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Flashcards in MS Deck (39)
1

MS is an autoimmune reaction against?

oligodendrocytes

2

In MS, what do you get destruction of?

myelin

3

are peripheral nerves affected?

no

4

normally, macrophages cannot easily cross the BBB, but what do they express that allows them to adhere and cross the endothelium?

glycoprotein α4 β1

5

show up on MRI as white blobs, roughly 2-10mm in size, and can occur anywhere in the CNS, although most commonly occur at the optic nerves, periventricular lesion, brainstem and cerebellar connections?

plaques

6

what is the most common form of MS?

relapsing remitting (RR)

7

what is uhtoffs phenomenon?

symptoms worse during increased heat - conduction slows with increased heat

8

most common presenting symptom?

fatigue/lethargy

9

what is lhermittes sign?

on flexion of the neck, there is an electric shock sensation down the spine and into the limbs

10

what are upper motor neurone signs?

spasticity, weakness, brisk reflexes

11

what do oligoclonal bands show?

there is lots of antibody to something in the CSF - there will be oligoclonal bands in 80% of cases

12

for diagnosis, you need at least 1 attack and multiple plaques on MRI

y

13

often used as symptomatic treatment. It is an antagonist of GABA receptor ?

Baclofen

14

how do you manage urinary incontinence?

oxybutanin or self catheterisaton

15

a condition affecting the movement of the eyes which is characteristic of MS?

internuclear opthalmoplegia

16

in INO, when patient looks to left what happens?

let eye is fine, right eye does not go past midline

17

in INO, when patient looks to right what happens ?

right eye is fine, left eye does not go past midline

18

what is the definitive investigation in MS?

MRI

19

in visual evoked potentials, a delayed response indicates what?

there is evidence of some sort of optic nerve lesion

20

what other conditions can mimic lesion on MRI?

sarcoidosis, SLE, bechets syndrome

21

what is the severity of the disease like ?

Some patients may be able to live normally for many years, whilst other will becomes severely disabled.

22

female to male?

f:m 3:1

23

what pyramidal dysfunction ?

increased tone, spasticity and weakness

24

weakness in arms and legs?

weakness in extensors in arms and flexors in legs

25

you get loss of dorsal column. what does this cause?

proprioception and vibration (DEE PEE VEE)

26

you get pain and paraesthesia

y

27

what cerebellar defects can you get?

ataxia

28

what criteria is used for diagnosis?

mcdonalds

29

to satisfy dissemination in place, you need?

objective evidence of neurological deficits localised in two sepatrate parts of the CNS

30

for dissemination in time, you need?

onset of neurological deficits separated by at least one month

31

what are blood tests like in MS?

negative

32

for spastcity, what can you give?

BT - baclofen or tizanidine. or botulinum toxin

33

For sensory symptoms, can give?

sense maga
amytriptyline or gabapentin

34

for urinary symptoms of frequency etc. tx?

Bladder drill, anticholinergics eg oxybutanin,desmopressin and catheterisation

35

for fatigue?

Amantadine and modafinil (amanmod)
Hyperbaric oxygen

36

First line therapy

Interferon Beta – avonex,rebif, betaseron,extavia

Glitiramer acetate

Techfedira

37

Second line therapy

Monoclonal antibodies tysabri, lemtrada, zymbrata

Fingolimod

38

Third line

mitoxantrone

39

S1P modulator ?

fingolimod