Multiple Sclerosis

Question 1

MS is an idiopathic disorder exclusively of ______) ___ matter. MS is more common in____ who live in ___climates.

Answer 1

CNS (brain and cord) white

white women
colder

Question 2

The most common presentation is

Answer 2

focal sensory symptoms
+
gait and balance problems.

Question 3

CxFx MS general rule:

Answer 3

multiple neurological deficits of the CNS affecting any aspect of CNS functioning

Question 4

2° most common presentation

Answer 4

optic neuritis: Blurry vision or visual disturbance

Question 5

3° most common presentation

Answer 5

motor and sensory abnormalities

Question 6

The least common abnormalities are____

Answer 6

cognitive defects and dementia

Question 7

Sexual function in MS _____

Answer 7

remains relatively intact

Question 8

______, characteristic of MS., is the inability to adduct one eye with nystagmus in the other eye.

Answer 8

Internuclear ophthalmoplegia (INO)

Question 9

Other findings: of MS

Answer 9

Fatigue
Spasticity and hyperreflexia
Cerebellar deficits

Question 10

the best initial test

Answer 10

MRI is both the best initial test and the most accurate test.

SHOWS: MS plaques appear white and are exclusively in the white matter

Question 11

Lumbar puncture shows
Protein:
WBC
and something else…

Answer 11

mild elevation in protein
fewer than 50 to 100 WBCs.
Oligoclonal bands (85% but NOT specific of MS)

Question 12

Oligoclonal bands are the answer in the 3% to 5% of patients with an _____.

Answer 12

equivocal or nondiagnostic MRI

Question 13

Visual and auditory evoked

potentials are

Answer 13

always the wrong

answer.

Question 14

best initial therapy for acute exacerbations of disease

Answer 14

High-dose steroids

shorten the duration of
exacerbation.

Question 15

Drugs That Prevent Relapse and Progression

Answer 15

Glatiramer: copaxone 
avonex rebif: Beta-interferon
Ocrevus: Ocrelizumab (anti-CD20)
ORAL: Gilenya® (fingolimod)
dimethyl fumarate (tecfidera)
Tysabri :Natalizumab*************

Question 16

This drug is used because it increases walking

distance.

Answer 16

Dalfampridine (ampira)

Question 17

A patient develops worsening neurological deficits with the use of a chronic suppressive medication. The MRI shows new, multiple white matter hypodense lesions. Dx?

Answer 17

progressive multifocal leukoencephalopathy (PML).

Question 18

progressive multifocal leukoencephalopathy (PML). what causes this?

Answer 18

Tysabri :Natalizumab

Question 19

_________ are the best first choice for prevention of relapse.

Answer 19

Glatiramer and beta-interferon