MS

Question 1

what

Answer 1

chronic + progressive condition which involves demyelination in CNS

inflammatin + immune cells damage myelin

Question 2

when does it typically present

Answer 2

young adults

Question 3

more common in what sex

Answer 3

females

Question 4

how does pregnancy affect symptoms

Answer 4

improve

Question 5

key expression

Answer 5

disseminated in time and space

Question 6

associations

Answer 6

multiple genes
EBV
low vitD
smoking 
obesity

Question 7

features: eye movement abnormalities

Answer 7

6th nerve palsy

• internuclear ophthalmoplegia
• conjugate lateral gaze disorder

Question 8

features: focal weakness

Answer 8

bells palsy
horner’s
limb paralysis
incontinence

Question 9

features: focal sensory symptoms

Answer 9

trigeminal neuralgia
numbness
paraeshesia
Lhermitte’s sign

Question 10

Lhermitte’s sign

Answer 10

electric shock sensation travels down spin and into limbs when flexing neck

caused by stretching demyelinated dorsal column

Question 11

features: ataxia

Answer 11

problem with coodrinated movement

sensory - loss proprioceptive sense
or
cerebellar - problem with cerebellum coordinating movements

Question 12

disease patterns

Answer 12

relapsing remitting
secondary progressive
primary progressive

Question 13

disease patterns: relapsing remitting

Answer 13

most common at initial Dx

episodes of disease followed by recovery

acive
non-active
worsening
not worsening

Question 14

disease patterns: secondary progressive

Answer 14

was RR at first but now progressive worsening of Sx with incomplete remissions

symptoms become more and more permanent

Question 15

disease patterns: primary progressive

Answer 15

worsening of disease and symptoms from point of Dx w/o initial RR

Question 16

MRI shows

Answer 16

lesions

Question 17

LP shows

Answer 17

oligoclonal bands in CSF

Question 18

optic neuritis features

Answer 18

unilateral reduced vision

• central scotoma
• pain on eye movement
• impaired colour vision
• relative afferent pupillary defect

Question 19

Mx optic neuritis

Answer 19

opthalmolosy assessment

seroids

Question 20

Mx - disease modifications

Answer 20

disease modifying drugs - beta inferon

biologic therapy

Question 21

Mx - treating relapses

Answer 21

methylprednisolone

500mg oral daily 5 days

1g IV daily 3-5days where oral Rx failed or severe

Question 22

symptomatic Mx - neuropathic pain

Answer 22

amitriptyline

gabapentin

Question 23

symptomatic Mx - urge incontinene

Answer 23

anticholinergic

e.g. tolterodine

Question 24

symptomatic Mx - spasticity

Answer 24

baclofen
gabapentin
physio

Question 25

MR - with or w/o contrast

Answer 25

with