Term
What age population gets MS?
Male or female?
Race? |
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Definition
20-40 year olds (mean 30 yrs)
female
caucasion |
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Term
Dysmyelinating or demyelinating disease?
Abnormal or defective myelin formation (genetic abnormality) |
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Definition
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Term
Dysmyelinating or demyelinating disease?
Damage to myelin previously normally formed |
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Definition
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Term
| What does multiple sclerosis mean? |
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Definition
| multiple scars (on the brain) |
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Term
All of the following statements about MS are incorrect except
1. MS is a disease of the CNS
2. MS is most common in women over 40 years of age
3. MS patients always have an initial relapsing course
4. MS can be cured with interferon therapy |
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Definition
MS is a disease of the central nervous system
MS, which have central demyelination, don’t get peripheral neuropathy |
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Term
| What is an immune-mediated, demyelinating and neurodegenenerative disease of the central nervous system white and gray matter characterized by neurologic dysfunction separated in time and space |
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Definition
Multiple Sclerosis
space and time=episodes of neurologic problems that affect different areas of CNS causing different symptoms and they occur at different times (30 days apart) |
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Term
Which studies are required to diagnose MS?
i. MRI
ii. CSF (spinal tap)
iii. Evoked potentials
iv. All of the above
v. None of the above |
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Definition
| You don’t need any of these studies to diagnose MS. You can diagnose it clinically |
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Term
| Is MS a life threatening disease? |
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Definition
| No - but it is a disabling disease after trauma |
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Term
What is NOT a challenge for the neurologist for MS
Difficult diagnosis
No single specific test
No two cases of MS are alike
No specific age
No proven cause
No known cure
MS is unpredictable
Partially effect treatments |
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Definition
No specific age
(affects 20-40 year olds) |
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Term
What is the duration of MS disease?
What is the percent of severely disabled MS patients? |
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Definition
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Term
What is the main reason most MS are unemployed?
Second? |
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Definition
loss of cognitive function
fatigue (severe exhaustion) |
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Term
| What is the risk of genetically similar individuals developing MS? |
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Definition
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Term
| What is the hypothesis of the (3) factors that may cause the abnormal immunological response that causes MS? |
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Definition
genetic predisposition
environmental factor
infectious agents (viral?)
-but it's really not that simple, may include diet, sunlight, smoking, hormones, heavy metals, etc |
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Term
| Where do MS lesions usually occur in the brain? |
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Definition
| deep within the brain around the ventricles |
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Term
| What is 3 step pathology of MS? |
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Definition
Inflammation - lymphocytes travel through blood vessels into the CNS
demyelination
axonal loss |
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Term
| Does MS affect the white matter, gray matter, or both? |
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Definition
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Term
True or false:
An MS can also have remyelination |
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Definition
True
not only do they have demyelination and loss of nerve fibers but also have demyelination by oligodendrocytes = attempt to recover |
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Term
What is the most common symptom of MS?
second most common? |
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Definition
Sensory symptoms in arms/legs (numbness, weakness)
unilateral vision loss |
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Term
What is NOT a common MS symptom?
Bladder symptoms
Fatigue
Pain
Inability to sleep
Cognitive dysfunction
Depression |
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Definition
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Term
What type of MS do most patients start with?
What happens if you don't treat this? |
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Definition
Relapsing-remitting MS (have relapse of numbness in legs, etc)
Goes to secondary progressive MS (start with relapses and then gradually get worse all the time) |
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Term
| What type of MS is the most difficult to diagnose because instead of relapsing, they start as gradual worsening of gait, difficulty walk, spasticity in legs, lose balance, and develop bladder problems? |
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Definition
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Term
| What is the most sensitive and best imaging study we have for MS and shows a lot of activity of the disease that goes unnoticed? |
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Definition
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Term
True or false:
Someone that has MS that is in clinical remission and has no symptoms means that the disease has gone away. |
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Definition
False
They are developing lesions that come and go all the time. It is just affecting areas of the brain that are clinically silent. |
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Term
| How are visual evoked potentials study helpful in MS diagnostics? |
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Definition
| Can see difference of milliseconds it takes for signal of each eye to reach the brain to see if person has optic neuritis |
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Term
| What is the comprehensive management of MS? |
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Definition
Disease Modifying Therapy
Treatment of acute relapses
Management of symptoms
Patient education
Family education |
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Term
| What is the goal to treatment of MS? |
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Definition
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Term
| What is the best treatment of acute MS relapse? |
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Definition
| Glucocorticoids (steroids) |
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Term
| What is the 1st oral drug for MS? |
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Definition
| Fingolimod (before that people had to take injections every day) |
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Term
| Has MS treatment completely stopped the progression of disease/stopped relapses? |
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Definition
No
We cut down number of relapses, number of MRI and slowed down the disease |
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Term
True or false:
Everyone with MS has different symptoms. |
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Definition
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Term
Which factors increase the risk of developing MS?
family history
genes
pregnancy
place of residency
all of the above |
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Definition
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Term
True or false:
Treatment with interferon’s beta agents cures MS. |
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Definition
False
reduces relapses rate and reduces MRI disease activity |
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