With Complete Solutions
MS Facts correct answer: Most wide spread disabling
neurological condition of young adults around the world
• Approximately 400,000 people with MS in the US, 1-2 million
world wide
• Can be developed at any age, most typically diagnosed
between the ages of 20-40
• About 200 cases are diagnosed in the US each week
• Rate of MS is twice as high in the northern states above the
37th parallel
What is MS? correct answer: An inflammatory disease of the
CNS: the brain and the spinal cord.
• It is a disease of the "white matter" tissue
• nerve fibers which communicate internally within the CNS and
with nerves supplying the rest of the body
What happens w/ MS? correct answer: • Patches of damage
("plaques" or "lesions") appear in CNS white matter (location
and pattern appears random)
• Myelin is lost at lesion site
• Location and extent of damage relates to severity of symptoms
Pathophys of MS correct answer: Both genetic and
environmental factors
• Abnormal immune response to infection or environmental
trigger in genetically susceptible individuals
• Activated peripheral t-cells breach the blood brain barrier.
,• Inflammatory response against myelin, axons and
oligodendrocytes.
• Neurologic signs result from blocked nerve conduction/ axonal
transection
Epidemiology of MS correct answer: • Genetic Predisposition
• It is not hereditary but has genetic aspects:
• 1/1000 risk in the general population
• 2-5/100 for person with a close relative with MS
• 1/20-50 for a sibling of a person with MS
• 1/3 for an identical twin
• Exposure before puberty to an agent may trigger an abnormal
immune response in adulthood.
• Ethnic differences: more common in caucasians of Northern
European ancestry than Hispanics or African Americans.
• More prevalent in higher latitudes.
Relapsing Remitting MS (RRMS) correct answer: • Clearly
defined acute attacks with full recovery or partial residual deficit
• Periods between attacks characterized by lack of disease
progression
• 85% of people initially diagnosed with RRMS
Secondary Progressive MS (SPMS) correct answer: • Begins
with initial relapsing remitting course followed by progression at
variable rate that may include occasional relapses and plateaus.
• Of the 85% who begin with RRMS, more than 50% will
develop SPMS within 10 years
• 90% within 25 years
, Primary Progressive MS (PPMS) correct answer: Characterized
by progression of disability from onset with or without plateaus
or remissions or minor improvements.
• 10% of people diagnosed with PPNS
Progressive Relapsing MS (PRMS) correct answer: •
Progression from onset but with clear acute relapses.
• 5% of people diagnosed with PRMS
Diagnosis of MS correct answer: • No single definitive
diagnostic test- clinically based on medical history, signs and
symptoms.
Definite diagnoses requires:
1• Evidence of lesions in at least 2 distinct areas of the CNS
2• Evidence that the lesions occurred at discrete points in time
- MRI is abnormal in 95% of people in MS
• Lumbar puncture : CSF oligoclonal bands
• No better explanation
• Frequently pts have had the disease for several yrs before the
affirmed diagnosis
• "Clinically Isolated Syndrome"
MS Symptoms correct answer: • Fatigue, Weakness
• Impaired Ambulation • Imbalance, Incoordination
• Bowel/Bladder Dysfunction
• Visual Disturbances
• Cognitive Impairment
• Tremor
• Spasticity
• Pain