Multiple Sclerosis - Hon

Question 1

Common MS symptoms

Answer 1

Paresthesias, gait disturbance, weakness, visual loss, urinary difficulty, dysarthria, hemiparesis

Question 2

Transverse myelitis

Answer 2

Inflammation of 1/2 of spinal cord, causing Brown-Sequard-like symptoms

Question 3

Optic neuritis

Answer 3

Common cause of visual loss in MS

Question 4

4 types of MS

Answer 4

Relapsing, remitting
Secondary progressive (R,R first)
Primary progressive
Benign

Question 5

General causes of MS?

Answer 5

Genetics

Sensitization (childhood event or illness) –> later triggering (viral infection, post-partum)

Question 6

MS on imaging

Answer 6

Ovoid lesions of high signal on T2WI in PERIVENTRICULAR white matter and spinal cord

Question 7

Enhancing lesion = ?

Answer 7

Recent, new, and/or active

Question 8

MS on LP (CSF)

Answer 8

Oligoclonal bands or increased IgG synthesis

Question 9

MS is diagnosed by ____________ (3 criteria)

Answer 9

MULTIPLE LESIONS over SPACE and TIME

Question 10

Old/classic drugs used to slow the progression of MS

Answer 10

Interferon Beta, Glatirimer acetate

Question 11

Drugs ending in “-mab” are for what?

Answer 11

Immune diseases (MS)
"-MAB" = monoclonal antibody

Question 12

FIRST treatment for acute exacerbation of MS

Answer 12

Corticosteroids (Solumedrol) followed by Prednisone taper

Question 13

MS vs. ADEM

Answer 13

ADEM never recurs

Question 14

Classic presentation of MS on imaging (compared to other DDx)

Answer 14

Multiple, enhancing (new) + non-enhancing (old) lesions

Question 15

MS vs. Neuromyelitis Optica (Devic’s)

Answer 15

Devic’s = LONG segments of spinal cord, sparing of brain, Aquaphorin Ab’s in blood and CSF

Question 16

Treatment for NMO

Answer 16

Steroids, plasma exchange, immunosuppresion (Rituxumab)