Multiple Sclerosis

Question 1

def multiple sclerosis

Answer 1

autoimmune inflammation and demyelination of the central nervous system

Question 2

RF for multiple sclerosis

Answer 2

genetics
EBV
smoking
vitamin D deficiency
obesity
northern european

Question 3

epi for multiple sclerosis

Answer 3

young (20-40Y) females

Question 4

basic patho for multiple sclerosis

Answer 4

triggering of T cells ➔ cytokines ➔ immune cells vs myelin sheaths and oligodendrocytes ➔ demyelination ➔ axons ➔ scar tissue ➔ gliosis ➔ inadequate remyelination

but basically autoimmune rxn vs the mueline sheath ➔ demyelination and damage to the underlying nerve/axons ➔ slowed or disrupted nerve impulses

Question 5

presentation of multiple sclerosis

Answer 5

common first presentation: optic neuritis

cerebellar involvement (charcot’s triad): scanning/slurred speech, nystagmus, tremors

other:
- transverse myelitis: back pain, bowel/bladder dysfunction, weakness/sensation changes in limbs

Question 6

how to ix MS?

Answer 6

r/o other potential causes for MS symptoms

MS criteria ➔ use MRI and CSF analysis to support dx
- may see demyelinating lesions in the CNS

Question 7

how to tx MS

Answer 7

refer to neurologist ➔ consider rheum and ophthalmology
acutely - can give steroids

otherwise tx the symptoms

pt education on resources they can access