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30 Cards in this Set

  • Front
  • Back
MS predominantly affects the myelin of which system?
Central nervous system
What type of cells make myelin in the CNS? A single oligodendrocyte myelinates how many neurons?
Oligodendrocyte. 40-100.
The Schwann cells myelinate how many axons? What types of nerves does it myelinate and not myelinate?
A single axon. Cranial and spinal nerves; not olfactory and optic.
Where does destruction of myelin occur in MS? What stain is used on myelin?
Perivenular areas. Luxol fast blue PAS
What are Dawson's fingers?
Finger-like projection areas of demyelination.
How does demyelination in viruses differ from that of MS?
It is centered around the oligodendroglia. (PML)
What is a circumscribe area of demyelination called? What does it consist of?
a "plaque" with demyelination and inflammatory cells.
What types of cells are in the inflammatory area? Which cells secrete local Ig's? Where do the Ig's accumulate?
T lymphocytes, macs, and plasma cells. Plasma cells. In the CSF.
What contributes to the developmt of neurologic dysfxn?
Axonal injury
What is a major effect of demyelination? What are the effects on a person that may result?
Cessation of nerve conduction. Loss of vision, anesthesia, or paralysis.
This may cause non-organic symptoms in pt's making them seek psychiatric eval?
Anomalous (abnormal) conduction b/t neighboring axons.
What are the "shock-like" sensations tha some may experience in MS? When do they normally occur?
L'Hermittes phenomenon. Sensations traveling from the region of the spinal cord to upper and lower extremities. Upon neck flexion.
What age group does MS normally occur in? Who usually gets it, M or F?
3rd-5th decade. females 3:2(male).
What is the vision loss in one eye called? What is a Marcus-Gunn pupil?
Central scotoma. THe pupil has a delayed sluggish response to light.
What is another name for central scotoma?
Retrobulbur neuritis.
What does demyelination of the MLF cause? What is the effect? What is the correct dx. for this problem?
Diplopia. Failure to adduct for horizontal lateral gaze. Internuclear ophthalmoplegia
Motor involvement is assoc'd with what types of signs?
UMN: spasticity, hyperreflexia, and extensor plantar responses (pos. Babinski)
What type of sensory disturbance can occur?
Tic doloreaux - trigeminal neuralgia.
An inner ear infection may actually be what? Cerebellar dysfxn results in what symptoms?
Vertigo. Ataxia and tremors.
85% of pt's display this type of MS with variable amt's of time b/t exacerbations and relapses?
Relapsing-remitting course
Half of the R-R course will evolve into this type? 10% will follow this insidious course which is called?
Secondary progressive. Primary progressive.
What labs confirm the dx of MS?
Non! All clinical.
What else may MS appear to be? (Diff. dx's)
Vasculitis of the CNS, sarcoidosis, infections, tumor, etc.
What lab's may aid in dx?
CSF IfG is elevated (albumin normal), oligoclonal bands, evoked responses, MRI to see plaques
What genetic HLA haplotypes tend to be represented in this disease?
HLA A3, B7, Dw2, DRw3
What climate does it usually occur in? When does one acquire the disease?
Temperate. By age 15.
What is used to treat MS?
Corticosteroids (immunosuppression), &cyclophosphamide
What is used for a 3 day tx of an acute exacerbation?
A high dose IV of methylprednisone.
What drug has been found to dec. the freq. of new exacerbations by 33% and to dec. new MRI lesions?
Interferon beta
What drug is used to treat relapsing MS? What chemotherapeutive drug may also treat the relapsing or progressive pt? What is its side effect?
Glatiramer acetate (Copaxone). Novantrone (mitoxantrone). Cardiotoxicity.