Multiple Sclerosis Flashcards
Most young adults are diagnosed with which subtype of MS?
Relapsing-Remitting MS (RRMS)
Most middled-aged patients are diagnosed with which subtype of MS?
Primary Progressive MS (PPMS)
RRMS which converts to PPMS is called what?
Secondary Progressive MS (SPMS)
What is it called when a patient has a single MS attack?
Clinically Isolated Syndrome (CIS)
What is it called when a patient has MS on MRI without clinical symptoms?
Radiologically Isolated Syndrome (RIS)
Epidemiologically, what are the characteristics of a typical MS patient when first diagnosed?
A young Caucasian woman
Does MS affect white or gray matter?
Both!
Meningeal nodules from MS are made of what types of cells?
B and plasma cells
Which HLA type confers a three-fold risk for MS?
HLA DR2
How much more at risk are you for MS if a first-degree relative is diagnosed?
10-20 fold risk
What are some environmental risk factors for MS?
Viruses (esp EBV), VitD deficiency, smoking, obesity
What is the result of a high salt diet?
There is no increased risk for development of MS, but a high salt diet is linked to worsening of progression when disease is already present.
Are neurological findings on an MS patient usually bilateral or unilateral?
Unilateral
What are the anatomical regions of the brain where MS is usually visualized with MRI?
Periventricular regions, corpus callosum, juxtacortical areas, spinal cord, brainstem and cerebellum.
What role does CSF analysis play in diagnosing MS?
Not much of a diagnostic role - mostly used for research.
What would be the results of Evoked Potentials in an MS patient?
Prolonged conduction rate times consistent with demyelination.
Evoked Potentials are only used in the diagnosis of what subtype of MS?
PPMS
What is the most prognostic MRI finding?
Atrophy
What psychiatric condition are MS patients highly at risk for?
Depression and suicide
What percentage of RRMS cases evolve into SPMS?
50%
What is the main treatment for acute attacks?
Steroids (plasma exchange for severe demyelination unresponsive to steroids)
What is the “ABC-R” 1st line therapy for RRMS?
Avonex (IF beta-1a), Betaseron (IF beta-1b), Copaxone (Glatiramer acetate), Rebif (IF beta-1a)
Tysabri (Natalizumab) is a new monoclonal antibody against what?
alpha4-integrin
