multiple sclerosis

Question 1

multiple sclerosis

Answer 1

demyelinating autoimmune disease of CNS

Question 2

global brain atrophy

Answer 2

decrease in brain volume due to atrophy of brain
(due to demyelination and loss of axons)

Question 3

what happens to size of subarachnoid space because of global brain atrophy?

Answer 3

increase in size

Question 4

relapse remitting

Answer 4

periods of time with increased severity, followed by better but progressively gets worse
85-90%

Question 5

Secondary progressive

Answer 5

steady increase in severity post relapse
>80%

Question 6

primary progressive

Answer 6

steady increase in severity since onset
10-15%

Question 7

diagnosis

Answer 7

MRI -> visualise lesions in CNS
Oligoclonal Bands (in CSF) = antibodies in CNS = inflammation

Question 8

prevalence

Answer 8

increases with more distance from equator (because less vitamin d)

Question 9

myelin reactive t cells

Answer 9

recognise self are destroyed or inactive
active? (in MS) genetic component, female, caucasian, smoking, obesity, vit d deficiency

Question 10

cytotoxic t cell

Answer 10

directly interacts with and kills cells (kills oligo)

Question 11

helper t cell

Answer 11

immune generals, direct response of other immune cells, promote pro-inflam

Question 12

b cell

Answer 12

produce antibodies against self

Question 13

antigen presenting cells

Answer 13

activate / reactivate t cells, produce inflam mediators, phagocytose myelin

Question 14

Th1

Answer 14

pathological -> IFN-y, TNF-a

Question 15

Th17

Answer 15

pathological -> IL-17A, GM-CSF

Question 16

Th2

Answer 16

protective - IL4

Question 17

Tregs

Answer 17

protective - IL10

Question 18

pathological t cells

Answer 18

proinflam cytokine release

Question 19

protective t cells

Answer 19

anti inflam cytokine release

Question 20

active lesions

Answer 20

early disease, hypercellular, BBB permeable, demyelinating, axon loss

Question 21

mixed active / inactive lesions

Answer 21

hypocellular centre, demyelinating or post, axon loss, ring of microglia @ boarder

Question 22

inactive lesions

Answer 22

hypocellular (doesnt have any cells in), axon loss, glial scars

Question 23

diffuse global tissue injury

Answer 23

lead to brain injury
inflam, microglia activation, mild demyelination, axon loss

Question 24

oligodendrocyte death & myelin damage

Answer 24

destructed via phagocytosis (from macrophages)
helper t cells -> help via inflam & b cells
leads to myelin loss and oligo death

Question 25

myelin damage

Answer 25

disrupts saltatory conduction, axons more vulncerable to damage, mictochondrial dysfunction, ion channel distribution (still where nodes are), inflammatory mediators

Question 26

remyelination

Answer 26

occurs naturally @ start, getting harder as time progresses (thinner myelin with smaller nodes)

Question 27

remyelination failure - how?

Answer 27

inhibiton of OPC degeneration (from inflam, inhib molecules, astrocyte derived compounds)

Question 28

interferon B

Answer 28

CYTOKINE TO TREAT ms
T CELL ACTIVITY down, antigen presenting cells, b cell prolif down

Question 29

tysabri

Answer 29

dont let immune cells enter brain via antibodies

Question 30

gllenys

Answer 30

s1p receptor modulator, prevents immune cells leaving lymphoid organs

Question 31

ocervus

Answer 31

b cell depleting therapy
anti-CD20 antibody (bound = cell death)

Question 32

stem cell transplantation

Answer 32

immune system reset, replace immune cells with haematopoietic stem cells

Question 33

promoting OPC maturation

Answer 33

promotes remyelination

Question 34

targeting inhibitors of remyelination

Answer 34

encourage phagocytosis of myelin debris

Question 35

microglia

Answer 35

can be pro/anti inflam

Question 36

EBV and MS

Answer 36

infect b cell, overproduction, pro inflam