Multiple Sclerosis

Question 1

What are the 4 different clinical courses of of MS?

Answer 1

1) Relapsing remitting
2) Secondary progressive
3) Progressive relapsing
4) Primary progressive

Question 2

Which drug can help combat fatigue in MS patients?

Answer 2

Modafinil

Question 3

What would be in the differential for MS? (5)

Answer 3

• Vasculitis
• Granulomatous disorder
• Vascular disease
• Structural lesion
• Infection

Question 4

What may be seen on a brain MRI of an MS patient?

Answer 4

Hyper-intensities in the periventricular white matter

Question 5

What are we looking for if we take a LP in an MS patient?

Answer 5

Oligoclonal bands; positive result in 90% of cases, but not a specific test.

Question 6

State 3 treatment options for an individual suffering from sensory symptoms

Answer 6

• Anti-convulsant (e.g. gabapentin)
• Anti-depressant (e.g. amitriptyline)
• TENS machine

Question 7

What can cause urinary tract dysfunction in these patients?

Answer 7

Multifactorial, involving damage to the CNS resulting in urinary retention and detrusor instability.

Question 8

Which drug is 1st line RRMS?

Answer 8

Tecfedira

Question 9

Which infection are those taking 2nd line therapies particularly at risk of and what is the causative virus?

Answer 9

Progressive multifocal leukoencephalopathy; JC virus.

Question 10

How regularly should 2nd line therapy patients be monitored?

Answer 10

6-monthly