MS Flashcards
Does MS affect gray matter?
Somewhat–but mostly white matter
What is the most common type of demyelinating disease?
MS
What is the pathophysiology of MS?
Autoimmune attack against the oligodendrocytes
What is the geographical distribution of MS?
Increased in the temperate zones
What is the ratio of MS in females:males?
2-3:1 females:males
What is the peak age of onset for MS?
33
What virus is present in almost all MS patients?
EBV
Titers of what virus increase with MS?
EBV
What is the risk of developing MS if you have a 1st degree relative?
2-6%
What ethnicity is usually affected with MS?
Caucasians
What is the risk to children if a pt has MS?
1/40
What is the concordance rate between identical twin for MS?
30%
What is the HLA haplotype that is implicated with MS?
HLA-DR2
What is the immunology behind MS?
Predominately an aberrant T-cell mediated disease, caused by activation of circulating CD4 cells specific for myelin basic protein.
These cells are allowed to cross the BBB
What is the outcome of axonal degeneration?
Either heal or terminate
What are the three types of MS? Which is most common?
- Relapsing-remitting
- Primary progressive
- Secondary progressive
What percent of MS patients have a benign course? Intermediate? Malignant?
Benign = 10-20% Intermediate = 70-80% Malignant = 10%
Which gender is a negative prognostic indicator?
Male
Is younger or older age at onset of MS associated with worse outcome?
Older
Symptoms from what part of the brain is a significantly poor prognostic indicator for MS?
Posterior fossa symptoms at onset (cerebellar)
What ethnicity have a worse course of MS?
Blacks
True or false: significant residual disability from the first attack of MS has no prognostic value
False–prognosticates a bad outcome
What are the three majors tests that may be useful in diagnosing MS?
- CSF
- MRI
- Evoked potentials
What exam findings are indicative of MS?
- UMN s/sx
- RAPD
- Disk edema