MS

Question 1

What is MS?

Answer 1

an inflammatory demyelinating disorder of the CNS

Question 2

What is significant about the plaques in MS?

Answer 2

disseminated in time and place

Question 3

What sex has most common incidence of MS?

Answer 3

Female 3:1

Question 4

What are the 4 clinical courses of MS?

Answer 4

Relapsing Remitting
Primary Progressive
Progressive relapsing
Secondary Progressive

Question 5

Describe relapsing remitting MS?

Answer 5

flare ups followed by asymptomatic phases

Question 6

Describe the clinical course of primary progressive MS?

Answer 6

constantly worsening gradually over a period of time

Question 7

Describe the clinical course of progressive relapsing MS?

Answer 7

constant gradual progression combined with flare ups and partial remission

Question 8

Describe the clinical course of secondary progressive MS?

Answer 8

asymptomatic + flare ups and then gradual progression.

Question 9

What category of dysfunction do symptoms such as hypertonia, spasticity and weakness come under?

Answer 9

pyramidal dysfunction

Question 10

Which eye condition is commonly seen in MS?

Answer 10

optic neuritis

Question 11

Is optic neuritis painless or painful visual loss?

Answer 11

Painful

Question 12

What is an RAPD?

Answer 12

relative adherent pupillary defect

a medical sign observed during the swinging-flashlight test whereupon the patient’s pupils constrict less (therefore appearing to dilate) when a bright light is swung from the unaffected eye to the affected eye

Question 13

Which sensory modalities are affected in dorsal column loss?

Answer 13

proprioception

vibration

Question 14

What common sensory symptoms are seen in MS>

Answer 14

pain
paraesthesia
numbness
trigeminal neuralgia

Question 15

What category of disorders encompasses symptoms such as ataxia, intention tremor, nystagmus, past pointing, pendular reflexes and dysdiadokinesis?

Answer 15

cerebellar dysfunction

Question 16

Which component of the pathway is involved in internuclear ophthalmoplegia?

Answer 16

medial longitudinal fasciculus

Question 17

What drug can be given to combat fatigue in MS?

Answer 17

amantadine

Question 18

What drug can be given to combat fatigue in MS patients who feel sleepy?

Answer 18

modafinil

Question 19

What is the diagnostic criteria for MS?

Answer 19

at least two episodes suggestive of demyelination - disseminated in time and place

Question 20

What is the best scan to diagnose MS?

Answer 20

MRI

Question 21

What is seen in CSF of MS patients?

Answer 21

oligoclonal bands

Question 22

What medications are used in acute MS exacerbations?

Answer 22

oral/IV steroids depending on severity

Question 23

What medications can be used to treat spasticity?

Answer 23

baclofen
tizanidine
Botox
(intrathecal baclofen/phenol)

Question 24

What treatments can be given for sensory symptoms of MS? e.g. pain, numbness, paraesthesia

Answer 24

anti-convulsant - gabapentin 
antidepressant - amitriptyline 
TENS 
acupuncture 
lignocaine infusion

Question 25

Which medications can be used to treat detrusor hypersensitivity?

Answer 25

anti-cholinergics - oxybutynin

Question 26

What first line disease modifying therapy is used in MS patients?

Answer 26

interferon B 
glitiramer acetate (copaxone)
tecfedira

Question 27

What second line disease modifying therapy is used in MS patients?

Answer 27

monoclonal antibodies - tysabri, lemtrada

fingolimod

Question 28

What third line disease modifying therapy is used in MS patients?

Answer 28

mitoxantrone

Question 29

what is PML?

Answer 29

progressive multifocal leukoencephalopathy

Question 30

Which virus causes PML?

Answer 30

JC virus

Question 31

What is the underlying factor that allows development of PML?

Answer 31

disease modifying drugs and immunomodulation

Question 32

Which organ does mitoxantrone damage in a dose-dependent fashion?

Answer 32

the heart