MBB 18 - Multiple Sclerosis (MS) Questions
With Complete Solutions
Multiple Sclerosis (MS) correct answer: *Autoimmune*-
modulated disease affecting the *optic nerves, brain and spinal
cord*
- the *prototype of CNS demyelinating diseases*
- It is the most common cause of non-traumatic disability in
young adults
- MS has become a very exciting field within Neurology due to
rapidly expanding treatment options
Key features of MS pathology in the brain, spinal cord and optic
nerves: correct answer: 1.) *Inflammation*
2.) *Demyelination = loss of myelin (oligodendrocytes produce
myelin in the CNS)*, a fatty sheet around nerve fibers helping
w/ signal transport. Destruction of this sheet *slows down signal
transport* causing neuro symptoms
3.) *Axonal damage* = damage to the actual nerve fiber (aka
"neuro-degeneration")
Cause of MS correct answer: Unknown
Likely a complex interaction of genetic predisposition (>50
genetic markers identified, each with only incremental impact)
& poorly understood environmental factors (suspects include
Epstein Barr Virus (EBV), lack of sunshine and/or Vitamin D).
Cure for MS correct answer: Now >10 meds FDA-approved to
control MS disease, specifically to reduce risk of relapse and
MRI worsening in pts w/ MS -or- progression to definite MS in
, people with a first demyelinating event (AKA "clinical-isolated
syndrome") who appear at increased risk of MS
MS Epidemiology correct answer: - Affects women ~3 times as
often as men
- Diagnosed usually in pts 20-40; less commonly but still
possible in pediatric population and >65yrs
- Affects *Caucasians more* often than other ethnicities, but
also occurs in African Americans, Hispanics, Asians
- Geographical areas of low risk vs high risk. Uncommon in
equatorial climates; *increasing prevalence with northern
latitudes*
Clinical Presentation --- what symptoms occur with MS? correct
answer: Large range of neuro symptoms can occur based on
specific affected CNS area
- physical symptoms, such as weakness, gait impairment, but
- also more "hidden symptoms", such as bladder/bowel
dysfunction, cognitive difficulties or fatigue as common
symptoms
- Initial symptoms are varied. Often initially presenting w/
sensory abnormalities (numbness, tingling, pins-and-needles),
vision loss due to optic neuritis, vertigo or in more severe cases
also focal weakness, abnormal gait, or ataxia already at initial
presentation
*Several common clinical presentations seen in MS include*:
correct answer: 1.) *Optic Neuritis*
2.) Internuclear ophthalmoplegia
3.) Lhermitte sign
4.) Transverse Myelitis
With Complete Solutions
Multiple Sclerosis (MS) correct answer: *Autoimmune*-
modulated disease affecting the *optic nerves, brain and spinal
cord*
- the *prototype of CNS demyelinating diseases*
- It is the most common cause of non-traumatic disability in
young adults
- MS has become a very exciting field within Neurology due to
rapidly expanding treatment options
Key features of MS pathology in the brain, spinal cord and optic
nerves: correct answer: 1.) *Inflammation*
2.) *Demyelination = loss of myelin (oligodendrocytes produce
myelin in the CNS)*, a fatty sheet around nerve fibers helping
w/ signal transport. Destruction of this sheet *slows down signal
transport* causing neuro symptoms
3.) *Axonal damage* = damage to the actual nerve fiber (aka
"neuro-degeneration")
Cause of MS correct answer: Unknown
Likely a complex interaction of genetic predisposition (>50
genetic markers identified, each with only incremental impact)
& poorly understood environmental factors (suspects include
Epstein Barr Virus (EBV), lack of sunshine and/or Vitamin D).
Cure for MS correct answer: Now >10 meds FDA-approved to
control MS disease, specifically to reduce risk of relapse and
MRI worsening in pts w/ MS -or- progression to definite MS in
, people with a first demyelinating event (AKA "clinical-isolated
syndrome") who appear at increased risk of MS
MS Epidemiology correct answer: - Affects women ~3 times as
often as men
- Diagnosed usually in pts 20-40; less commonly but still
possible in pediatric population and >65yrs
- Affects *Caucasians more* often than other ethnicities, but
also occurs in African Americans, Hispanics, Asians
- Geographical areas of low risk vs high risk. Uncommon in
equatorial climates; *increasing prevalence with northern
latitudes*
Clinical Presentation --- what symptoms occur with MS? correct
answer: Large range of neuro symptoms can occur based on
specific affected CNS area
- physical symptoms, such as weakness, gait impairment, but
- also more "hidden symptoms", such as bladder/bowel
dysfunction, cognitive difficulties or fatigue as common
symptoms
- Initial symptoms are varied. Often initially presenting w/
sensory abnormalities (numbness, tingling, pins-and-needles),
vision loss due to optic neuritis, vertigo or in more severe cases
also focal weakness, abnormal gait, or ataxia already at initial
presentation
*Several common clinical presentations seen in MS include*:
correct answer: 1.) *Optic Neuritis*
2.) Internuclear ophthalmoplegia
3.) Lhermitte sign
4.) Transverse Myelitis
