Multiple sclerosis Flashcards

1
Q

what is multiple sclerosis

A

chronic inflammatory and degenerative disease of the central nervous system

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2
Q

what characterises MS

A

inflammation
demyelination +/- variable extent of remyelination
neuronal injury/loss
astrogliosis

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3
Q

what are the risk factors for MS

A

genetics play a part
vitamin D deficiency
smoking
Epstein-Barr virus
obesity
can have every risk factor and still not get MS

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4
Q

what are the clinical features of MS

A

begin with attacks of symptoms (relapsing-remitting MS) where there is a focal area of scarring in a clinically eloquent area of the brain
reaches a point where patients can’t recover from these relapses and get progressively worse (secondary progressive MS)

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5
Q

what occurs in secondary progressive MS

A

diffuse activation of microglia and diffuse loss of neural tissue known as neurodegeneration

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5
Q

what is primary progressive MS

A

continuously degenerating MS

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6
Q

how is MS diagnosed

A

diagnosis of exclusion
history/examination (dissemination in space and time)
tests to support diagnosis such as lumbar puncture and MRI
diagnostic criteria are called the Mcdonald criteria

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7
Q

what is dissemination in space and how is it determined

A

lesions that have occurred in different anatomical regions
can be determined using MRI

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8
Q

what is dissemination in time and how is it determined

A

separate events that don’t occur at the same time
contrast called gadolinium will show dissemination of time as acute lesions upon MRI will show leakiness, whereas, more longstanding lesions will not
from a lumbar puncture oligoclonal bands in CSF that don’t match up with the serum bands indicate there is inflammation in the brain not present in the blood, shows dissemination in time

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9
Q

what is the treatment for MS

A

mostly for the relapsing-remitting stage
immunosuppressant and immunomodulatory for relapsing-remitting stage known as disease-modifying therapies
for the progressive stage there is no treatment, focus on management

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