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Neurology - professional - batt > MS > Flashcards

MS Flashcards

1
Q

What is MS?

A

an inflammatory demyelinating disorder of the CNS

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2
Q

What are the clinical features of MS?

A

pyramidal dysfunction; optic neuritis; sensory symptoms; lower urinary tract dysfunction; cerbellar and brainstem features; cognitive impairment

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3
Q

What are teh features of pyramidal dysfunction seen with MS?

A

increased tone- velocity dependant; spasticity; weakness of extensors of upper; flexors of lower

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4
Q

What is seen with optic neuritis?

A

painful visual loss that lasts for 1-2 weeks and is associated with RAPD

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5
Q

What sensory symtpoms are seen with MS?

A

pain; parasthesia; DC loss of proprioceptio nand vibration; numbness; trigeminal neuralgia

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6
Q

What features are seen with cerebellar dysfunction?

A

ataxia; intention tremor; nystagmus; pendular reflexes; dysdiadokinesia; dysarthria

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7
Q

What is seen with brainstem dysfunction?

A

diplpopia; facial weakness

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8
Q

Where is the problem in internuclear ophthalmoplegia?

A

medial longitudinal fasciulus

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9
Q

What happens in internuclear ophthalmogplegia?

A

distortion of binocular vision; failure of adduction- diplopia; nystagmus in abducting eye and lag

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10
Q

What are the symptoms of lower urinary tract dysfunction with MS?

A

frequency; nocturia; urgency; urge incontinence and retention

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11
Q

How is a diagnosis of MS made?

A

at least 2 peisodes suggestive of demyelination with dissemintation in time and place

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12
Q

What is the purpose of doing blood tests in suspected MS?

A

to rule other things outj rather than rule in

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13
Q

Why is PV; FBC and CRP done?

A

to rule out vasculitis or sarcoid- high eosinophils

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14
Q

Why are autoantibodies done?

A

to rule out sarcoid and vasculitis

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15
Q

What viruses are tested in patients with suspected MS?

A

borellia; HIV; syphilis

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16
Q

What is seen in the CSF of patients with MS?

A

matched oligoclonal bands

17
Q

What are the treatments for pyramidal dysfunction?

A

PT; OT; antispasmodic agent

18
Q

What are the treatments for spasticity?

A

PT; oral- baclofen; tizanidine; botulinum toxin; intrathecal baclofen/phenol

19
Q

What probem can oral baclofen cause?

A

postural hypotension

20
Q

What are hte treatments for sensory symptoms in MS?

A

anticonvulsant eg gabapentin; antidepressant- amitriptyline; tens; acupuncture; lignocaine

21
Q

What are the problems in MS that cause lower urinary tract dysfunction?

A

increased tone at bladder neck; detrusor hypersensitivity; detrusor sphyncteric dyssensergia

22
Q

What happens with detrusor sphyncteric dyssenergia?

A

both the detrusor and sphincter contract at the same time so pt wants to pass urine but can;t

23
Q

What are the treatments for lower urinary tract dysfunction?

A

bladder drill; anticholinergics eg oxybutynin; desmopressin; catheterisation

24
Q

When is desmopressin used?

A

for short periods eg for travel

25
Q

What are teh treatments for fatigue?

A

amantadine; modafinil if sleepy; hyperbaric oxygen

26
Q

What are the first line therapies for disease modifyuing therapy?

A

interferon beta; glitiramer acetate; tecfedira

27
Q

What are hte second line disease modifying therapies?

A

mocolonal antibody; fingolimod

28
Q

What is the third line disease modifying therapy?

A

mitoxantrone

29
Q

What is the method of delviery of interferon beta and copaxone?

A

injectable sc or im

30
Q

What is the efficacy of interferon beta and copaxone?

A

decrease relapses by 1/3rd and decrease severity of realpses by 50%

31
Q

What drug is the first line in relapsing remitting MS?

A

tecfidera

32
Q

When are monoclonal anitbody treatments indicated in MS?

A

pts with rapidly evolving severe relapsing remittting MS or with high disease actvitiy despite treatment with an interferon

33
Q

What are the problems with fingolimod?

A

cardiac issues; llmphopenia; HT; PML

34
Q

What drugs are associated with PML?

A

tecfidera and all second line therapies

35
Q

What drug has the highest risk of PML?

A

tysabri

36
Q

What increases your risk of PML?

A

being JC virus positive

37
Q

What type of MS is mitoxantrone used for?

A

relapsing progressive MS

38
Q

What is the main problem with mitoxantrone?

A

cardiac toxicity and malignancies

Neurology - professional - batt (40 decks)

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