Multiple Sclerosis ; Lecture

Question 1

What is multiple sclerosis (MS)?

Answer 1

MS is an inflammatory demyelinating disease of the central nervous system (CNS), affecting the brain and spinal cord.

Question 2

MS is the most common cause of _________ in young adults in the UK.

Answer 2

disability.

Question 3

True/False: MS is more common in men than in women.

Answer 3

False (female-to-male ratio is 2:1).

Question 4

What are the incidence and prevalence rates of MS in the UK?

Answer 4

Incidence: 7 per 100,000 per year.
Prevalence: 120 per 100,000.

Question 5

The lifetime risk of developing MS is approximately _______

Answer 5

1 in 400.

Question 6

True/False: MS shares a similar epidemiological profile to other autoimmune diseases.

Answer 6

True.

Question 7

What are the key immune cells involved in MS pathophysiology?

Answer 7

CD8 T cells.
Th17 cells.
B cells.
Macrophages.

Question 8

The primary pathological processes in MS include _________, conduction block, and axonal transection.

Answer 8

demyelination.

Question 9

True/False: Axonal loss is irreversible and contributes to permanent disability in MS.

Answer 9

True.

Question 10

What are the common symptoms of MS based on lesion location?

Answer 10

Optic nerve: Visual loss, eye pain.
Cerebral hemispheres: Cognitive changes, visual field loss, hemiplegia.
Brainstem: Eye movement disorders, vertigo, ataxia.
Spinal cord: Weakness, bladder, bowel, and sexual difficulties.

Question 11

MS relapses last >48 hours and are often associated with _________ impairment.

Answer 11

neurological.

Question 12

True/False: Fatigue and cognitive impairment are common in MS, even in the early stages.

Answer 12

true

Question 13

What is the McDonald Criteria for MS diagnosis?

Answer 13

Dissemination in space (DIS).
Dissemination in time (DIT).
No alternative neurologic disease explains the symptoms.

Question 14

MRI findings in MS include _________ lesions, _________ lesions, and _________ fingers.

Answer 14

periventricular; juxtacortical; Dawson’s.

Question 15

True/False: CSF analysis can confirm MS if oligoclonal bands are present without atypical findings.

Answer 15

True.

Question 16

Name three conditions that can also cause oligoclonal bands in CSF except MS.

Answer 16

Lupus (25%).
Sarcoidosis (15–51%).
Behçet’s disease (8–20%).

Question 17

A 21-year-old student presents with ascending weakness, bladder disturbance, and inability to walk. Lumbar puncture shows raised WCC with all lymphocytes, normal protein, and glucose. What should be investigated?

Answer 17

MS, with imaging and further assessment for dissemination in space and time.

Question 18

A key finding on MRI supporting MS is the presence of _________ lesions in the _________.

Answer 18

periventricular; corpus callosum.

Question 19

What are the goals of MS treatment?

Answer 19

Reduce relapse duration with steroids.
Decrease relapse frequency with disease-modifying therapies.
Manage symptoms with supportive therapies.

Question 20

Disease-modifying therapies _________ the rate of disability progression and reduce relapse rates.

Answer 20

slow.

Question 21

True/False: Steroids improve the long-term outcome of MS.

Answer 21

False (they reduce relapse duration but don’t affect long-term outcomes).

Question 22

What are common allied health interventions in MS?

Answer 22

Physiotherapy: Post-relapse recovery, spasticity, functional aids.
Occupational therapy: ADL assistance, fatigue, cognitive aids.

Question 23

Fatigue and neuropathic pain are often managed with _________ and _________ medications.

Answer 23

amantadine; gabapentin.

Question 24

What factors are associated with a worse prognosis in MS?

Answer 24

Male gender.
Older age at onset.
Primary progressive subtype.

Question 25

Early use of _________ improves long-term outcomes by reducing irreversible damage. Context ?

Answer 25

disease-modifying therapies.