Exam 4: MS

Question 1

Multiple Sclerosis

Answer 1

Autoimmune process causes the degeneration of myelin sheath

Inflammation and disintegration of myelin sheath, can be regenerated (periods of remission)

85% of cases is relapsing-remitting

Peak onset is 25-35 years old, higher incidence in women

Diagnosis: MRI (Glial scarring), lumbar puncture (IgG band)

Question 2

Signs and symptoms of MS

Answer 2

Weakness, paralysis of limbs, trunk, head
Scanning speech
Spasticity of muscles
Numbness and tingling
Blurred vision
Diplopia
Scotoma
Vertigo, tinnitus
Lhermitte’s sign: Shock going down back
Constipation
Spastic bladder, flaccid bladder
Nystagmus
Ataxia
Dysarthria
Dysphagia
Cognitive impairment

Question 3

Immunomodulators

Answer 3

Interferon, rotate injection site

Should be started early in course of disease, reduce frequency of relapse, not effective in primary progressive type

Flu like symptoms common

Question 4

Methylprednisolone

Answer 4

IV used for exacerbations

Treats acute relapse in remitting relapsing course, shortens duration of relapse

Monitor: WBC, blood glucose, lipids, high sodium, low potassium

Question 5

Baclofen

Answer 5

Treats spasticity