Multiple Sclerosis

Question 1

MS pathological definition

Answer 1

Inflammatory disease of CNS characterised by demyelination and variable degrees of axonal loss and gliosis

Question 2

MS clinical definition

Answer 2

Objective CNS dysfunction involving 2+ white matter structures

Question 3

Histopathological changes in MS

Answer 3

Inflammation + lymphocytes
Peri venular inflammatory change
Demyelination
Gliosis

Question 4

Gliosis

Answer 4

Nerves replaced by scarring

Question 5

Is demyelination and gliosis reversible

Answer 5

Demyelination - yes
Gliosis - no

Question 6

How is the BBB effected by MS attacks

Answer 6

Breaks down for around 6 wks

Question 7

Gross pathological changes in MS

Answer 7

Cerebral atrophy
Ventricular enlargements

Question 8

What is seen on analysis of the CSF of a MS pt

Answer 8

Oligoclonal bands

Question 9

What produces oligoclonal bands

Answer 9

IgG

Question 10

Can oligoclonal bands be seen in MS pt serum

Answer 10

Yes but less common, always seen in CSF

Question 11

What suggests the immune response causing MS only occurs in the CNS not the periphery

Answer 11

Oligoclonal bands show IgG always present in CSF, not usually present in serum

Question 12

MS age of onset

Answer 12

20-40 yrs

Question 13

What areas in MS more common in

Answer 13

Temperate climates

Question 14

Deficiency of which vitamin is linked to MS

Answer 14

Vitamin D

Question 15

What virus is linked to MS

Answer 15

Epstein barr

Question 16

MS risk factors

Answer 16

Vitamin d deficiency
Epstein Barr virus
Smoking
Childhood/adolescent obesity
Solvent exposure

Question 17

Which gene has the most significant impact on MS risk

Answer 17

HLA

Question 18

What is EDSS

Answer 18

Expanded disability status scale

Question 19

At which EDSS levels does a pt need a stick to walk

Answer 19

EDSS 6

Question 20

At what EDSS level is a pt bedbound

Answer 20

EDSS9

Question 21

What is the range of EDSS levels

Answer 21

EDSS0-9

Question 22

MS signs and symptoms

Answer 22

Spasticity
Weakness
Gait abnormalities and unsteadiness
Positive and negative sensory effects
Incoordination
Diplopia
Vertigo
Nysgptagmus
Dysarthria
Optic neuritis
Incontinence
Depression
Poor concentration
Forgetfulness
Fatigue

Question 23

Difference between positive and negative sensory effects

Answer 23

Positive - pins and needles, water running over skin feeling
Negative - loss of sensation

Question 24

Damage to what area of the brain causes Diplopia vertigo nystagmus and dysarthria

Answer 24

Brainstem

Question 25

3 Clinical subtypes of MS

Answer 25

Primary progressive MS
relapsing remitting MS
secondary progressive MS

Question 26

Primary progressive MS

Answer 26

Steady incr in disability without attacks

Question 27

Relapsing remitting MS

Answer 27

Unpredictable attacks which may or may not leave permanent deficits followed by periods of remission

Question 28

Secondary progressive MS

Answer 28

Initial relapsing remitting MS that begins to decline without periods of remission

Question 29

MS treatment

Answer 29

Immunomodulation and Immunosuppression
Induction therapy

Question 30

MS induction therapy

Answer 30

Strong immunosuppression for a short time to reset immune system followed by weaker immunosuppression to regulate immune system and