Patient talk Flashcards

1
Q

what treatment helps binocular double vision

A

a patch on one eye

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2
Q

what could give you monocular double vision

A

retinal detachment

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3
Q

is monocular or binocular double vision more neurological

A

binocular

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4
Q

which localisation does loss of balance suggest

A

cerebellum

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5
Q

imaging choice to diagnose MS

A

MRI

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6
Q

what localisation does numbness from the weight down suggest

A

thoracic spinal chord

it is tightly packed so a small lesion can cause bilateral dysfunction

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7
Q

what localisation does numbness in 1 leg suggest

A

lesion in sensory cortex of the brain

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8
Q

which test, other than MRI, can confirm MS

A

lumber puncture

immunoglobulin test positive

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9
Q

what can bad lumbar puncture technique cause

A

headache
reduced mobility
nausea
now smaller needles much less likely for CSF leaks through puncture

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10
Q

2 stages of MS

A

relapsing remitting MS

secondary progressive MS - symptoms get worse over time

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11
Q

treatments available

A

many for RR MS

none for secondary progressive MS

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12
Q

MS definition

A

a chronic inflammatory disease of CNS of unknown cause causing oligodendroglial and axonal pathology

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13
Q

who is affected by MS

A

typically young adults with relapsing-remitting pattern or chronic progressive evolution

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14
Q

how do you diagnose MS

A
cerebrospinal fluid (CSF)analysis typically shows indicies of inflammation 
MRI demonstrates characteristic legions in CNS matter - high signals = white spots
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15
Q

onset and symptoms of MS

A

present in young adults - 20-40yrs

involve any neurological function - most commonly sensory, motor and visual symptoms

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16
Q

clinical course of MS

A

begin as relapsing-remitting disorder

evolve into progressive course (secondary progressive MS)

17
Q

diagnosis of MS - summary

A

based on clinical history

supported by CSF analysis and MRI

18
Q

pathophysiology of MS

A

cause unknown
inflammation
loss of myelin in CNS

19
Q

therapy

A

immuno-modulatory and immuno-suppressive treatment (introduced n 1990s) reduce relapses
effect on evolution and progressive MS still unclear

20
Q

case summary - relapse-remitting

A

age 17 - nauseam double vision, L sided numbness - presenting relapse
Attend AandE - lumber puncture, brain infection/inflammation suspected - complete recovery 3 wks
1997 - recurrence - 2nd relapse
1998 - leg numbness waist down, imbalance - 3rd relapse
same winter - 4th relapse
1979 - L leg numbness 10 days - recovery - 5th relapse
1985 (aged 36) - sensory disturbance in mouth - 6th relapse
seen at SMH. LP - confirm inflammation in CNS - diagnosis of relapsing-remitting MS - no treatment

21
Q

case summary - secondary progressive MS

A
1993 (34) - limping L leg 
1995 - stick 
'97 - 1 then 2 crutches
2000 onwards - wheelchair occasionally 
2003 - wheelchair bound 
progressive deterioration over 15 years 
tetraplegic