SECRETS Neurology - MS

Question 1

MS classic pt

Answer 1

young woman
mult episodes of neuro dysfunction = limb paresthesias, motor weakness, visual impairment (neuritis), internuclear ophthalmoplegia, vertigo

bladder, bowel incontinence
intention tremor
sensory deficits on one side of body

Question 2

MS pathognomonic

Answer 2

bilateral internuclear ophthalmoplegia

Question 3

MS pathophysiology

Answer 3

T-cell recognition of myelin basic protein as antigen –> activate immune system against myelin sheath and oligodendrocytes

type IV hypersensitivity reaction

autoantibodies against myelin sheath and oligodendrocytes

Question 4

MS progression

Answer 4

relapsing and remitting
or
chronically progressive

Question 5

MS MRI & CSF electrophoresis findings

Answer 5

multiple plaques in diff areas of white matter, esp periventricular areas

oligoclonal Ig bands
+ IgG & myelin basic protein

Question 6

MS UMN or LMN?

Answer 6

UMN

Question 7

MS tx

Answer 7

interferon-B to decrease rate of relapse
immunosuppressive drugs to decrease progression

no tx to decrease severity of attacks