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Block 5 Week 6 Dani > Multiple Sclerosis Falkenberg > Flashcards

Multiple Sclerosis Falkenberg Flashcards

1
Q

What is multiple sclerosis?

A

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

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2
Q

What is the pathology of MS?

A 
plaques-scars,lesions
areas of inflammation
infiltration of macrophages and T cells
destruction of myelin
axonal damage
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3
Q

Why do we get MS?

A

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

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4
Q

T/F

MS causes destruction of myelin as well as destruction of axons

A

T

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5
Q

What is the etiology of MS?

A

autoimmune disease
environmental
infectious
genetic

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6
Q

What is the age of onset of MS?

A

20-40 yrs

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7
Q

What is the most common neurological disease of young adults?

A

MS

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8
Q

Which gender is more likely to have MS?

A

females

2:1 ratio

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9
Q

Is there a genetic component in MS?

A

yes 1st degree relatives 10-20X risk

monozygotic twins 30% concordance

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10
Q

T/F

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

A

T

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11
Q

T/F

Along the equator is high risk for MS

A

F

higher north the worst

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12
Q

Is the course of MS consitant b/w patients?

A

no it is variable between individuals

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13
Q

What are common symptoms of MS?

A 
visual distubrances
vertig
limb weakness
optic neuritis
numbness
fatigue
pain
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14
Q

Is there cognitive impairment in MS patients?

A

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

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15
Q

What are the four main disease patterns of MS?

A

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

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16
Q

What is relapsing remitting MS?

A

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

17
Q

What is secondary progressive relapse?

A

not big relapses, things just get worse

18
Q

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

A

Secondary progressive

19
Q

What is primary progressive MS?

A

linearly worse

20
Q

Progressive relapsing?

A

spikes of suckiness

21
Q

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

A

T

22
Q

T/F

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

A

T

23
Q

How do you diagnose MS?

A 
H and P
neuro exam
MRI
Spinal Tap
Evoked potentials (flash light conduction test)
McDonald critera
24
Q

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

A

the lesions are separated by space and time

25
Q

What are UBOs?

A

unidentified bright objects on the brain :)

26
Q

how can a spinal tap lead you to diagnose MS?

A

increased oligoclonal bands and increased IgG

27
Q

What is the treatment for MS?

A 
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
28
Q

What is the general treatment for MS?

A

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

29
Q

T/F Heat makes MS worse

A

T!

30
Q

What drugs are helpful for MS?

A 
beta interferons
monoclonal antiboies
receptor modulator
teraflunomide
dimethyl fumerate
chemotherapy
31
Q

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

A

monoclonal antibody

32
Q

What treatments are used for proressive diseases?

A

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

33
Q

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

A

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

34
Q

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

A

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

35
Q

What is the research future of MS?

A

stem cells
genetics
sensitize immune system
neuro-protection

36
Q

What is the future testing for MS?

A

antibody testing

genetics

37
Q

What is the future treatments for MS?

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

Block 5 Week 6 Dani (9 decks)

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