multiple sclerosis

Question 1

multiple sclerosis

Answer 1

chronic, inflam, autoimmune, potentially diabiling (can be progressive), brain and spinal cord (white and grey matter)
inflam, demyelination, scar dev (gliosis)

Question 2

demyelination

Answer 2

sclerosis, plaque formation, loss of axons

Question 3

gliosis

Answer 3

glial cells form myelin sheath (affect neural transmission) - CNS or PNS

Question 4

etiology

Answer 4

unknown
autoimmune, may be triggered by infection, genetic predisposition

Question 5

rf

Answer 5

20-40, F (but more severe in M), mod cool climate (northern US), white, fam hx
possible: smoke, vit D def, obesity, infection (epstein barr)

Question 6

patho

Answer 6

autoimmune against myelin sheath (white and grey, brain and spinal)
T lymph crosses BBB, antigen-antibody rxn initiates inflam, attack oligodendrocytes which create myelin, axons demyelinated and plaques/sclerosis forms, axons destroyed (nerve impulses slowed, nerve damage)

Question 7

neurons affected

Answer 7

early: nerve fiber not affected, impulse still transmitted, may notice weakness
later: axons destroyed, impulses blocked, perm loss of function

Question 8

disease course

Answer 8

varying types of progression (most have exacerbations, L of these varies)

Question 9

benign

Answer 9

no disability with return to baseline btw attacks, no loss of function

Question 10

relapse remiting

Answer 10

RRMS
most common, long remission periods, few exacerbations, stable btw, normal disability progression

Question 11

primary progressive

Answer 11

PPMS
steady increase in disability without attacks, no exacerbation-remission course

Question 12

secondary progressive

Answer 12

SPMS
initial relapse-remission that progresses to no remission

Question 13

progressive relapsing

Answer 13

PRMS
steady decline with superimposed attacks

Question 14

cm

Answer 14

none unique, depend on nerve involvement
most common: paresthesia of face, trunk, limbs
decreased muscle function, numb, tingle, weakness, optic neuritis, unilateral vision loss, impaired gait, urinary incont, seizures
cognitive problems (cog fog - [], cant think clearly, not memory issue), vision problems, dep (indep and function), fatigue, pain (chronic/acute, burn/stab), bowel/bladder (c, incont, retention), weakness, paralysis, sexual issues, muscle stiff/spasm, walk/balance (vertigo)