MS Part 1 Flashcards

1
Q

What is MS and how does it affect the CNS?

A

MS is an autoimmune disease that causes inflammation, demyelination, and neurological deterioration in the CNS.

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2
Q

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A

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3
Q

What are some genetic and environmental risk factors for MS?

A
  • genetics (family history)
  • low Vitamin D
  • smoking
  • obesity are key risk factors
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4
Q

What are common epidemiological patterns in MS (e.g., geography, gender)?

A

MS is more common in people living farther from the equator and in women (3x more common).

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5
Q

What causes MS, and how does the immune system contribute?

A

MS is believed to be caused by an autoimmune response that attacks the myelin sheath in the CNS.

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6
Q

How does demyelination affect nerve conduction in MS?

A

Demyelination slows or blocks nerve conduction, leading to rapid nerve fatigue and eventually conduction block.

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7
Q

What happens during a relapse vs. a remission?

A

A relapse is an acute worsening of neurological function; remission is a period of partial or full recovery.

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8
Q

How do oligodendrocytes and plaques contribute to permanent disability?

A

Repeated attacks damage oligodendrocytes, preventing remyelination and leading to the formation of plaques, causing neurodegeneration.

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9
Q

What triggers a pseudo-relapse, and how is it different from a true relapse?

A

A pseudo-relapse is a temporary worsening of symptoms due to heat or stress, resolving within 24 hours.

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10
Q

What is the McDonald Criteria and how is it used to diagnose MS?

A

The McDonald Criteria requires evidence of 2 distinct attacks and > 2 lesions on MRI for diagnosis.

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11
Q

How does MRI contribute to the diagnosis of MS?

A

MRI detects plaques and lesions in the white matter of the brain and spinal cord, indicating demyelination.

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12
Q

What role does a lumbar puncture play in MS diagnosis?

A

A lumbar puncture can show elevated cerebrospinal fluid (CSF) protein levels, supporting MS diagnosis.

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13
Q

How are relapses and exacerbations defined in MS?

A

Relapses are defined by new or worsening symptoms lasting over 24 hours, not related to other causes.

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14
Q

What are the four main types of MS ?

A
  • Relapsing-Remitting
  • Secondary Progressive
  • Primary Progressive
  • Progressive Relapsing
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15
Q

How does Clinically Isolated Syndrome (CIS) relate to MS development?

A

CIS is a first episode of symptoms that may or may not develop into MS.

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16
Q

What percentage of MS patients experience relapsing-remitting MS?

A

About 85% of people with MS are diagnosed with Relapsing-Remitting MS.

17
Q

How does secondary progressive MS typically progress?

A

It involves a continuous decline in function with fewer or no relapses and remissions.

18
Q

What is the difference between primary progressive and progressive relapsing MS?

A
  • Primary progressive has steady decline from onset without attacks.
  • Progressive relapsing has relapses with worsening symptoms.
19
Q

What are the common sensory symptoms of MS?

A

Common sensory symptoms include…

  • paresthesias
  • numbness
  • pain
  • Lhermitte’s sign (electric shock sensation with neck flexion).
20
Q

What are the motor symptoms of MS, and how do they affect function?

A

Motor symptoms include

  • fatigue
  • paresis
  • spasticity
  • ataxia

affecting muscle strength, coordination, and mobility.

21
Q

How do cognitive impairments present in MS?

A

Cognitive impairments include memory deficits, decreased attention, and diminished executive functions.

22
Q

What is Uhthoff’s Phenomenon, and how does thermosensitivity affect MS patients?

A

Uhthoff’s Phenomenon is a worsening of symptoms in response to heat; thermosensitivity causes fatigue and decreased function.

23
Q

How do vision problems manifest in MS (e.g., optic neuritis)?

A

MS patients can experience blurred vision, double vision, and optic neuritis, causing temporary vision loss or pain.

24
Q

How do MS patients commonly experience fatigue, and how does it differ from typical fatigue?

A

MS fatigue is chronic, worsens with heat, and can occur even after rest; it interferes with daily activities.

25
Q

What are the bowel and bladder dysfunctions associated with MS?

A

Spastic or flaccid bladder, constipation, and incontinence are common bowel and bladder dysfunctions.

26
Q

What role do depression and anxiety play in the life of someone with MS?

A

Up to 50% of individuals with MS experience major depression and anxiety, affecting quality of life and social function.

27
Q

What is the EDSS scale, and how is it used to quantify disability in MS?

A

The EDSS is an ordinal scale from 0-10 used by neurologists to quantify disability in MS.

28
Q

What is the general prognosis for individuals with MS?

A

MS is not typically fatal, but it leads to progressive disability in mobility and function.

29
Q

How does MS affect mobility over time?

A

Over time, MS causes gait impairment, increased fall risk, and a need for assistive devices.

30
Q

What factors contribute to the progression of disability in MS patients?

A
  • disease type
  • frequency of relapses
  • co-morbidities
  • response to treatment affect disability progression.
31
Q

What disease-modifying therapies are available for MS?

A

DMTs like Ocrevus, Betaseron, and Tysabri slow disease progression and reduce relapses.

32
Q

How can physical therapy address fatigue and spasticity in MS patients?

A

PT helps manage fatigue with energy conservation strategies and reduces spasticity with stretching and mobility exercises.

33
Q

What role do cooling strategies play in managing thermosensitivity in MS?

A

Cooling vests, fans, and ice packs help reduce overheating and prevent Uhthoff’s Phenomenon.

34
Q

What lifestyle factors can positively or negatively impact the course of MS?

A

Exercise, stress management, and avoiding overheating can improve symptoms, while smoking and inactivity can worsen progression.