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neurology > MULTIPLE SCLEROSIS > Flashcards

MULTIPLE SCLEROSIS Flashcards

1
Q

what is MS

A

AUTOIMMUNE DISEASES ; DEMYLINATION

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2
Q

AGE OF ONSET MS

A

15- 50 BUT PEAK 20 -40

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3
Q

WHO IS AFFECTED THE MOST IN MS

A

FEMALE MORE THAN MALE ; RATIO ; 2;1

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4
Q

RACE OF MS

A

HIGHER IN CAUCASIANS

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5
Q

CAUSES OF MS

A

UNKNOWN
THEROY
GENETICS ; FEMALE
GENES ENDING FOR [ HLA DR2]ENVIROMENTAL FACTORS ; INFECTIONS ;, EBV , HHV6
VIT D DEFEINCY ; HIGHER RATES IN NORTHEN AND SOUTH POLES

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6
Q

CLINICAL PRESENTATION OF MS

A

1.MENTALITY DYSFUNCTION ; DEPRESSION , EUPHORIA , COGNITIVE IMPAIREMENYT
1.SPEECH DYSFUNCTION ; STACCATO , SLURRED , SCANNING
3. CRANIAL NERVE INVOLVEMENT ; 3,2 , 7 ,8
MOTOR DYSFUCNTION ; PARAPAREISIS
SENSORY DYSUNCTION ; PARATHESIA
LHERTHMEN SIGN
CEREBELLAR DYSFUNCTION ; ATAXIA
AUTONOMIC DYSFUNCTION ‘SEXUAL DYSFUCNTION
URGENCY [ MOST COMMON BLADDER FEATUERS]
BOWEL DYSFUNCTION
EPILSEY RARE
UTHOFF PHENOMENA

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7
Q

investigations for ms

A

MRI
CSF FOR OLIGOCLONAL BANDS
VEPS
fundus examination ;pallor of the optic disc

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8
Q

ms diagnosis use MC DOLAND CRITERIA

A

1, dissemenation in space
2. dissemenation in time

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9
Q

disseminated space

A

perventricular
juxtacortical
infratentorial
spinal cord

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10
Q

what tool used to asses severity of MS

A

EDSS [ expanded disability status scale]
MS functional [ cognitive , hand function , ambulation of distance and ambulation of speed]

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11
Q

dd of MS

A

ADEM
TRANSVERE MYELITIS
BECHEST DISEASE
scaroidosis
neuromylitis optica [devic disease]
HIV
NEUROSYPHILIS
VITAMIN B 12 DEFECIENCY
SPINAL CORD NEOPLAS E.G [EPEDYMOMAS]
vascuilitc disease as SLE , PAN

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12
Q

what is transvere myelitis

A

acute inflammation that affecting spinal cord can affect one or more than one segement ; commonly affect thoracic segements

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13
Q

causes of transverse myelitis

A

idiopathic
infection ; HS ,HZ EBV , INFLEUNZA
BACTERIAL INFECTION AS TB , SYPHILIS , DIPTHERIA
AFTER VACCINATion
and may be asoociated with vascilits
iatrogenic and toxic ; psot lumbar , iv heroin
demylineation with MS

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14
Q

what is the clinical presentation of MS ?

A

shock stage ;
flaccid paraplegia and most important sensoy lost below level of the lesion all sensation is lost
and may have sphincteric problem as retention of urine with over flow
recovery stage ; as spastic paraplegia and loss all of senstation below level of the lesion
sphinceteric ;percipetency of micturation

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15
Q

what investigations done for TM

A

CSF
MRI ; USED TO SPOT AREAS OF INflammation

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16
Q

treatment of TM

A

Symptomatic treatment
steroid

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17
Q

what is devic disease or neuromylitis optic ?

A

itis optic neuritis with myleitis

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18
Q

NMO common in which speicies

A

japanes

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19
Q

investigations for devic disease

A

MRI for brain normal and spinal cord
lesion in spinal is lage extensive can take 3 segemnts or more
vep
csf ; NMO IgG [ AQUAA 4 ] [key]. oligclonal band

20
Q

prognsosi of devic disease

A

poor receovery between attacks

21
Q

treatment of devic disease

A

plasma pherisis

22
Q

what is ADEM ?

A

autoimmune disease in CNS sudden inflammation and emylination in brain and spinal cord

23
Q

causes of ADEM

A

POST infection ., vaccine

24
Q

clinical presentation of ADEM

A

it is single event of demylination that occur more in children and adolesecent
FAHM [ fever common]
visual problems , seizuers [ common]
weakness
irritability
confusion
drowzzines
coma

25
Q

how to differntiate between MS vs ADEM

A

ADEM ; CHILDREN AND ADOLESECNT AND it is only one attack , that have FAHNM , SEZIEURS , EMNGISM DCL
WHILE
MS ; it is relapsing - remitting disease , common in adult more in female . no seizuers , fever

26
Q

what investigation for ADEM

A

MRI FOR BRAIN AND SPINAL CORD
VEP
CSF ; high WBCS AND PROTEIN

27
Q

what is the treatment of ADEM

A

STEROIS TO REDUCE INFLAMMATION
IVIG TO BIND AND NEUTRALIZE AUTO ANTIBODIES
MAY IN SEVERE CASES DO PLASMA EXCHANGE

28
Q

what is sarcoidosis

A

is is multisystem inflammatory disease

29
Q

common in which race

A

female , afrocarribean

30
Q

sarcoidosis coomon site affected

A

hilar lymphnode

31
Q

describe lesion of scarcoidosis

A

non caseating granuloma

32
Q

clinical presentation of the sarcoidosis

A

uveitis
systemic ; rash , weight loss , arthralgia
specific symtpoms ; shortness of breath and coughing , tender leg nodule and vision change s

33
Q

investigations done for sracoidosis

A

chest x ray ; hilar lymph node
blood test ; calcium is high and ACE is high
BAL [t cell in lung is high]
gold standard is biopsy

34
Q

treatment of sarcoidosis

A

may take steroid

35
Q

what is bechest disease

A

it is multisystem recuurent inflammatory disease
affect mainly turkey then asia then western countries

36
Q

bechst diseases ?

A

is tis vasculitis disease

37
Q

to diagnose behcet disease we need

A

oral ulcer plus 2 ;
genital ulcer
uveitis
skin lesionas pustular , nodsum
pathergy test
increase in the inflammatory markers

38
Q

what is pathery test

A

skin prick in the fore arm
then after 2 dyas if occur red pump or pustule
this is due to hypersenstivity in response to trauma
this test used in ; not specific
behcet disease

39
Q

what is sle

A

autoimmune disorder

40
Q

clinical presentation of sle

A

Afro-caribbean
Skin – malar, photosens, discoid, Raynaud’s
Renal – nephritis
Serositis – arthritis, mouth ulcers
Blood – haemolytic anaemia, ↓WCC, ↓plts
Cardiac – peri-/endo-/myo-carditis
Lungs – pleuritis, pleural effusions
CNS – cerebral vasculitis, transverse myelitis
PNS - myositis
ANA, dsDNA antibodies

41
Q

investigations fo sle

A

ANA and Ds DNA [ SPECIFIC] FOR SLE

42
Q

what is sijogren disease

A

90% Female
* Primary (Sicca syndrome) or secondary to other autoimmune
disorders ( mixed connective tissue disease and rheumatoid arthritis)
* Presentation : Dry eyes , Dry mouth
* Arthralgia, myalgia, parotitis, periph neuropathy
* CNS involvement – transverse myelitis, optic neuritis (?overlap with
NMO?), cerebral vasculitis
* Anti-Ro/SSA, anti-La/SSB or RF

43
Q

specific serology for sojgren syndrome

A

ANTI ro /ss a
anti LA /ssb or rf

44
Q

what is cerebral vascuilits

A

Primary or secondary to systemic vasculitis(SLE)
* Acute, subacute, may relapse-remit
* Headache
* Seizures
* Stroke-like
* Encephalopathy / cognitive deterioration / psychiatric
* Movement disorders (chorea)
* Systemic features - fever, night sweats, rash, weight loss,
arthropathy, ↑inflammatory marker

45
Q

what is giant cell arterits [ most common form of arteritis ]

A

> 50y
Systemic symptoms/PMR
Scalp tender
Visual loss (AION) [double vision ]
Jaw claudication
↑ESR, ↑plts, abn LFTs
Temporal artery biopsy

neurology (5 decks)

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