Multiple Sclerosis

Question 1

activity of what cells are reduced in MS pts

Answer 1

suppressor CD8+ T cells

Question 2

activity of what cells are increased in MS patients

Answer 2

inducer T cells

Question 3

early acute lesions show

Answer 3

marked hypercellularity, macrophage infiltration, and astrocytosis with peri-venous inflammation with lymphocytes and plasma cells

Question 4

inactive lesions in MS are

Answer 4

hypocellular

Question 5

lhermitte sign

Answer 5

sensation of electricity down back after flexion of the neck; indicates a lesion of the posterior column of the cervical cord

Question 6

opitc nueritis is a

Answer 6

painful loss of vision

Question 7

internucleuar ophthalmoplegia

Answer 7

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

Question 8

MS should be considered whenever a young adult presents with

Answer 8

trigeminal neurlagia

Question 9

uthoff’s phenomenon

Answer 9

avoid hot tubs and saunas

Question 10

What are the characteristic distrubution and morphology on a T2 weihted MRI

Answer 10

periventricular distribution
dawson’s fingers
juxtacortical
infratentorial

Question 11

what is used to identifiy areas of active inflammation in MS patients

Answer 11

gadolinium enhancement

Question 12

self injectables

Answer 12

interferons, glatiramer acetate

Question 13

infusions

Answer 13

natalizumab, and mitoxantone

Question 14

orals

Answer 14

fingolimod, teriflunomide, dimethylfumarate

Question 15

mechanisms of interferon

Answer 15

decrease blood brain barrier permability

Question 16

side effects of interferons

Answer 16

flu like symptoms and depression

Question 17

what is the mechanism of glatiramer acetate

Answer 17

activation of T2 suppressor cells

Question 18

what are the side effects of glatiramer acetate

Answer 18

chest pressure

Question 19

what are the side effets of teriflunomide (aubagio)

Answer 19

pregnancy category X

Question 20

what drug has a 6 hour monitoring effect (first dose bradycarida)

Answer 20

fingolimod (gilenya)

Question 21

what are the side effects of natalizumab (monoclonal antibody)

Answer 21

progressive multifocal leukoencephalopathy (JC virus reactivation)

Question 22

what drug is approved for secondary progressive MS

Answer 22

mitoxantrone (novantrone)

Question 23

what is the mechanism for mitoxantrone

Answer 23

broad immunosuppresion of T cells, B cells and macrophages

Question 24

what are the side effects of mitoxantrone

Answer 24

cardiotoxicity

Question 25

what drugs are used for severe acute attack of symptoms

Answer 25

treatment of relapse

Question 26

risk of corticosteriod treatments

Answer 26

avascular necrosis

Question 27

what is acute disseminated encephalomyelitis

Answer 27

follows infection or vaccination in children resulting in fever, headaches, meningismus (some pts are diagnosed with ADEM later develop MS)

Question 28

what is the effect of subacute combined degeneration

Answer 28

injury to the posterior column of the spinal cord from a B12 deficiency

Question 29

what other autoimmune disorders can mimic MS symptoms

Answer 29

lupus, sjorgren and sarcoidosis

Question 30

what is central pontine mylinolyiss

Answer 30

associated with hyponatremia, ETOH and malnutiriton resulting in dysrathria, opthalmoplegia, mental status change, paralysis, seizures and comma