Multiple sclerosis Flashcards

1
Q

what is the leading cause of neurological disability in America?

A

MS

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2
Q

is MS a demyelinating disease, an axonal disease, or both?

A

both

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3
Q

is MS a disease of white matter, gray matter, or both?

A

both

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4
Q

what is the peak age of onset for MS? what is the range?

A

33 (18-55)

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5
Q

what virus is thought to be a trigger for MS?

A

EBV

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6
Q

what is the only genetic factor of confirmed importance for MS? which chromosome?

A

HLA class two on chromosome 6

HLA-DRBI*1501

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7
Q

what is the concordance rate of MS in monozygotic twins?

A

30%

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8
Q

what represents the highest odds of getting MS?

A

if both parents have it - 35%

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9
Q

what are the immunological features of MS?

A
  • predominantly an aberrant T cell immune response
  • activation of circulating CD4 cells specific for myelin basic protein, proteolipid protein, MOG and MAG
  • dysfunction in the BBB allowing the activated cells to cross into the CNS attacking myelin
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10
Q

what is the most important (and common) type of MS?

A

relapsing-remitting

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11
Q

what are the poor prognostic indicators for MS clinical course?

A
  • male
  • older age at onset
  • posterior fossa symptoms at onset
  • AA
  • significant residual disability from first attack
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12
Q

focal findings in corpus callosum?

A

MS

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13
Q

the presence of what CSF findings is suggestive of MS?

A

oligoclonal IgG bands

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14
Q

what are characteristics of devic’s disease (neuromyelitis optica)?

A
  • affects only optic nerves and cervical spinal cord
  • blindness, quadriplegia
  • spares brain parenchyma
  • purely B cell mediated
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15
Q

what is the pathophysiology of devic’s disease (neuromyelitis optica)?

A

affects aquaporin-4 channels

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16
Q

what is acute disseminated encephalomyelitis (ADEM)?

A
  • febrile illness
  • pediatric more common than adult population
  • typically involves gray and white matter of CNS
  • typically monophasic (SINGLE lesion, not multiple)
17
Q

what is the role of ampryra in MS treatment? what is an adverse effect?

A
  • improvement of gait
  • speeds conduction time in demyelinated nerves
  • seizures