PDF - MS Flashcards
Pathology MS?
Acquired disorder w/ immune-mediated destruction of normal CNS myelin and secondary loss of axons
Classic MS lesion?
White matter plaques in optic nerves, spinal cord, and brain with a periventricular predominance
What is Natalizumab?
Monoclonal Ig which blocks adhesion - effective new treatment for MS
- Limited by potentially severe side effects
Who is MS less common in?
People born further from equator
Familial risk MS?
Siblings have a 20x greater risk
Common MS patient?
- Onset between the ages of 20 - 40
- 2:1 female to male
Normal cause death in MS?
Medical complications associated w/ significant immobility
such as infection, malnutrition, and PE
What is optic neuritis?
Partial or total loss of vision in one eye
- Most common presenting sign MS
Definition MS attack?
- Lasts at least 24 hours in absence of fever or infection
`What is a pseudo exacerbation?
Recurrence of previous symptoms during infection
- Depolarization / conduction through myelinated or “healed” CNS region is impaired by elevated temp
What does disseminated in space mean?
MS lesions in different parts of CNS
Diagnostic prerequisites in MS?
Separation in space and time
CSF findings in MS?
- Oligoclonal bands
2. Increased Ig synthesis
Curative treatment MS?
None
Rx acute MS attack?
A few days of IV, high-dose steroids, 500-
1000 mg/day for 3-5 days, w/ or w/o oral taper
*Never used as maintenance Rx
First maintenance drug in MS?
- Beta-interferon
- Glatiramer acetate
- Were shown to reduce severity / frequency of attacks
How does beta interferon work?
Protein that enhances suppressor T-cell function, decreases lymphocyte traffic into CNS, reduce antigen presentation, and lessen cytokine production
How does Glatiramer acetate work?
Polypeptide resembling myelin basic protein, a byproduct of myelin destruction
- May compete w/ myelin antigens in binding to antigen presenting inflammatory cells, and favorably influence lymphocyte activity and cytokine production
What is Dalfampridine?
Oral K channel blocker improving walking speed, by enhancin conduction in demyelinated areas in MS
What is Natalizumab?
Monoclonal Ig that interferes with binding of lymphocytes to CNS vascular cell adhesion molecules, stopping
autoimmune cells from breaching BBB
Side effect Natalizumab?
Reactivation of latent JC polyomavirus, which fatally
infects oligodendrocytes and is untreatable
