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Neurology (Calum) > MS > Flashcards

Flashcards in MS Deck (32)
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1
Q

What is MS?

A

an inflammatory demyelinating disorder of the CNS

2
Q

What is significant about the plaques in MS?

A

disseminated in time and place

3
Q

What sex has most common incidence of MS?

A

Female 3:1

4
Q

What are the 4 clinical courses of MS?

A

Relapsing Remitting
Primary Progressive
Progressive relapsing
Secondary Progressive

5
Q

Describe relapsing remitting MS?

A

flare ups followed by asymptomatic phases

6
Q

Describe the clinical course of primary progressive MS?

A

constantly worsening gradually over a period of time

7
Q

Describe the clinical course of progressive relapsing MS?

A

constant gradual progression combined with flare ups and partial remission

8
Q

Describe the clinical course of secondary progressive MS?

A

asymptomatic + flare ups and then gradual progression.

9
Q

What category of dysfunction do symptoms such as hypertonia, spasticity and weakness come under?

A

pyramidal dysfunction

10
Q

Which eye condition is commonly seen in MS?

A

optic neuritis

11
Q

Is optic neuritis painless or painful visual loss?

A

Painful

12
Q

What is an RAPD?

A

relative adherent pupillary defect

a medical sign observed during the swinging-flashlight test whereupon the patient’s pupils constrict less (therefore appearing to dilate) when a bright light is swung from the unaffected eye to the affected eye

13
Q

Which sensory modalities are affected in dorsal column loss?

A

proprioception

vibration

14
Q

What common sensory symptoms are seen in MS>

A

pain
paraesthesia
numbness
trigeminal neuralgia

15
Q

What category of disorders encompasses symptoms such as ataxia, intention tremor, nystagmus, past pointing, pendular reflexes and dysdiadokinesis?

A

cerebellar dysfunction

16
Q

Which component of the pathway is involved in internuclear ophthalmoplegia?

A

medial longitudinal fasciculus

17
Q

What drug can be given to combat fatigue in MS?

A

amantadine

18
Q

What drug can be given to combat fatigue in MS patients who feel sleepy?

A

modafinil

19
Q

What is the diagnostic criteria for MS?

A

at least two episodes suggestive of demyelination - disseminated in time and place

20
Q

What is the best scan to diagnose MS?

A

MRI

21
Q

What is seen in CSF of MS patients?

A

oligoclonal bands

22
Q

What medications are used in acute MS exacerbations?

A

oral/IV steroids depending on severity

23
Q

What medications can be used to treat spasticity?

A

baclofen
tizanidine
Botox
(intrathecal baclofen/phenol)

24
Q

What treatments can be given for sensory symptoms of MS? e.g. pain, numbness, paraesthesia

A
anti-convulsant - gabapentin 
antidepressant - amitriptyline 
TENS 
acupuncture 
lignocaine infusion
25
Q

Which medications can be used to treat detrusor hypersensitivity?

A

anti-cholinergics - oxybutynin

26
Q

What first line disease modifying therapy is used in MS patients?

A
interferon B 
glitiramer acetate (copaxone)
tecfedira
27
Q

What second line disease modifying therapy is used in MS patients?

A

monoclonal antibodies - tysabri, lemtrada

fingolimod

28
Q

What third line disease modifying therapy is used in MS patients?

A

mitoxantrone

29
Q

what is PML?

A

progressive multifocal leukoencephalopathy

30
Q

Which virus causes PML?

A

JC virus

31
Q

What is the underlying factor that allows development of PML?

A

disease modifying drugs and immunomodulation

32
Q

Which organ does mitoxantrone damage in a dose-dependent fashion?

A

the heart