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Flashcards in Clinical classification of MS Deck (19)
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1
Q

What % are RR and what % are PP or PR

A

85% RR

15% PP OR PR

2
Q

What is the first attack in RR MS?

A

Clinically isolated syndrome -
Onset to peak worsening- days
Recover - may be complete or incomplete

3
Q

3 MAIN initial symptoms

A
  1. Sensory MOSTLY LIMB not face (30-43%)
  2. Optic neuritis (14-24%)
  3. Weakness - acute (9-40%)
4
Q

If you have a CIS in MS

A

MAJORITY 50-70% of patients will have multiple lesions on MRI

5
Q

Over time… what happens to MRI burden

A

Increases - total number of accumulated lesions goes up

6
Q

Over time what happens to MRI activity or the number of attacks?

A

DECREASES - more attacks earlier

- permanent disability also goes up

7
Q

What does a new relapse or new lesion mean?

A

Dissemination in time

8
Q

Multiple in MS refers to

A

Multiple in SPACE AND TIME

9
Q

Common symptoms in MS

A
  • easy fatiguability
  • Impaired vision
  • brainstem dysfunction
  • cerebellar problem
  • sensory issues
  • Motor - spasticity
  • retention/incontinnence urinary
10
Q

Common Physical FINDINGS

A
1. intelligence not affected - may have memory loss - attention loss - not linked to disability
2 - Optic nerve atrophy, scotoma, RAPD
3 - impaired smooth pursuit, INO, 
4- Dysarthria
5 - emotional lability
6- exaggerated gag and jaw reflex
7- UMN signs
8 - Decreased vibration/prop/two point discrimination
9 - cerebellar
11
Q

Diagnosis of MS IS PRIMARILY

A

A clinical diagnosis

12
Q

which is more sensitive in MS- cranial or Spinal MRI

A

CRANIAL MRI is more sensitive

OVER 50 - spinal MRI is more specific

13
Q

Majority of MS lesions are

A

Clinically silent

14
Q

spiNAL CORD MRI is abnormal in

A

75% of cases

15
Q

In patients over 50

A

a spinal mri IS valuable! and more specific

16
Q

Differential DX for MS

A
  1. Sarcoidosis
  2. Vasculitis
  3. Lupus
  4. ADEM
  5. HIV
17
Q

When do you question a diagnosis of MS

A
  1. 60
  2. all symptoms leading to single site
  3. lack of optic nerve, oculomotor, sensory or bladder involvement after many years
  4. absence of remission
  5. CSF/MRI persistently normal
18
Q

Unfavorable prognosis

A
  1. high relapse
  2. short interval to second attack
  3. lack of full recovery
  4. older age at onset
  5. male gender
  6. high burden on first MRI
  7. early cerebellar involvement
  8. motor onset
19
Q

Corticosteroids ARE

A

NOT EFFECTIVE IN SLOWING OR PREVENTING PRGORESSION