MULTIPLE SCLEROSIS Flashcards

1
Q

mulitple areas of white matter inflammation, demyelination, sclerosis

A

MS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

type of onset?

age of peak onset?

A

unimodal age of onset

20-30 y/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

where is incidence higher?

A

temperate regions, lower in tropical areas

higher in the north USA than south

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

• Similar to relapsing-remitting MS in humans
• Induced in susceptible rats by immunizing them with normal
brain/spinal cord tissue, or myelin basic protein
• T-cells initiate the response

what is this?

A

experimental allergic encephalomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what lymphocytes are in the CSF indicated for MS?

A

CD4+CDw29+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

TNF is toxic too?

A

oligocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

chromosome mostly affected in patients with MS?

A

MHC on chr 6 gene codes for HLA markers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

types of viruses that are believed to cause MS?

A

EBV, picornaviruses, measles, rubella, mumps, HTLV-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

most cases of MS are of what type?

10%? 5%?

A

chronic progressive

primary progressive
progressive relapsing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

most affected areas of the body?

A
optic nerve/chiasm 
spinal cord (lateral/posterior columns)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

number one symptom of MS?

A

fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

gold standard of MS diagnosis?

A

MRI of brain with and without contrast, bright T2, target appearance on T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

laboratory test?

A

CSF
oligoclonal bands
myelin basic protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

corticosteroids are used for?

A

acute exacerbations only otherwise, 1 g IV qd (250 mg IV q 6 hr) of solmedrol for 3-5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

name this prophylaxis:

Glycosylated amino acid almost identical to native interferon

• Appears to have an immunomodulatory effect, inhibits cell migration and cell-mediated inflammation

A

Interferon-b-1a

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

name this prophylaxis:

Nonglycosylated, with serine for cysteine substitution

• Mechanism felt to be the same as 1a

A

Interferon- b-1b

17
Q

name this prophylaxis:

Random polymer of basic amino acids

A

glatiramer acetate

18
Q

name this oral prophylaxis:

sphingosine 1-phosphate receptor modulation

pyrimidine synthesis inhib.

Nrf2 pathway activator

A

Fingolimod (Gilenya)

Teriflunomode (Aubagio)

Dimethyl fumarate (Tecfidera)

19
Q

Positive prognostic factors?

A
  • Early onset
  • Sensory symptoms at onset
  • Female
  • Relapsing-remitting course
  • Minimal residual disability five years after diagnosis
20
Q

negative prognostic factors?

A
  • Late (>40 y/o) onset

* Progressive course