Multiple Sclerosis

Question 1

Types of M.S

Answer 1

Primary progressive MS
Relapsing-remitting MS
Secondary Progressive MS

Question 2

Rate of Primary progressive MS

Answer 2

5-10%

Question 3

Rate of Relapsing-remitting MS?

Answer 3

20-30%

Question 4

Rate of 2ndary progressive MS?

Answer 4

60%

Question 5

Course of primary progressive MS?

Answer 5

Steady progressive with no remission

Question 6

Course of relapsing-remitting MS?

Answer 6

relapses and remissions with no serious disability

Question 7

Course of 2ndary progressive MS?

Answer 7

at first relapsing & remitting, later progressively deteriorating

Question 8

Onset of MS?

Answer 8

20-40

Question 9

What is MS?

Answer 9

Multiple demyelination of neurons

Question 10

where MS affects mostly?

Answer 10

Optic nerve
Cerebellum
Brain stem
Spinal cord

Question 11

Ocular features of MS?

Answer 11

• Optic neuritis (unilateral visual loss)
  -Intranuclear Ophthalmoplegia (Diplopia or/and nystagmus)
  -Ocular motor cranial neuropathy (sixth nerve palsy)

Question 12

what does MS predominantly affects? white or grey matter?

Answer 12

white

Question 13

F to M frequency of MS?

Answer 13

twice more common in F

Question 14

What happens to MS as distance increases from the equator?

Answer 14

It inreases.

Question 15

Monozygote concordance in MS?

Answer 15

25%

Question 16

Psychiatric features of MS?

Answer 16

Depression
Suicide
Mania
Emotional stability

Question 17

Most common psychiatric feature in MS?

Answer 17

Depression

Question 18

Life-time prevalence of depression in MS?

Answer 18

25-50%

Question 19

Challenge in diagnosis of depression in MS?

Answer 19

Somatic features of depression are not easy to distinguish from that of MS

Question 20

Preferred diagnostic indicators of Depression in MS?

Answer 20

• Severe mood change
• Diurnal Mood
  -Suicidal
  -Pessimistic
  -Functionally impaired not explained to motor disabilities induced by MS

Question 21

First line treatment for depression in MS?

Answer 21

SSRIs

Question 22

given the association between interferon therapy and depression in MS, what is general recommendation?

Answer 22

If there is history of depression, Prophylactic SSRI in those who are put on interferon

Question 23

frequency of suicide in ms?

Answer 23

common

Question 24

risk factor for suicide in MS ?

Answer 24

-Male
-Young onset
-Substance abuse
-Isolation
-Hx of depression

Question 25

Frequency of mania in MS?

Answer 25

common

Question 26

Which Rx if preferred over lithium to treat Mania in MS?

Answer 26

Mood stabilizers

Due to tolerance

Question 27

recommended rx for emotional liability in MS?

Answer 27

SSRI
Amitriptyline

Question 28

Psychiatric side effects of treatments of MS?

Answer 28

• 75% Affective symptoms (Mania>depression)
  -50% Psychosis (hallucination)
  -25% Dilirium

Question 29

how long psychotic side effects of MS treatment last?

Answer 29

days to weeks

Question 30

How long do affective side effects of MS treatments last?

Answer 30

Weeks to months

Question 31

what MS treatments is commonly associated with anxiety and depression?

Answer 31

G l a t i r a m e r

Question 32

Types of INF-Beta given to MS ( just for knowledge maybe)?

Answer 32

*INF-Beta 1A

   Intramuscular 
   Weekly or monthly

*INT-Beta 1b
subcutaneous
every other day