L36 - MS

Question 1

optic neuritis

Answer 1

inflammation of the optic nerve

Question 2

symptoms of optic neuritis

Answer 2

pain and loss of vision

Question 3

prognosis of optic neuritis

Answer 3

• 95% return to visual acuity within 6 months with no treatment
• 50% go on to develop MS within 10 years

Question 4

Lhermitte’s phenomenon

Answer 4

electric shock when you bend your head

Question 5

inflammation of the spinal cord

Answer 5

traverse myelitis

Question 6

prognosis of traverse myelitis

Answer 6

50% go on to develop MS

Question 7

cause of traverse myelitis

Answer 7

50% due to viruses e.g., herpes zoster

Question 8

symptoms of traverse myelitis

Answer 8

Lhermitte’s phenomenon

may affect bladder

Question 9

clinically definite MS

Answer 9

optic neuritis and transverse myelitis at different times

Question 10

not definite MS

Answer 10

• Clinically isolated syndrome (CIS)
• Myelitis and optic neuritis at the same time
• Recurrent myelitis
• Recurrent (same eye) or sequential (opposite eyes) neuritis

Question 11

investigations of optic neuritis and transverse myelitis

Answer 11

lumbar puncture: abnormal antibodies present

flame lesions in MRI scan (not definite as can have within MS and not everyone with MS has)

Question 12

most important thing in diagnosing MS

Answer 12

history

Question 13

who is more prone to get MS

Answer 13

• women
• 30-40 year olds
• poles of the equator

Question 14

what is MS

Answer 14

an autoimmune condition: inflammatory reaction in the CNS causing loss of myelin and slowing of nerve conduction

Question 15

disease modifying treatments

Answer 15

• suppressing the immune system

Question 16

dimethylfumarate

Answer 16

treats psoriasis and MS

• reduces lymphocyte count
• side effect: nausea

Question 17

ataxia

Answer 17

loss of balance and movement

Question 18

tysabri

Answer 18

first humanised monoclonal antibody approved treatment with MS

• inhibits adhesion molecules of the surface of immune cells
• prevents immune cells from migrating from the bloodstream to the brain

Question 19

prognosis of MS

Answer 19

treatable but not curable

Question 20

types of disease progression

Answer 20

• relapsing-remitting MS
• primary progressive MS
• secondary progressive MS
• progressive relapsing MS

Question 21

brain in MS

Answer 21

shrinks

Question 22

% of MS patients confined to a wheelchair within 10 years of diagnosis

Answer 22

15

Question 23

treatment of secondary progressive MS

Answer 23

management of acute relapse - corticotherapy

Question 24

symptoms of MS

Answer 24

fatigue
mood problems
genitosphincteral problems
pain
sensory problems
tremor
spasticity

Question 25

relapsing-remitting MS

Answer 25

flares then relaxes
on repeat
flares get worse each time

Question 26

primary progressive MS

Answer 26

10%

progressive

Question 27

secondary progressive MS

Answer 27

flare up
relaxes
when it flares again, it begins to progress

Question 28

progressive relapsing MS

Answer 28

(5%
progresses
sharp fares within this progression
each time flares, progression gets steeper