Lecture 3 - MS Flashcards
MS: affects CNS, PNS, or both? presents in younger or older patients? Women or men? geographic area?
CNS ie oligodendrocytes;
younger women;
farther away from equator
MS plaques:
initially, inflammation centered around ____. axon ____;
chronic: see glial ____ and loss of _____
vessels (perivacular);
sparing;
scarring, oligodendrocytes
higher levels of vitamin ___ are associated with lower incidence of developing MS. what enviornmental exposure is associated with an increased risk?
D;
smoking
MS:
charcot triad in FA = SIIIN
Scanning speech Intention Tremor (Incontinence INO) Nystagmus
MS:
2 eye symptoms =
______ dysfunction
symptoms may be exacerbated with _____
optic neuritis, INO;
bladder/bowel;
increased temperature
optic neuritis causes a _____ defect aka a “_____” pupil. INO is due to a lesion in the _____.
afferent; marcus gunn;
MLF
in INO, the contralateral ___ nucleus does not stimulate the _____ to contract. the abducting eye gets _____. convergence is ____
CN3;
medial rectus;
nystagmus;
normal
MS subtypes:
most common subtype? can progress to ____
_____ is when there is progression with no relapses.
relapsing remitting;
secondary progressive;
primary progressive
MS findings:
increased ____, ____, and _____ in CSF;
_____ on electrophoresis
IgG, lymphocytes, myelin basic protein;
oligoclonal bands
MS on MRI:
____ plaques aka called “____ ____”.
are lesions enhancing or non-enhancing?
periventricular (perpendicular to ventricles);
dawson fingers;
enhancing (indicates active disease)
MRI:
on T1, ______ are seen which correlates with degree of ___ loss
black holes;
axon
MS treatment (Disease modifying agents): 2 injectables = interferon \_\_\_\_, \_\_\_\_\_
beta, glatiramer
MS oral dmards:
fingolimid is a ____ receptor modulator. BG 12, teriflunomide
S1P
natalizumab:
targets ____.
most important side effect
alpha 4 integrin;
risk of PML in patients with JC virus
treat acute MS symptoms with _____
IV steroids
