ATSU SOMA Exam 4
Is susceptibility to MS monogenic or polygenic? - correct answer ✔✔Polygenic
Do the genetic considerations of MS involve genetic contributions, environmental contributions, or
both? - correct answer ✔✔Both
The strongest genetic susceptibility for MS is which gene? - correct answer ✔✔HLA-DQ6
HLA-DQ6 accounts for how much of MS disease risk? - correct answer ✔✔12%
What is the risk of developing MS if your identical twin has MS? - correct answer ✔✔1/3
What is the risk of developing MS if a fraternal twin has MS? - correct answer ✔✔1/15
What is the risk of developing MS if a sibling has MS? - correct answer ✔✔1/25
What is the risk of developing MS if a parent or half-sibling has MS? - correct answer ✔✔1/50
What is the risk of developing MS if a first cousin has MS? - correct answer ✔✔1/100
What is the risk of developing MS if a spouse has MS? - correct answer ✔✔1/1000
What is the risk of developing MS if no one in the family has MS? - correct answer ✔✔1/1000
What structure works to keep inflammatory cells out, but at sites of inflammation this structure is
disrupted which allows these cells to sneak into the CNS? - correct answer ✔✔Blood-brain barrier
,What are some of the main invaders of the CNS in MS? - correct answer ✔✔CD4 T cells
Cytotoxic CD8 cells
B lymphocytes
Myelin-specific autoantibodies
Macrophages
Autoantibodies will bind to and mark oligodendrocytes for destruction in MS, and which cells will engulf
them? - correct answer ✔✔Macrophages
The oligodendrocytes that survive and are not engulfed in MS can remyelinate axons and they produce
what? - correct answer ✔✔Shadow plaques
As lesions in MS evolve, what process occurs to create gliotic plaques that have a hardened texture
referred to as sclerosis? - correct answer ✔✔Astrocytic proliferation (gliosis)
Which type of plaques are white matter lesions that show evidence of persistent inflammation,
progressive axonal loss and gradual concentric expansion? - correct answer ✔✔Chronic active plaques
When a nerve impulse moves across a myelinated axon, it jumps from what to what? - correct answer
✔✔Node of Ranvier to Node of Ranvier
Each Node of Ranvier houses what specific channel? - correct answer ✔✔Sodium channel
When an axon is demyelinated, you are exposing which channels which are typically buried underneath
the myelin sheath? So, when the sheath is no longer there the nerve impulse runs into these free
channels resulting in hyperpolarization, slowing it down and leading to a conduction block - correct
answer ✔✔Voltage-dependent potassium channels
Diagnostic criteria for MS requires how many episodes and how many signs reflecting pathology in
noncontiguous white matter tracts of the CNS? - correct answer ✔✔2+ episodes
2+ signs
,Symptoms must last how long and occur as distinct episodes separated by how long to be diagnosed as
MS? - correct answer ✔✔>24 hours
1 month+
If a patient only has 1 of the required 2 signs to be diagnosed for MS, the 2nd one can be documented by
which 2 abnormal findings? - correct answer ✔✔1. Abnormal MRI
2. Evoked potentials
An MS patient with an abnormal MRI will show which type of lesions? - correct answer ✔✔1. Focal
white matter lesions
2. Enhancing and non-enhancing lesions in an asymptomatic location
What measures electrical activity by repetitive stimulation of selected peripheral nerves or of the brain?
- correct answer ✔✔Evoked potentials
What are the abnormalities found in the CSF in MS? - correct answer ✔✔1. Mononuclear cell pleocytosis
(increased cell count)
2. Increased intrathecally synthesized IgG
How many oligoclonal bands, not present in a paired serum sample, are found in >90% of MS patients? -
correct answer ✔✔2+
Varicella infections are frequently associated with which disease related to MS? - correct answer
✔✔Acute Disseminated Encephalomyelitis (ADEM)
Is ADEM more common in adults or children? - correct answer ✔✔Children
What is the hallmark of ADEM? - correct answer ✔✔Widely scattered foci of perivenular inflammation
and demyelination of white and gray matter
, What is the most explosive form of ADEM which has lesions that are vasculitis and hemorrhagic and has
a devastating clinical course? - correct answer ✔✔Acute Hemorrhagic Leukoencephalitis
Autoantibodies to which proteins are detected in the CSF in patients with ADEM? - correct answer
✔✔Myelin-binding protein (MBP)
Myelin Oligodendrocyte Glycoprotein (MOG)
What is the lymphocytic pleocytosis in patients with ADEM? (# amount) - correct answer ✔✔greater
than or equal to 200 cells/microliter (occurs in 80% of patients)
What are some of the most common initial symptoms for patients with MS? - correct answer ✔✔1. Pain
2. Sensory loss
3. Optic neuritis
4. Weakness
5. Paresthesia
6. Diplopia
7. Ataxia
In MS, if the sensory impairment of the trunk and legs is below a horizontal line on the torso, what does
this show? - correct answer ✔✔The spine is the origin of sensory disturbance
In MS, for patients experiencing Optic Neuritis, they also experience decreased color perception in which
field of vision? - correct answer ✔✔Central
Which pupillary defect is typically present in MS? - correct answer ✔✔Afferent pupillary defect (Marcus-
Gunn pupil)
The weakness felt by patients with MS is affiliated with which motor neuron and is accompanied by
what? - correct answer ✔✔Upper motor neuron
Hyperreflexia
Is susceptibility to MS monogenic or polygenic? - correct answer ✔✔Polygenic
Do the genetic considerations of MS involve genetic contributions, environmental contributions, or
both? - correct answer ✔✔Both
The strongest genetic susceptibility for MS is which gene? - correct answer ✔✔HLA-DQ6
HLA-DQ6 accounts for how much of MS disease risk? - correct answer ✔✔12%
What is the risk of developing MS if your identical twin has MS? - correct answer ✔✔1/3
What is the risk of developing MS if a fraternal twin has MS? - correct answer ✔✔1/15
What is the risk of developing MS if a sibling has MS? - correct answer ✔✔1/25
What is the risk of developing MS if a parent or half-sibling has MS? - correct answer ✔✔1/50
What is the risk of developing MS if a first cousin has MS? - correct answer ✔✔1/100
What is the risk of developing MS if a spouse has MS? - correct answer ✔✔1/1000
What is the risk of developing MS if no one in the family has MS? - correct answer ✔✔1/1000
What structure works to keep inflammatory cells out, but at sites of inflammation this structure is
disrupted which allows these cells to sneak into the CNS? - correct answer ✔✔Blood-brain barrier
,What are some of the main invaders of the CNS in MS? - correct answer ✔✔CD4 T cells
Cytotoxic CD8 cells
B lymphocytes
Myelin-specific autoantibodies
Macrophages
Autoantibodies will bind to and mark oligodendrocytes for destruction in MS, and which cells will engulf
them? - correct answer ✔✔Macrophages
The oligodendrocytes that survive and are not engulfed in MS can remyelinate axons and they produce
what? - correct answer ✔✔Shadow plaques
As lesions in MS evolve, what process occurs to create gliotic plaques that have a hardened texture
referred to as sclerosis? - correct answer ✔✔Astrocytic proliferation (gliosis)
Which type of plaques are white matter lesions that show evidence of persistent inflammation,
progressive axonal loss and gradual concentric expansion? - correct answer ✔✔Chronic active plaques
When a nerve impulse moves across a myelinated axon, it jumps from what to what? - correct answer
✔✔Node of Ranvier to Node of Ranvier
Each Node of Ranvier houses what specific channel? - correct answer ✔✔Sodium channel
When an axon is demyelinated, you are exposing which channels which are typically buried underneath
the myelin sheath? So, when the sheath is no longer there the nerve impulse runs into these free
channels resulting in hyperpolarization, slowing it down and leading to a conduction block - correct
answer ✔✔Voltage-dependent potassium channels
Diagnostic criteria for MS requires how many episodes and how many signs reflecting pathology in
noncontiguous white matter tracts of the CNS? - correct answer ✔✔2+ episodes
2+ signs
,Symptoms must last how long and occur as distinct episodes separated by how long to be diagnosed as
MS? - correct answer ✔✔>24 hours
1 month+
If a patient only has 1 of the required 2 signs to be diagnosed for MS, the 2nd one can be documented by
which 2 abnormal findings? - correct answer ✔✔1. Abnormal MRI
2. Evoked potentials
An MS patient with an abnormal MRI will show which type of lesions? - correct answer ✔✔1. Focal
white matter lesions
2. Enhancing and non-enhancing lesions in an asymptomatic location
What measures electrical activity by repetitive stimulation of selected peripheral nerves or of the brain?
- correct answer ✔✔Evoked potentials
What are the abnormalities found in the CSF in MS? - correct answer ✔✔1. Mononuclear cell pleocytosis
(increased cell count)
2. Increased intrathecally synthesized IgG
How many oligoclonal bands, not present in a paired serum sample, are found in >90% of MS patients? -
correct answer ✔✔2+
Varicella infections are frequently associated with which disease related to MS? - correct answer
✔✔Acute Disseminated Encephalomyelitis (ADEM)
Is ADEM more common in adults or children? - correct answer ✔✔Children
What is the hallmark of ADEM? - correct answer ✔✔Widely scattered foci of perivenular inflammation
and demyelination of white and gray matter
, What is the most explosive form of ADEM which has lesions that are vasculitis and hemorrhagic and has
a devastating clinical course? - correct answer ✔✔Acute Hemorrhagic Leukoencephalitis
Autoantibodies to which proteins are detected in the CSF in patients with ADEM? - correct answer
✔✔Myelin-binding protein (MBP)
Myelin Oligodendrocyte Glycoprotein (MOG)
What is the lymphocytic pleocytosis in patients with ADEM? (# amount) - correct answer ✔✔greater
than or equal to 200 cells/microliter (occurs in 80% of patients)
What are some of the most common initial symptoms for patients with MS? - correct answer ✔✔1. Pain
2. Sensory loss
3. Optic neuritis
4. Weakness
5. Paresthesia
6. Diplopia
7. Ataxia
In MS, if the sensory impairment of the trunk and legs is below a horizontal line on the torso, what does
this show? - correct answer ✔✔The spine is the origin of sensory disturbance
In MS, for patients experiencing Optic Neuritis, they also experience decreased color perception in which
field of vision? - correct answer ✔✔Central
Which pupillary defect is typically present in MS? - correct answer ✔✔Afferent pupillary defect (Marcus-
Gunn pupil)
The weakness felt by patients with MS is affiliated with which motor neuron and is accompanied by
what? - correct answer ✔✔Upper motor neuron
Hyperreflexia
