant disability in 20-25 years?
30%
True or false: MS is thought to decrease lifespan by 15 years.
False; it is thought to decrease lifespan by 7 years.
Name the associated grading scale for the following conditions:
TBI
MS
IIH
TBI: Glasgow coma scale
MS: McDonald criteria
IIH: Modified Dandy criteria
