Sketchy Path: Neuro - "Multiple Sclerosis"

Question 1

Multiple sclerosis results from demyelination of ________________.

Answer 1

oligodendrocytes in the central nervous system (like the white fez on Dr. Who’s head and the cracked oligo-robot)

Question 2

MS most commonly affects ______________.

Answer 2

women in their 20s and 30s

Question 3

What genetic type leads to increased incidence of MS?

Answer 3

HLA-DR2 (like the phone booth’s DooR 2 open)

Question 4

_____________ may trigger MS.

Answer 4

Viral infections (like the dodecahedron on the phone booth)

Question 5

MS is more common in countries _____________.

Answer 5

far from the Equator

Question 6

Active plaques contain lots of ______________.

Answer 6

macrophages eating myelin debris (like the macro-cages on fire around the robot filled with white paper) and activated T cells (like the helper knight with the sword)

Question 7

Active plaques are surrounded by ________________.

Answer 7

reactive gliosis (represented by the astrocyte stars on the robot)

Question 8

Plaques most often form near the _______________, though they can appear anywhere in the CNS.

Answer 8

periventricular area

Question 9

MS presents with what symptoms?

Answer 9

• FNDs separated by time and space (like the time and space phone booth)
• Fatigue (guy lying down)
• Intolerance to heat (like the guy set on fire)
• Optic neuritis (robot with one flaming eye)
• Internuclear ophthalmoplegia, INO (Madame La Fleur hitting robot)
• Bowel and bladder incontinence (robot leaking yellow and brown oils)
• Lhermitte’s sign: a feeling of electricity shooting down the spine with flexion of the neck (robot with electricity shooting out of back)
• Intentional tremor (Winston Churchill shaking his OUTSTRETCHED arm)
• Scanning speech

Question 10

Optic neuritis presents with ocular pain that worsens with ________________.

Answer 10

movement

Question 11

MS commonly presents with ____________ in the distal extremities.

Answer 11

numbness (like the woman wearing gloves)

Question 12

MS can present with _______-reflexia.

Answer 12

hyper (like the robot with the reflex hammer)

Question 13

The best diagnostic for MS is ______________.

Answer 13

MRI showing multiple lesions that change over time

Question 14

In addition to MRI, _______________ can help diagnose MS.

Answer 14

LP (showing IgG oligoclonal bands)

Think of the robots with cloned antibody arms.