Multiple Sclerosis Falkenberg Flashcards
What is multiple sclerosis?
multiple scarred areas in the brain due to brain lesions in CNS due to demylination
What is the pathology of MS?
plaques-scars,lesions areas of inflammation infiltration of macrophages and T cells destruction of myelin axonal damage
Why do we get MS?
YOu have macrophages and lymphoctes and T cells and they get activated by an antigen. Attack oligodendrocytes and myelin
T/F
MS causes destruction of myelin as well as destruction of axons
T
What is the etiology of MS?
autoimmune disease
environmental
infectious
genetic
What is the age of onset of MS?
20-40 yrs
What is the most common neurological disease of young adults?
MS
Which gender is more likely to have MS?
females
2:1 ratio
Is there a genetic component in MS?
yes 1st degree relatives 10-20X risk
monozygotic twins 30% concordance
T/F
MS can be associated with where you lived the first 15 years of your life
T
T/F
Along the equator is high risk for MS
F
higher north the worst
Is the course of MS consitant b/w patients?
no it is variable between individuals
What are common symptoms of MS?
visual distubrances vertig limb weakness optic neuritis numbness fatigue pain
Is there cognitive impairment in MS patients?
not an impairment, just a slowing of cognitive function (i.e takes longer to find the answer)
What are the four main disease patterns of MS?
relapsing-remitting (RRMS) 75%
secondary progressive (SPMS)
primary progressive (PPMS) 10-15%
Progressive-Relapsing (PRMS)
What is relapsing remitting MS?
overtime you have deficits and then go back to baseline or just slightly worse
What is secondary progressive relapse?
not big relapses, things just get worse
50% of RRMS will develop what type of pattern after 10 years, and 90% within 25 years?
Secondary progressive
What is primary progressive MS?
linearly worse
Progressive relapsing?
spikes of suckiness
T/F there are four different pattern types of MS and each patient only has 1
T
T/F
early disease of MS may be inflammatory and later may be degenerative
T
How do you diagnose MS?
H and P neuro exam MRI Spinal Tap Evoked potentials (flash light conduction test) McDonald critera
When doing a neurological exam and MRI what do you need to remember?
the lesions are separated by space and time
What are UBOs?
unidentified bright objects on the brain :)
how can a spinal tap lead you to diagnose MS?
increased oligoclonal bands and increased IgG
What is the treatment for MS?
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
What is the general treatment for MS?
exercise, nutrition, rest/sleep, stress avoidance, heat avoidance, avoid infections (get your flu shots)
T/F Heat makes MS worse
T!
What drugs are helpful for MS?
beta interferons monoclonal antiboies receptor modulator teraflunomide dimethyl fumerate chemotherapy
What is a drug that is good for MS but can have a serious sideffect (Progressive multifocal leukoencephalopathy)?
monoclonal antibody
What treatments are used for proressive diseases?
nothing really works but they use steroids, chemotherapy, botox, plasma exchange,
(alternative treatments: cranial sacral massage, bee venom, goats blood)
Why can you treat relapsing remitting but not really progressive MS?
because relapsing and remitting still has its origins in autoimmune problems, once you get to progressive its no longer an autoimmune problem really.
When do you want to give disease modifying drugs to MS patients?
As early as possible!!! DO NOT WAIT to give these drugs
What is the research future of MS?
stem cells
genetics
sensitize immune system
neuro-protection
What is the future testing for MS?
antibody testing
genetics
What is the future treatments for MS?
small molecule biologics numerous drugs in trials now skin patches tolerance-directed therapy vaccinations
