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Flashcards in Multiple Sclerosis Deck (36)
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1
Q

Immune-mediated disease of the CNS that is associated with inflammation, demyelination, axonal loss/neurodegeneration/atrophy in both white and grey matter

A

Multiple Sclerosis

2
Q

Most common cause of non-traumatic disability in young adults

A

MS

3
Q

There is a higher incidence of MS in

A

Women

4
Q

EBV infection, vitamin D insufficiency, smoking tobacco, and obesity are all environmental risk factors for

A

MS

5
Q

In a brain with MS, we see

A

White matter plaques

6
Q

Induces conduction blocks in structurally intact axons, drives demyelination, and induces transection of axons (with consequent conduction block) within acute lesions

A

Lymphocyte-driven inflammation

7
Q

Activated microglial cells might contribute to the repair mechanisms that lead to

A

Remyelination or to the degeneration of axons

8
Q

Redistribution of sodium channels along demyelinated axons could restore

A

Conduction

9
Q

Astrocytic activation and proliferation (gliosis) might impede

A

Repair

10
Q

Focal disturbances of function >24 hours

–Occur on average once a year in untreated patients

A

MS Relapse

11
Q

MS relapses occur in the absence of

A

Environmental, metabolic, or infectious processes

12
Q

At least one objective clinical episode with neurological symptoms lasting for 24 hours or longer (with no symptomatic infection)* is required for diagnosis of

A

Relapsing-Remitting MS (RRMS)

13
Q

We also need dissemination in time and space to diagnose with

A

RRMS

14
Q

One year of disease progression is needed to diagnose with

A

Primary-Progressive MS (PPMS)

15
Q

We use blood tests to exclude MS mimics such as

A

Lyme Disease or B12 Deficiency

16
Q

What is an infectious disease that mimics MS?

A

Lyme Disease

17
Q

What are four inflammatory diseases that mimic MS?

A

SLE, Sarcoidosis, Neuromyelitis, and ADEM

18
Q

Cervical or thoracic spondylosis also mimics

A

MS

19
Q

Often a monophasic demyelinating disease

-May be induced by viruses or vaccination

A

ADEM

20
Q

The most common tick-transmitted disease in the northern hemisphere

-Caused by spirochetes of the Borrelia burgdorferi species complex

A

Lyme Disease

21
Q

Frequently indistinguishable from MS on both clinical and radiologic grounds. Patients may have focal neurologic deficits, relapsing–remitting disease

A

Lyme Disease

22
Q

Brain WM abnormalities with MS-like features are found in approximately

A

75% of lyme patients

23
Q

Characterized by a specific IgG antibody marker (NMO antibody)

A

Neuromyelitis Optica Spectrum Disorders (NOSD)

24
Q

The target antigen in NMOSD is a water channel abundant in the CNS called

A

Aquaporin-4

25
Q

Characterized by inflammatory demyelination in the CNS, for example in the optic nerves and spinal cord

A

NMOSD

26
Q

What is used to treat acute MS relapses?

A

High dose IV steroids or ACTH

27
Q

What is a common high-dose IV steroid used to treat acute MS relapse?

A

Methylprednisone

28
Q

2nd generation fumaric acid ester used as a disease modifying treatment for MS

A

BG 12

29
Q

Monoclonal antibody blocking adhesion of VLA-4 positive T cells to VCAM-1 positive endothelial cells

-used as SMT

A

Natalizumab

30
Q

S1P receptor agonist used as DMT

A

Fingolimod

31
Q

Monoclonal antibody targeting and deleting CD20 positive B cells

-Used as DMT

A

Ocrelizumab

32
Q

Increases risk of infections and malignancies

A

Ocrelizumab

33
Q

Has been shown to cause PML in 0.3% of treated patients

A

Natalizumab

34
Q

What are two DMTs for secondary progressive MS (SPMS) and Primary Progressive MS (PPMS)

A

Mitoxantrone and Ocrelizumab

35
Q

Has been approved by FDA for SPMS but is not commonly used due to potential serious adverse effects

A

Mitoxantrone

36
Q

Approved for PPMS in 2017

A

Ocrelizumab