CERTIFIED MULTIPLE SCLEROSIS
SPECIALIST EXAM PREP (CMSC) 123
QUESTIONS SCORED A+ TO PASS!!
1 of 34
Definition
10-59 years, highest incidence between 20-40 years
Average age of onset is 28-30 years
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Clinical Course and Natural History:
Epidemiology: Gender
Secondary Progressive
, Clinical Course and Natural History:
Advanced Disease Epidemiology: Age of Onset
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2 of 34
Definition
Obtain detailed and accurate history in chronological order
Is the patient's speech coherent? Is the language fluent? Is the
language appropriate for the level of education?
Assess level of consciousness, orientation memory, intellectual
status and speech.
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Diagnosis of Multiple
Sclerosis: Diagnosis of Multiple Sclerosis:
Diagnostic Testing: Diagnostic Testing:
Clinical Examination - Medical Clinical Examination - Sensory Exam
History
Diagnosis of Multiple Sclerosis: Diagnosis of Multiple Sclerosis:
Diagnostic Testing: Diagnostic Testing:
Clinical Examination - Components Clinical Examination - Reflexes
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3 of 34
,Term
Diagnosis of Multiple Sclerosis:
Diagnostic Testing:
Clinical Examination - Cranial Nerve 1 (CNI)
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Optic nerve Olfactory nerve
Visual acuity, gross visual fields Sense of smell
Hypoglossal Acoustic nerve Hearing and
Motor nerve of the tongue equilibrium
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4 of 34
Definition
Disruption of the BBB occurs with inflammation.
Gd enhancement occurs at active sites. Enhancement usually
subsides in 3 to 6 weeks leaving a "white spot" on imaging.
These areas can become larger and reinflamed with new disease
activity.
Repeated inflammation may cause extensive damage within the
lesion. These may appear as hypointense lesions (T1 black holes)
New MRI lesions can be "clinically silent" due to:
Location of the lesion
, Number of lesions
Severity of the damage
RRMS: great deal of MRI activity
SPMS: more symptomatic, less MRI activity. Chronic, older lesions
that reflect irreversible axonal damage and atrophy.
Per Consortium of Multiple Sclerosis Centers, MRI should be be
used as part of the diagnosis of MS. No current recommendation for
MRI at preset intervals. Repeat MRI is appropriate if change of
condition of the patient or change in treatment is considered.
Give this one a try later!
Patient Empowerment: Advocacy:
Patient Rights Evolution of MS Lesion
Rehabilitation: Assistive Technology Adherence to Treatment
Don't know?
5 of 34
Definition
Females have 3>1 greater risk of developing MS (70-75%)
PPMS = 50/50
SPECIALIST EXAM PREP (CMSC) 123
QUESTIONS SCORED A+ TO PASS!!
1 of 34
Definition
10-59 years, highest incidence between 20-40 years
Average age of onset is 28-30 years
Give this one a try later!
Clinical Course and Natural History:
Epidemiology: Gender
Secondary Progressive
, Clinical Course and Natural History:
Advanced Disease Epidemiology: Age of Onset
Don't know?
2 of 34
Definition
Obtain detailed and accurate history in chronological order
Is the patient's speech coherent? Is the language fluent? Is the
language appropriate for the level of education?
Assess level of consciousness, orientation memory, intellectual
status and speech.
Give this one a try later!
Diagnosis of Multiple
Sclerosis: Diagnosis of Multiple Sclerosis:
Diagnostic Testing: Diagnostic Testing:
Clinical Examination - Medical Clinical Examination - Sensory Exam
History
Diagnosis of Multiple Sclerosis: Diagnosis of Multiple Sclerosis:
Diagnostic Testing: Diagnostic Testing:
Clinical Examination - Components Clinical Examination - Reflexes
Don't know?
3 of 34
,Term
Diagnosis of Multiple Sclerosis:
Diagnostic Testing:
Clinical Examination - Cranial Nerve 1 (CNI)
Give this one a try later!
Optic nerve Olfactory nerve
Visual acuity, gross visual fields Sense of smell
Hypoglossal Acoustic nerve Hearing and
Motor nerve of the tongue equilibrium
Don't know?
4 of 34
Definition
Disruption of the BBB occurs with inflammation.
Gd enhancement occurs at active sites. Enhancement usually
subsides in 3 to 6 weeks leaving a "white spot" on imaging.
These areas can become larger and reinflamed with new disease
activity.
Repeated inflammation may cause extensive damage within the
lesion. These may appear as hypointense lesions (T1 black holes)
New MRI lesions can be "clinically silent" due to:
Location of the lesion
, Number of lesions
Severity of the damage
RRMS: great deal of MRI activity
SPMS: more symptomatic, less MRI activity. Chronic, older lesions
that reflect irreversible axonal damage and atrophy.
Per Consortium of Multiple Sclerosis Centers, MRI should be be
used as part of the diagnosis of MS. No current recommendation for
MRI at preset intervals. Repeat MRI is appropriate if change of
condition of the patient or change in treatment is considered.
Give this one a try later!
Patient Empowerment: Advocacy:
Patient Rights Evolution of MS Lesion
Rehabilitation: Assistive Technology Adherence to Treatment
Don't know?
5 of 34
Definition
Females have 3>1 greater risk of developing MS (70-75%)
PPMS = 50/50
