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34 Cards in this Set
- Front
- Back
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what symptoms can MS patients have
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visual loss, diplopia, paralysis, ataxia, sexual dysfuction, bladder dysfunction, cognitive impairment
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what is destroyed in MS
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oligodendrocytes and then axons too
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what ages are the first attacks of MS sseen
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between 20-40
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what sex gets MS and what sex has a poorer prognosis
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mostly women get MS but men have a poorer prognosis esp if they become sympomatic at a later
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how do you describe the frequency of MS attacks
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relapsing and remitting
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what are the 3 main symptoms in the first attack
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sudden visual loss w pain! (optic neuritis), opthalmaplegia, weakness, paresthesia- from myelitis
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what is kurtzke's rule
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ninety percent of disability will occur within the first 10 years of dx
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what is benign ms
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pt who have a small number of attacks and regain full function
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what helps to make an easy dx of MS
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there have been to or more attacks in the CNS and there are effects in two parts of CNS
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what imaging test is best for MS
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MRI- might be able to see it after first attack
gadolinium shows RECENT demylination |
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what pupillary symptom is seen in MS
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pupil afferent defect, aka marcus gunman, when light is moved from normal eye to affected eye there is dilation
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what does optic neuritis look like with eye exam
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inflam behind retina, then pallor of the optic disc
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what drug should be given to MS pt with optic neuritis
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CS intravenous. they wil mostl likely recover all their vision
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what is internuclear opthalmaplegia
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When looking to one side, the ADDUCTING eye cannot reach the medial edge of the eye, and the ABDUCTING eye goes part-way, but has severe nystagmus. convergence is unimpaired
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what causes internuclear opthalmaplegia
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damage to the MLF which links nucleus of cn VI with contralat cn III
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what humna leukocyte antigen are assoc with MS
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DR15, DR3, DR4
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what might the degenerated oligodendrocytes be replaced with
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precursors of oligos and other glial cells
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why are the oligos attacked
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molecular mimicry..originally some other antigen was attacked that is similar to myelin and the next time it attacks myelin
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what are some previous viruses that may be assoc with MS infections
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EBV, CMV, HSV, mumps
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what are the most common MRI findings in MS
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1. Nine hyperintense (t2) lesions, with one or more gasolinium enhancing lesion
2. at least one infratentorial lesion 3. at least one juxtacortical lesion including the SC 4. at least three periventricular lesions consider a cervical or thoracic MRI to look for more |
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what is an even more specific test than MRI for MS
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LP- oligoclonal bands
also increased levels of myelin basic protein, increase wbc but always under 100 |
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what are the DMT's of MS
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ABC's: 1. avenox, weekly, interferon beta1a, 2. Betaseron every other day interferon 1b 3. Capaxone everyday glaterimer acetate 4. Rebif 3x week interferon1a>>>>these are all for relapsing and remitting MS
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what newer DMT is assoc with PML but may be more effective for MS, given via IV. may limit entrance of t cell into cns
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natalizumab
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what chemo agents is also used for MS. what is a major side effect
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mitoxantrone. cardio toxic. only drug approved for secondary MS
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what antispasmolytics can be used with MS
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lioresal and tizanidine
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what drugs agents for pain in MS
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gabapentin and pregalabin
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what drug for fatigue in ms
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amandtidine
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what dz is this: Optic neuritis and spinal cord demyelination (myelitis) without brain demyelination
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neuromyelitis optica (NMO) or Deviks dz
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what does Sc MRI show in NMO
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show severe damage AT THREE OR MORE LEVELS
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how is NMO treated
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at first with CS and then with immunosprressants such as azathioprine
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what do most NMO pt have antibodies to
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aquaphorin channels
the AB is called NMO Igg it binds to the channel |
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is NMO unilat or bilat
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unilat but more comonly bilat than ms
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what does NMO ususally occur after
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myelitis, or an infection
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what drugs are used to treat NMO
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immunosuppressant: azathioprine or prednisone
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