Term
| What is an early sign of MS? |
|
Definition
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Term
|
Definition
numbness and tingling
fatigue
muscle weakness
ataxia
dysmetria
labile mood
mental disturbance
Lhermitte's sign |
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Term
| What is a nearly universal sign of MS? |
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Definition
| All pt's will complain of fatigue and muscle weakness |
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Term
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Definition
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Term
| What is Lhermitte's sign? |
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Definition
| If a pt tries to touch their chin to their chest, they will get an 'electric shock' sensation going down their leg. |
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Term
| What are the four presentation patters of MS? |
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Definition
Relapsing-Remitting
Secondary-Progresive
Primary-Progressive
Progressive-Relapsing |
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Term
| What % of MS pt's show a relapsing-remitting presentation pattern? |
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Definition
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Term
| If MS is untreated, how long before it will progress from relapsing-remitting to secondary progressive? |
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Definition
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Term
| What % of MS pt's will go onto secondary progressive presentation even with tx? |
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Definition
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Term
| What is the most common initial presentation of MS in men? |
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Definition
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Term
| What is the most common initial presentation of MS in women? |
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Definition
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Term
| What is generally comorbid with a primary progressive form of MS? |
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Definition
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Term
| If a pt is older at the time of dx, what is a more common presentation pattern for MS? |
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Definition
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Term
| What is the least common MS presentation pattern? |
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Definition
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Term
| What are methods of dx'ing MS? |
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Definition
Imaging (MRI w/ FLAIR)
Electrodiagnosis (VECP)
Test CSF oligoclonal bands |
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Term
| What is MS oligoclonal band testing? |
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Definition
| Ab's are tested for in the blood and CSF. If they present in only the CSF, then this suggests that the immune response is in the CNS |
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Term
| What is the currently preferred imaging test for MS? |
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Definition
| FLAIR MRI; it picks up the most lesions of any of the image tests |
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Term
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Definition
| test for MS by testing conduction velocity in the optic nerve |
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Term
| What are tx for MS trying to accomplish? |
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Definition
| Treat the symptoms, as the dz itself cannot be reversed or cured. |
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Term
| What are drug tx for MS symptoms? |
|
Definition
Tx for MS:
Pemoline or amantadine for fatigue
Diazepam or tizanidine for muscle spasticity
Water and fiber for constipation
Amitriptyline for depression
Corticosteroids during severe attack: IV methylprednisolone |
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Term
| What is a corticosteroid tx's for MS? |
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Definition
| IV methylprednisolone for 3-8 days |
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Term
| What is used to treat relapsing-remitting MS? |
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Definition
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Term
| When should interferons be started in MS tx? |
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Definition
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Term
| What is Interferon Beta1a drug Avonex used for? |
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Definition
| MS tx, weekly intramuscular injection |
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Term
| What is Interferon Beta 1b drugs betaseron and Extavia used for? |
|
Definition
| daily subcutaneous injections |
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Term
| What is Interferon Beta1a drug Rebif used for? |
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Definition
| Subcutaneous injections 3x per week |
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Term
| What does interferon tx reduce in MS pt's? |
|
Definition
| prevents relapses and new plaque formations |
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Term
| What is Glatiramer (Copaxone)? |
|
Definition
| Resembles myelin basic proteins, so tricks immune system to attack them instead. |
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Term
| How is Glatiramer administered? |
|
Definition
| daily subcutaneous injections |
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Term
|
Definition
First oral drug for RRMS
Traps T cells in lymph nodes to prevent migration to the CNS |
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Term
| What are SE of oral fingolimod? |
|
Definition
increased risk of cancer and infection
Can cause macular edema |
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Term
| How often should MS pt's on oral fingolimod have an eye exam? |
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Definition
| Every 3-4 months to check for macular edema |
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Term
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Definition
| MS drug that is used only with very strict guidelines due to Progressive Multifocal Leukoencephalopathy SE that is 100% fatal |
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Term
| How is Natalizumab administered? |
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Definition
| IV infusion q 4w (once a month) |
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Term
| What is the mechanism of Natalizumab? |
|
Definition
| blocks inflammatory cells from entering brain and spinal cord |
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Term
| What are SE of natalizumab? |
|
Definition
hepatotoxicity
progressive multifocal leukoencephalopathy |
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Term
| What is a curious SE of mitoxantrone? |
|
Definition
| Urine and sclera take on a blue color |
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Term
|
Definition
| immunosuppressor used to tx MS |
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Term
| How is mitoxantrone administered? |
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Definition
|
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Term
| what are risks of mitoxantrone use? |
|
Definition
| cardiomyopathy and myelopsuppression, so only given for 2-3 years |
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Term
|
Definition
| Used to treat refractory MS which is resistant to tx. |
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Term
| What are statin drugs used for in MS? |
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Definition
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Term
| What are advantages of statin drugs for MS tx? |
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Definition
| Less cost than other tx's, oral administration |
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Term
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Definition
| A potential future MS vaccine meant to induce immune response against the harmful, misdirected T-cells that cause MS |
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Term
| What is Recombinant T-cell receptor ligand? |
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Definition
| Future MS tx, attaches onto pathogenic T-Cell, causing a 'boat anchor' effect where the cell is then too big to enter the CNS |
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Term
| What is hyaluronic acid inhibition used for? |
|
Definition
| To stimulate oligodendrocytes to maturity to help preserve myelin in MS tx, this will preserve existing myelin |
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Term
| What are monthly steroids being tested for? |
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Definition
| Potential use as future MS tx |
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Term
| What is testosterone gel being tested for? |
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Definition
| As a future MS tx in men with the RRMS form. |
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