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14 Cards in this Set

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What diagnostic test would you order for multiple sclerosis
MRI
Cerebral or Spinal plaques
possible causes of MS
Possible infectious stimulus
Epstien Barre Virus
Positive Prognostic factors of MS
More benign in women
earlier age of dx
relapsing form of disease
symptoms of ms
Cognitive
Paroxysmal: trigeminal neuralgia, pain, paresthesia, weakness, tonic seizure, dysarthia and ataxia, pruritus, diplopia, akinesia, dystonia
TWS PAD PAD PD
treatment of MS
Rebif/avonex
anticonvulsants
NSAID
Benzodiazepine
Modafinil
Corticosteroids
Interferon
Immunosupprestents
pathophysiology of Myasthenia gravis
autoimmune disease affecting blockage or neuromuscular junction
auto antibodies against acetylcholine receptors
some have thymic abnormalities
some have SLE RA Graves
the cardinal feature of mG is
degree of muscle weakness increases with exercise and improves with rest.
clinical presentation of mg
Bulbar muscles affected ie myasthenic snarl, nasal speech, loss of consanants, chewing and swallowing difficulties, head falls foward

Limb and trunk muscles
Myashenic crises of respiratory muscles may require intubation
What is a tensilon test and when is it used?
Diagnostic for MG. Test is positive if there is a temporary improvement in muscle strength.
medication for MG
The standard medication is anticholinestgerase : Pyridostigmine (mestinon) 30 mg q6
Treatment for mg
thymectomy (controversial)
immunosuppresive agents
corticosteroids
azathioprine
cyclosporine (monitor kidney and htn)
in the case of mg crises what is the therapy
plasmapheresis 2-4 l 2-3x/wkx2weeks
Treatment for MG crises
1. Respiratory assistance, pulmonary phsiotherapy/ Intubation
2. Stop Anticholenesterase meds
3. Treat underlying infection with antibiotics
4.Plasmapharesis
IAAP
Describe Gullian Barre syndrom
idiopathic acute inflammatory demylinateing polyneuropathy
Acute onset, starts distal
progressive muscle weakness