MS and Demyelinating Conditions

Question 1

who gets MS

Answer 1

mainly females in their 30s and 40s

Question 2

clinical features of MS

Answer 2

pyramidal dysfunction
optic neuritis
sensory symptoms
LUTS
cerebellar and brain stem features

Question 3

pyramidal dysfunction describes what features?

Answer 3

increased tone
spasticity
weakness in upper limb extensors and flexors of lower limbs

Question 4

define optic neuritis; what pupil problem is associated with?

Answer 4

painful visual loss for 1-2 weeks

RAPD

Question 5

sensory MS symptoms

Answer 5

pain
paraesthesia
dorsal column loss
numbness
trigeminal neuralgia

Question 6

dorsal column loss indicates loss of what functions

Answer 6

proprioception

vibration

Question 7

what features indicate cerebellar dysfunction?

Answer 7

ataxia
intention tremor
nystagmus
dysdiadokinesis - cant perform rapid movements
dysarthria - difficult speech

Question 8

brain stem dysfunction will affect what nerves?

Answer 8

cranial nerves

Question 9

what cranial nerve functions are affected in MS

Answer 9

diplopia

facial weakness

Question 10

what is internuclear ophthalmoplegia?

Answer 10

eye muscle paralysis

Question 11

presentation of internuclear ophthalmoplegia

Answer 11

distorted binocular vision
cant adduct eye
dipopia
nystagmus
lag

Question 12

do MS patients tend to get FUN or SISI LUTS symptoms?

Answer 12

FUN

Question 13

what kind of incontinence do MS patients get?

Answer 13

urge incontinence

Question 14

Tx of fatigue in MS

Answer 14

amantadine
modafinil if sleepy
O2

Question 15

how is MS diagnosed

Answer 15

2 episodes of demyelination

mcdonald criteria

Question 16

MS differentials

Answer 16

vasculitis
granulomatous disorder
vascular disease
infection
metabolic

Question 17

MS Ix

Answer 17

MRI
CSF
neurophysiology
blood tests

Question 18

what are the mcdonald criteria for MS?

Answer 18

lesion in more than 1 MS typical region

presence of contrast-enhancing and/or non-contrast enhancing lesions

Question 19

plasma viscosity is high in MS patients T or F

Answer 19

F

Question 20

MS is mainly a/an ____ disorder

Answer 20

inflammatory

Question 21

Tx of MS

Answer 21

DMARDs

symptomatic treatment

Question 22

Tx of mild acute exacerbation of MS

Answer 22

symptomatic Tx

Question 23

Tx of moderate acute exacerbation of MS

Answer 23

oral steroids

Question 24

Tx of severe acute exacerbation of MS

Answer 24

IV steroids

Question 25

will pyramidal dysfunction cause spasticity or flaccidity?

Answer 25

spasticity

Question 26

Tx for pyramidal dysfunction

Answer 26

anti-spasmodic agent

Question 27

Tx for spasticity

Answer 27

physio
baclofen
tizanidine
botox

Question 28

sensory symptoms experienced by MS patients?

Answer 28

pain
paraesthesia
numbness
trigeminal neuralgia

Question 29

how should sensory symptoms be treated in MS?

Answer 29

anti-convulsant eg gabapentin

anti-depressant eg amitriptyline

Question 30

why do people with MS get LUTS symptoms?

Answer 30

increased tone at bladder neck from detrusor muscle hypersensitivity

Question 31

Tx for LUTS symptoms in MS

Answer 31

bladder drill
oxybutynin
desmopressin
catheter

Question 32

name the different kinds of MS in terms of severity

Answer 32

subclinical
monosymptomatic
relapsing-remitting
secondary progressive

Question 33

brain volume ___ as MS progresses

Answer 33

decreases

Question 34

first line DMARD for MS

Answer 34

interferon beta

Question 35

second line DMARD therapy for MS

Answer 35

monoclonal antibodies

Question 36

third line DMARD therapy for MS

Answer 36

mitoxantrone

Question 37

interferon beta is delivered via what route

Answer 37

injection

Question 38

first line Tx for RR MS

Answer 38

tecfidera

Question 39

pathological process in MS?

Answer 39

immune cells pass through BBB
cells reactivate recruiting cytokines
immune cells attack myelin