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Neurology > Multiple sclerosis > Flashcards

Multiple sclerosis Flashcards

1
Q

Treatment for fatigue

A

Amantadine
Modafenil if sleepy
Hyperbaric oygen

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2
Q

Diagnosis of MS

A

At least 2 epsidoes suggestive of demyelination
Dissemination in time and place
McDonald criteria

Obv look at MRI and CSF etc

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3
Q

Evoked responses in MS

A

Delay in visual evoked response

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4
Q

Treatment for exacerbation of MS

A

Steroids

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5
Q

Spasticity treatment options

A

Passmedicine –> baclofen (gabapentin)

Education
Physiotherapy
Oral medication - baclofen,tizanidine
I.M. Botulinum toxin
Nerve blocks
Intrathecal baclofen / phenol   
Surgery
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6
Q

What is tizanadine?

A

A muscle relaxant

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7
Q

Treatment for sensory symptoms

A 
anti convulsant  eg. gabapentin
anti depressant eg. amitriptyline
tens machine
Acupuncture
Lignocaine infusion
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8
Q

Treatment for urinary tract dysfunction

A

Anticholinergics e.g oxybutynin
Desmopressin
Catheter

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9
Q

First line disease modifying therapy

A

Interferon beta
Copaxone
Tecfidera

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10
Q

Second line disease modifying therapy

A

Tysabri

Fingolimod

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11
Q

Third line disease modifying therapy

A

Mitoxantrone

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12
Q

Effect of interferon beta/copaxone

A

Reduce relapses by 1/3rd

Decreases severity of relapse by 50%

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13
Q

How do you adminster beta interferon/copaxone

A

Injectable - SC / IM

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14
Q

First line for relapsing remitting MS

A

Tecfidera

-44% reduction in relapse rate

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15
Q

How is tecfidera administered?

A

Orally

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16
Q

Treatment for:
Patients with rapidly evolving severe relapsing remitting multiple sclerosis

Patients with high disease activity despite treatment with a interferon

A

Tysabri

17
Q

Role of alpha4beta1 integrins in MS

A

Allow T cells to cross the BBB

18
Q

How does tysabri work?

A

Acts against the receptor that allows immune cells to cross the BBB

19
Q

Whats the weird thing you have to be really careful with when using tysabri?

A

JC virus

can cause PML - estimated risk 1/385 after 2 years

20
Q

What can JC virus cause?

A

PML (progressive multifocal leucoencephalopathy)

21
Q

How does fingolimod work?

A

S1P modulator

22
Q

When can you use mitoxantrone?

A

For relapsing progressive MS

23
Q

How many infusions of mitoxantrone can you receive?

A

12 over 2 years

-cardiac toxicity dose related

Neurology (56 decks)

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