Multiple Sclerosis Falkenberg

Question 1

What is multiple sclerosis?

Answer 1

multiple scarred areas in the brain due to brain lesions in CNS due to demylination

Question 2

What is the pathology of MS?

Answer 2

plaques-scars,lesions
areas of inflammation
infiltration of macrophages and T cells
destruction of myelin
axonal damage

Question 3

Why do we get MS?

Answer 3

YOu have macrophages and lymphoctes and T cells and they get activated by an antigen. Attack oligodendrocytes and myelin

Question 4

T/F

MS causes destruction of myelin as well as destruction of axons

Answer 4

T

Question 5

What is the etiology of MS?

Answer 5

autoimmune disease
environmental
infectious
genetic

Question 6

What is the age of onset of MS?

Answer 6

20-40 yrs

Question 7

What is the most common neurological disease of young adults?

Answer 7

MS

Question 8

Which gender is more likely to have MS?

Answer 8

females

2:1 ratio

Question 9

Is there a genetic component in MS?

Answer 9

yes 1st degree relatives 10-20X risk

monozygotic twins 30% concordance

Question 10

T/F

MS can be associated with where you lived the first 15 years of your life

Answer 10

T

Question 11

T/F

Along the equator is high risk for MS

Answer 11

F

higher north the worst

Question 12

Is the course of MS consitant b/w patients?

Answer 12

no it is variable between individuals

Question 13

What are common symptoms of MS?

Answer 13

visual distubrances
vertig
limb weakness
optic neuritis
numbness
fatigue
pain

Question 14

Is there cognitive impairment in MS patients?

Answer 14

not an impairment, just a slowing of cognitive function (i.e takes longer to find the answer)

Question 15

What are the four main disease patterns of MS?

Answer 15

relapsing-remitting (RRMS) 75%
secondary progressive (SPMS)
primary progressive (PPMS) 10-15%
Progressive-Relapsing (PRMS)

Question 16

What is relapsing remitting MS?

Answer 16

overtime you have deficits and then go back to baseline or just slightly worse

Question 17

What is secondary progressive relapse?

Answer 17

not big relapses, things just get worse

Question 18

50% of RRMS will develop what type of pattern after 10 years, and 90% within 25 years?

Answer 18

Secondary progressive

Question 19

What is primary progressive MS?

Answer 19

linearly worse

Question 20

Progressive relapsing?

Answer 20

spikes of suckiness

Question 21

T/F there are four different pattern types of MS and each patient only has 1

Answer 21

T

Question 22

T/F

early disease of MS may be inflammatory and later may be degenerative

Answer 22

T

Question 23

How do you diagnose MS?

Answer 23

H and P
neuro exam
MRI
Spinal Tap
Evoked potentials (flash light conduction test)
McDonald critera

Question 24

When doing a neurological exam and MRI what do you need to remember?

Answer 24

the lesions are separated by space and time

Question 25

What are UBOs?

Answer 25

unidentified bright objects on the brain :)

Question 26

how can a spinal tap lead you to diagnose MS?

Answer 26

increased oligoclonal bands and increased IgG

Question 27

What is the treatment for MS?

Answer 27

``` managment of acute attacks-steroids managament of symptoms- fatigue modification of disease course improvement or maintenance of physical function -ex. dalfampridine for ambulating psychosocial support ```

Question 28

What is the general treatment for MS?

Answer 28

exercise, nutrition, rest/sleep, stress avoidance, heat avoidance, avoid infections (get your flu shots)

Question 29

T/F Heat makes MS worse

Answer 29

T!

Question 30

What drugs are helpful for MS?

Answer 30

``` beta interferons monoclonal antiboies receptor modulator teraflunomide dimethyl fumerate chemotherapy ```

Question 31

What is a drug that is good for MS but can have a serious sideffect (Progressive multifocal leukoencephalopathy)?

Answer 31

monoclonal antibody

Question 32

What treatments are used for proressive diseases?

Answer 32

nothing really works but they use steroids, chemotherapy, botox, plasma exchange, (alternative treatments: cranial sacral massage, bee venom, goats blood)

Question 33

Why can you treat relapsing remitting but not really progressive MS?

Answer 33

because relapsing and remitting still has its origins in autoimmune problems, once you get to progressive its no longer an autoimmune problem really.

Question 34

When do you want to give disease modifying drugs to MS patients?

Answer 34

As early as possible!!! DO NOT WAIT to give these drugs

Question 35

What is the research future of MS?

Answer 35

stem cells genetics sensitize immune system neuro-protection

Question 36

What is the future testing for MS?

Answer 36

antibody testing | genetics

Question 37

What is the future treatments for MS?

Answer 37

``` small molecule biologics numerous drugs in trials now skin patches tolerance-directed therapy vaccinations ```