PDF - MS

Question 1

Pathology MS?

Answer 1

Acquired disorder w/ immune-mediated destruction of normal CNS myelin and secondary loss of axons

Question 2

Classic MS lesion?

Answer 2

White matter plaques in optic nerves, spinal cord, and brain with a periventricular predominance

Question 3

What is Natalizumab?

Answer 3

Monoclonal Ig which blocks adhesion - effective new treatment for MS
- Limited by potentially severe side effects

Question 4

Who is MS less common in?

Answer 4

People born further from equator

Question 5

Familial risk MS?

Answer 5

Siblings have a 20x greater risk

Question 6

Common MS patient?

Answer 6

• Onset between the ages of 20 - 40

- 2:1 female to male

Question 7

Normal cause death in MS?

Answer 7

Medical complications associated w/ significant immobility

such as infection, malnutrition, and PE

Question 8

What is optic neuritis?

Answer 8

Partial or total loss of vision in one eye

- Most common presenting sign MS

Question 9

Definition MS attack?

Answer 9

• Lasts at least 24 hours in absence of fever or infection

Question 10

`What is a pseudo exacerbation?

Answer 10

Recurrence of previous symptoms during infection

- Depolarization / conduction through myelinated or “healed” CNS region is impaired by elevated temp

Question 11

What does disseminated in space mean?

Answer 11

MS lesions in different parts of CNS

Question 12

Diagnostic prerequisites in MS?

Answer 12

Separation in space and time

Question 13

CSF findings in MS?

Answer 13

1. Oligoclonal bands

2. Increased Ig synthesis

Question 14

Curative treatment MS?

Answer 14

None

Question 15

Rx acute MS attack?

Answer 15

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

Question 16

First maintenance drug in MS?

Answer 16

1. Beta-interferon
2. Glatiramer acetate
   - Were shown to reduce severity / frequency of attacks

Question 17

How does beta interferon work?

Answer 17

Protein that enhances suppressor T-cell function, decreases lymphocyte traffic into CNS, reduce antigen presentation, and lessen cytokine production

Question 18

How does Glatiramer acetate work?

Answer 18

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

Question 19

What is Dalfampridine?

Answer 19

Oral K channel blocker improving walking speed, by enhancin conduction in demyelinated areas in MS

Question 20

What is Natalizumab?

Answer 20

Monoclonal Ig that interferes with binding of lymphocytes to CNS vascular cell adhesion molecules, stopping
autoimmune cells from breaching BBB

Question 21

Side effect Natalizumab?

Answer 21

Reactivation of latent JC polyomavirus, which fatally

infects oligodendrocytes and is untreatable