Multiple Sclerosis Flashcards
activity of what cells are reduced in MS pts
suppressor CD8+ T cells
activity of what cells are increased in MS patients
inducer T cells
early acute lesions show
marked hypercellularity, macrophage infiltration, and astrocytosis with peri-venous inflammation with lymphocytes and plasma cells
inactive lesions in MS are
hypocellular
lhermitte sign
sensation of electricity down back after flexion of the neck; indicates a lesion of the posterior column of the cervical cord
opitc nueritis is a
painful loss of vision
internucleuar ophthalmoplegia
lesion of the medial longitudinal fasciculus resulting in weakness of the medial rectus with failure of the eye to adduct on the side of the lesion
MS should be considered whenever a young adult presents with
trigeminal neurlagia
uthoff’s phenomenon
avoid hot tubs and saunas
What are the characteristic distrubution and morphology on a T2 weihted MRI
periventricular distribution
dawson’s fingers
juxtacortical
infratentorial
what is used to identifiy areas of active inflammation in MS patients
gadolinium enhancement
self injectables
interferons, glatiramer acetate
infusions
natalizumab, and mitoxantone
orals
fingolimod, teriflunomide, dimethylfumarate
mechanisms of interferon
decrease blood brain barrier permability
side effects of interferons
flu like symptoms and depression
what is the mechanism of glatiramer acetate
activation of T2 suppressor cells
what are the side effects of glatiramer acetate
chest pressure
what are the side effets of teriflunomide (aubagio)
pregnancy category X
what drug has a 6 hour monitoring effect (first dose bradycarida)
fingolimod (gilenya)
what are the side effects of natalizumab (monoclonal antibody)
progressive multifocal leukoencephalopathy (JC virus reactivation)
what drug is approved for secondary progressive MS
mitoxantrone (novantrone)
what is the mechanism for mitoxantrone
broad immunosuppresion of T cells, B cells and macrophages
what are the side effects of mitoxantrone
cardiotoxicity
what drugs are used for severe acute attack of symptoms
treatment of relapse
risk of corticosteriod treatments
avascular necrosis
what is acute disseminated encephalomyelitis
follows infection or vaccination in children resulting in fever, headaches, meningismus (some pts are diagnosed with ADEM later develop MS)
what is the effect of subacute combined degeneration
injury to the posterior column of the spinal cord from a B12 deficiency
what other autoimmune disorders can mimic MS symptoms
lupus, sjorgren and sarcoidosis
what is central pontine mylinolyiss
associated with hyponatremia, ETOH and malnutiriton resulting in dysrathria, opthalmoplegia, mental status change, paralysis, seizures and comma
