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Neuro > Multiple Sclerosis and other inflammatory CNS diseases > Flashcards

Multiple Sclerosis and other inflammatory CNS diseases Flashcards

1
Q

What is Multiple Sclerosis?

A

An inflammatory demyelinating disorder of the CNS

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2
Q

What does MS usually present?

A

30’s and 40’s

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3
Q

What are some clinical features of MS?

A 
Pyramidal dysfunction
Optic Neuritis
Sensory Symptoms
LR urinary tract dysfunction
Cerebellar and brain stem features
Cognitive impairment
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4
Q

What are the Pyramidal dysfunction?

A 
Increased tone
Spasticity
Weakness
Extensors of upper limbs
Flexors of lower limbs
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5
Q

What are the Sensory Symptoms?

A 
Pain
Paraesthesia
Dorsal column loss (Proprioception and vibration)
Numbness
Trigeminal neuralgia
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6
Q

What are the cerebellar dysfunctions?

A 
Ataxia
Intention Tremor
Nystagmus
Past pointing
Pendular reflexes
Dysdiadokinesis
Dysarthria
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7
Q

Diplopia is caused by problems with which cranial nerve?

A

VI Palsy

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8
Q

Facial weakness is caused by a problem with which cranial nerve?

A

VII Palsy

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9
Q

What is Internuclear Ophthamoplegia?

A 
Medial Longitudinal fasciculus
Distortion of binocular vision
Failure of adduction (diplopia)
Nystagmus in abducting eye
Lag
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10
Q

What drug can help with sleepiness?

A

Modafinil

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11
Q

What drug can help with fatigue?

A

Amantadine

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12
Q

What is the criteria for diagnosing MS?

A

At least 2 episodes of demyleniation
Dissemination in time and place
McDonald criteria

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13
Q

What tests are used to diagnose MS?

A

Clinical
MRI/CT
Neurophysiology
Blood tests

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14
Q

What blood tests are useful in diagnosing MS?

A 
PV, FBC, CRP
Renal liver bone profile
Auto antibody screen
Borellia, HIV, syphilis serology
B12 and folate
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15
Q

What is the treatment for a mild acute exacerbation of MS?

A

Symptom control

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16
Q

What is the treatment for a moderate acute exacerbation of MS?

A

Oral Steroids

17
Q

What is the treatment for a severe acute exacerbation of MS?

A

Admit/IV steroids

18
Q

What are potential treatments for spasticity?

A

Physio
Baclofen/Tizanidine
Botulinum toxin
Intrathecal baclofen/phenol

19
Q

Give an example of an anti-convulsant?

A

gabapentin

20
Q

Give an example of an anti-depressant?

A

Amitriptyline

21
Q

What drugs can help with incontinence?

A

Anti-cholinergics e.g. Oxybutynin

22
Q

What are first line drugs for MS?

A 
Interferon Beta (Avonex, Rebif, Betaseron, Extavia
Glitiramer acetate (Capaxone)
Tecfedira
23
Q

What are second line drugs for MS?

A

Monoclonal antibody - Tysabri, Lemtrada

Fingolimod

24
Q

What is a 3rd line drug for MS?

A

Mitoxantrone

25
Q

What virus is positive with PML associated with TYSABRI?

26
Q

What is Uhthoff’s sign?

A

When heat makes a demylenating disorder worse

Neuro (19 decks)

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