Multiple Sclerosis Flashcards
What is MS?
- Progressive autoimmune disease characterized by inflammation and demyelination
- characterized by lesions/plaques in the CNS as a result of inflammation, myelin destruction and scarring
- Pattern of relapses (worsening) and remissions (periods without disease progression, partial/complete recovery of symptoms)
Pathophysiology of MS
- Abnormal immune-mediated response triggering the activation of the immune cells (helper T-cells) which cross the BBB.
- Initiating damaging inflammatory cascade of events with demyelination/damage to myelin in the brain, spinal cord, & optic nerves
- Oligodendrocyte loss & axonal damage
➜in early stages some re-myelination can occur but as oligodendrocytes become damaged myelin repair does not occur
How does MS progress?
1st stage: inflammatory damage with demyelination & some axonal damage
2nd stage: degenerative changes including axonal and oligodendrocyte destruction
What best describes MS?
a) autoimmune disease
b) genetic disease
c) infectious disease
d) metabolic disease
A) Autoimmune disease
What is attacked in MS?
a) Blood vessels
b) Neurotransmitters
c) T-cells
d) Myelin
D) Myelin
Who is most likely to be diagnosed with MS?
a) 28 YO male
b) 60 YO male
c) 22 YO female
d) 55 YO female
C) 22 YO female
- Most commonly affects young adults between ages of 20 & 49.
- Women more than men
- more common in higher latitudes (further away from equator)
- Canada has one of the highest rates of MS in the world
Penelope reports recent blurred vision, tingling in her hands and feet and fatigue. Her doctor thinks she may have MS. What tests may her doctor complete?
a) Magnetic resonance imaging
b) Electrocardiogram
c) Cerebral angiography
d) ultrasound
A) MRI
highly sensitive for detecting MS plaques/lesions
Penelope was diagnosed with RRMS, she started taking disease-modifying medications, what is the benefit of disease modifying medications?
a) Stop the progression
b) Increase inflammation
c) Reduce relapses
d) Decrease spasticity
C) reduce relapses
Kameela has primary progressive MS. What types of mediations may be useful for her?
a) Medications for thinning blood
b) Medications for fatigue
c) Medication for freezing in gait
d) Medications for a resting tremor
B) Fatigue
treatment of the symptoms and fatigue is a symptom for MS (freezing in gait and resting tremor is more present in Parkinson’s)
Rachel has Uhthoff’s phenomenon due to a neurological condition, what factors may have increased her risk of this condition?
a) Smoking
b) Hypertension
c) Viral infection
d) High vitamin D levels
e) High fat diet
A & C
Environmental and genetic factors can increase risk of MS
- low vitamin D
- smoking
- epstein-barr virus
- obesity
Prisha was diagnosed with RRMS and presents with ataxia. What findings would we expect on assessment?
a) Stooped posture
b) Dysmetria
c) Weakness
d) Decreased ROM
e) Dysdiadochokinesis
B & E
What are the types of MS?
- Relasping-Remitting MS (RRMS)
- Secondary Progressive MS (SPMS)
- Primary-Progressive MS (PPMS)
What is RRMS?
- most common type of MS (85% of ppl living with MS)
- unpredictable defined relapses
- most ppl with RRMS eventually transition to SPMS
What is SPMS?
- starts off as RRMS
- relapses & remissions become less apparent with steady worsening of function
- occasional relapses and minor remissions and plateaus
- 50% of ppl with RRMS will develop SPMS with 10-20 yrs of initial diagnosis
What is PPMS?
- least common form of MS (15% of ppl with MS)
- progressive worsening from onset
- no relpases & remissions
