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Neurology > Multiple Sclerosis > Flashcards

Multiple Sclerosis Flashcards

1
Q

An autoimmune disorder that causes segmental demyelination of neurons in CNS

A

Multiple Sclerosis

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2
Q

The cardinal sign of MS

A

Charcot’s Triad

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3
Q

Charcot’s Triad

A

SIN: Scanning speech, Intention tremor, Nystagmus

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4
Q

Etiology of MS

A

Idiopathic

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5
Q

6 Risk factors of MS

A

Female, 20-40 years old, Geographical pattern, Family History, Smoking, Vitamin D Deficiency

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6
Q

Hallmark of MS

A

Multifocal Plaque Formation

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7
Q

Oligodendrocytes ratio

A

1:60

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8
Q

What imaging is used to detect Multifocal Plaque Formation?

A

MRI

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9
Q

Criteria used to confirm MS

A

Mcdonald’s Criteria

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10
Q

Mcdonald’s Criteria: 2 plaques

A

Clinically definite

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11
Q

Mcdonald’s Criteria: 1 attack

A

Clinically possible

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12
Q

Mcdonald’s Criteria: 1 or 2 plaques

A

Clinically probable

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13
Q

Mcdonald’s Criteria: 1 or 2 attack

A

Clinically probable

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14
Q

Mcdonald’s Criteria: 1 plaque

A

Clinically possible

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15
Q

Mcdonald’s Criteria: 2 attack

A

Clinically definite

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16
Q

Distinct pathologic pattern: Apoptosis of oligodendrocytes

A

Type 3

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17
Q

Distinct pathologic pattern: Cell-mediated destruction of myelin sheath by T-cells

A

Type 1

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18
Q

Distinct pathologic pattern: Primary degeneration of oligodendrocytes

A

Type 4

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19
Q

Distinct pathologic pattern: Cell-mediated destruction of myelin sheath by T-cells and Immunoglobulins

A

Type 2

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20
Q

What distinct pathologic pattern has a (+) repair of oligodendrocytes

A

Type 1 and 2

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21
Q

What is the most common distinct pathologic pattern of MS?

A

Type 2: Cell-mediated destruction of myelin sheath by T-cells and Immunoglobulins

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22
Q

What is the least common distinct pathologic pattern of MS?

A

Type 4: Primary degeneration of oligodendrocytes

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23
Q

Medications that are given in patients with MS

A

Immuno-regulator medications: Interferon B

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24
Q

Four medications under Interferon B

A

Betaseron, Extavia, Avonex, Rebif

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25
Q

Medication given during acute MS

A

Corticosteroid

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26
Q

MS sites of Predilection

A

POB CCCC: Periventricular white matter, Optic Nerve, Brainstem, Cortex, Cerebellum, Cervical SC (posterior white column)

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27
Q

What ST is present in MS?

A

Lhermitte Sign

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28
Q

Five clinical types of MS

A

Relapsing-Remitting, Secondary-Progressive, Primary-Progressive, Progressive-Relapsing, Fulminant

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29
Q

Progressive disease with little to no attacks

A

PPMS: Primary Progressive MS

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30
Q

Rapid progressive disease with series of attacks later in the course

A

Fulminant MS

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31
Q

Progressive disease with series of attacks later in the course

A

PRMS: Progressive Relapsing MS

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32
Q

Clinical type due to the patient not following prescribed intake of medicines

A

SPMS: Secondary Progressive MS

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33
Q

Exacerbating-remitting MS

A

RRMS: Relapsing Remitting MS

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34
Q

What is the onset symptoms of RRMS?

A

Sensory: paresthesia and optic neuritis

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35
Q

Poor prognosticating indicator of MS

A

Male, Motor onset, older onset, polysymptomatic onset, fewer MRI lesion

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36
Q

Most common clinical type of MS

A

RRMS

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37
Q

Least common clinical type of MS

A

PRMS

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38
Q

Percentage of RRMS

A

85%

39
Q

Percentage of SPSM

A

20%

40
Q

Percentage of PPMS

A

10%

41
Q

Percentage of PRMS

A

5%

42
Q

7 functional system affected in MS

A

Visual system, Pyramidal system, Sensory system, Cerebellar system, Brainstem, Mental System, Bowel/Bladder system

43
Q

Four clinical manifestation under visual system

A

Optic Neuritis, Nystagmus, Visual Scotoma, Diplopia/Ophthalmoplegia

44
Q

Ice pick like sensation behind eye with graying/blurring of vision that may lead to blindness

A

Optic Neuritis

45
Q

(+) Dark spots in the visual field

A

Visual Scotoma

46
Q

What extremity is most commonly affected in MS?

A

LE

47
Q

Most common, disabling symptom of MS

A

Fatigue

48
Q

Pseudo-exacerbation of symptoms due to increase body temperature

A

Uthoff’s phenomenon

49
Q

Fatigue exacerbates due to _____?

A

Worst in hot temperature

50
Q

Pseudo-exacerbation of Uthoff’s phenomenon is reversible after what time?

A

<24 hours

51
Q

Most common presenting symptoms of MS

A

Paresthesia

52
Q

Description of Paresthesia felt by MS

A

Electric-like sensation

53
Q

What paresthesia felt in the face?

A

Trigeminal Neuralgia / Tic Doulourex / Paroxysmal Pain Syndrome

54
Q

What paresthesia felt in the limb?

A

Paroxysmal Limb Pain / Dysesthetic Limb

55
Q

What paresthesia felt in the trunk?

A

MS Hug

56
Q

One of the most common pain complaint of patient’s with MS

A

Headache

57
Q

Hypersensitivity to light stimulus

A

Hyperpathia

58
Q

Painful band sensation around trunk

A

MS Hug

59
Q

Most common type of pain felt in MS

A

Paroxysmal Limb Pain / Dysesthetic Limb

60
Q

Five cerebellar ataxia seen in MS

A

Dysmetria, Dyssynergia, Dysdiadochokinesia, Intention Tremor, Gait Ataxia

61
Q

Description of gait ataxia

A

Drunkeness

62
Q

Cranial nerves affected in brainstem

A

CN 2,5,7,8

63
Q

Most common speech problem seen in MS with description as problem with controlling the volume

A

Scanning speech

64
Q

Three mental status manifestation of MS

A

Dementia, Attention deficit, Memory loss

65
Q

Most common bowel problem in MS

A

Constipation

66
Q

Most common bladder problem in MS

A

Detrussor Hyperflexia

67
Q

Four female sexual problems in MS

A

Decrease sensation, Loss of Libido, Vaginal Dryness, Difficulty in reaching orgasm

68
Q

Four male sexual problems in MS

A

Decrease sensation, Loss of Libido, Difficulty in ejaculation, Impotence

69
Q

Scale used to classify MS functional activity

A

Kurtzke Expanded Disability scale

70
Q

Kurtzke: No disability

A

1, 1.5

71
Q

Kurtzke: Fully ambulating without rest and assistance

A

4, 4.5, 5, 5.5

72
Q

Kurtzke: Bed bound

A

8, 8.5

73
Q

Kurtzke: Moderate disability

A

3, 3.5

74
Q

Kurtzke: Intermittent unilateral assistance 100m

A

6

75
Q

Kurtzke: Death

A

10

76
Q

Kurtzke: Normal

A

0

77
Q

Kurtzke: Bed ridden

A

9, 9.5

78
Q

Kurtzke: Moderate d/a 1 functional system

A

3

79
Q

Kurtzke: No d/a minimal sign in 2 functional system

A

1

80
Q

Kurtzke: Constant bilateral assistance 20m

A

6.5

81
Q

Kurtzke: Cannot walk beyond 5m

A

7

82
Q

Kurtzke: Minimal disability in 2 functional system

A

2.5

83
Q

Kurtzke: Unable to take few more steps

A

7.5

84
Q

Kurtzke: 500m

A

4

85
Q

Kurtzke: 100m

A

5.5

86
Q

Kurtzke: cannot eat, talk, swallow

A

9.5

87
Q

Kurtzke: can be out of bed

A

6

88
Q

Kurtzke: 200m

A

5

89
Q

Kurtzke: bed bound much of the day

A

8.5

90
Q

Kurtzke: can eat, talk, swallo

A

9

91
Q

Kurtzke: 300m

A

4.5

92
Q

Score for benign MS

A

<3

93
Q

Score of Malignant MS

A

3 or more

94
Q

Another name of malignant MS

A

Marburg Disease

Neurology (14 decks)

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