MS Flashcards
What is MS?
an inflammatory demyelinating disorder of the CNS
What is significant about the plaques in MS?
disseminated in time and place
What sex has most common incidence of MS?
Female 3:1
What are the 4 clinical courses of MS?
Relapsing Remitting
Primary Progressive
Progressive relapsing
Secondary Progressive
Describe relapsing remitting MS?
flare ups followed by asymptomatic phases
Describe the clinical course of primary progressive MS?
constantly worsening gradually over a period of time
Describe the clinical course of progressive relapsing MS?
constant gradual progression combined with flare ups and partial remission
Describe the clinical course of secondary progressive MS?
asymptomatic + flare ups and then gradual progression.
What category of dysfunction do symptoms such as hypertonia, spasticity and weakness come under?
pyramidal dysfunction
Which eye condition is commonly seen in MS?
optic neuritis
Is optic neuritis painless or painful visual loss?
Painful
What is an RAPD?
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
Which sensory modalities are affected in dorsal column loss?
proprioception
vibration
What common sensory symptoms are seen in MS>
pain
paraesthesia
numbness
trigeminal neuralgia
What category of disorders encompasses symptoms such as ataxia, intention tremor, nystagmus, past pointing, pendular reflexes and dysdiadokinesis?
cerebellar dysfunction
Which component of the pathway is involved in internuclear ophthalmoplegia?
medial longitudinal fasciculus
What drug can be given to combat fatigue in MS?
amantadine
What drug can be given to combat fatigue in MS patients who feel sleepy?
modafinil
What is the diagnostic criteria for MS?
at least two episodes suggestive of demyelination - disseminated in time and place
What is the best scan to diagnose MS?
MRI
What is seen in CSF of MS patients?
oligoclonal bands
What medications are used in acute MS exacerbations?
oral/IV steroids depending on severity
What medications can be used to treat spasticity?
baclofen
tizanidine
Botox
(intrathecal baclofen/phenol)
What treatments can be given for sensory symptoms of MS? e.g. pain, numbness, paraesthesia
anti-convulsant - gabapentin antidepressant - amitriptyline TENS acupuncture lignocaine infusion
Which medications can be used to treat detrusor hypersensitivity?
anti-cholinergics - oxybutynin
What first line disease modifying therapy is used in MS patients?
interferon B glitiramer acetate (copaxone) tecfedira
What second line disease modifying therapy is used in MS patients?
monoclonal antibodies - tysabri, lemtrada
fingolimod
What third line disease modifying therapy is used in MS patients?
mitoxantrone
what is PML?
progressive multifocal leukoencephalopathy
Which virus causes PML?
JC virus
What is the underlying factor that allows development of PML?
disease modifying drugs and immunomodulation
Which organ does mitoxantrone damage in a dose-dependent fashion?
the heart
