Multiple Sclerosis Certified Specialist Exam Questions with
Complete Solutions
Relapse Remitting Multiple Sclerosis (RRMS) - syndrome (RIS) is another early indicator of
ANSWER -Periods of acute worsening of demyelination but with no symptoms. RIS is
neurologic function, with some degree of usually detected incidentally in healthy people
recovery. There is o progression in between. who have an MRI that shows typical MS lesions.
About 85% individuals are dx with RRMS initially These people may remain asymptomatic (have
no symptoms), or go on to develop CIS or MS.
Therefore, RIS may represent the earliest
How often can remissions occur in RRMS? - indicator of MS before symptoms appear.
ANSWER -Remissions can be months to
years with no new signs of disease activity.
Deficits suffered during attacks or exacerbation Clinically Isolated Syndrome (CIS) -
may totally resolve or result in ongoing deficits. ANSWER -A term that describes a first
clinical episode with features suggestive of
multiple sclerosis. Usually occurs in young adults
Secondary Progressive (SPMS) - and affects optic nerves, brainstem, or the spinal
ANSWER -Following an initial relapse cord. They usually recover from their presenting
remitting course, the disease transitions in many episode. It is often the first manifestation of MS.
people to a steadily progressive form with
increased loss of function. OF the 85% who start
with RRMS, more than 50% will develop SPMA Advanced Disease - ANSWER -
within 10 years and 90% within 25 years.
Pediatric MS - ANSWER -5% of all patients
Primary Progressive Multiple Sclerosis (PPMS) - with MS develop the disease before age of 18,
ANSWER -Continuing worsening of 1% before the age of 10 years. Data suggests
disease from onset, without distinct relapses. IFN Beta and glatiramer acetate are safe,
Approximately 10% of people are dx with PPMS. effective, and well tolerated I the pediatric
population.
Progressive-Relapsing Multiple Sclerosis
(PPMS) - ANSWER -Progressive 10 year outlook for individuals with MS
neurologic decline with occasional acute (How many utilize a cane to ambulate? What
relapses. About 5% of people appear to have percentage require a wheelchair? How man
PRMS at diagnosis. convert to secondary progressive phase of the
disease? - ANSWER -1/2 of patients use a
cane to ambulate
Benign MS - ANSWER -Patients who have 15% require a wheelchair
rare attacks and are minimally disables 20 years Approximately 1/2 of patients convert to SPMS
after being diagnose with MS. About 10% of MS
patients experience a "benign course" of MS.
Multiple Sclerosis Definition - ANSWER -
The most common immune-mediated
Radiologically Isolated Syndrome (RIS) - inflammatory demyelinating disease of the central
ANSWER -Radiologically isolated nervous system (CNS) - the brain, spinal cord,
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, Multiple Sclerosis Certified Specialist Exam Questions with
Complete Solutions
and optic nerves- and is a leading cause of of some pathogen by phagocytic cells such as
disability in young adults. It is thought that the macrophage and neutrophils.
immune system attacks theCNS.
adaptive immunity - ANSWER -Antibodies
Myelin - ANSWER -Coating that surrounds that are produced to pathogens serve as an
the nerve fibers immunologic memory. Compromised primarily of
lympthocytic B cells, which produce the
antibodies that attach to specific antigens and T
Axons - ANSWER -Carry impulses away cells.
from the cell body
Nerve Fibers
Risks of the immune system - ANSWER -
Discomfort and collateral damage resulting from
How does MS get its name? - ANSWER - inflammation. Damage to self resulting from
Damaged myelin (demyelination) forms scar hypersensitivity or autoimmunity.
tissue (sclerosis) in multiple sites in the CNS.
The immune mechanisms thought to contribute to
Immune system and how it related to cause of the development of MS (6 steps) -
MS - ANSWER -It may be the result of ANSWER -1. TH1 cells are
abnormal immune response to some infectious stimulated/activated in the periphery by
or environmental trigger in a genetically presentation with antigens (possibly by a virus).
susceptible individual. 2. Once activate these cells rapidly increase in
numbers and release cytokines and
metalloproteinases that break down and
The pathologic process in MS begins in MS extracellular matrix of the blood brain barrier.
beginning with the activation of __________in 3. Once in the CNS, TH2 cells are presented with
the periphery after they are presented with a myelin protein that is similar to the antigen
possible virus. - ANSWER -CD4+ T cells presented in the periphery.
4. The reactivated T cells along with B cells,
macrophages, and CD8+ t cells interact to
What combination of cells produce an produce an inflammatory response resulting in
inflammatory response and subsequent myelin myelin damage.
damage through multiple mechanisms. - 5. Cells interact to produce an inflammatory
response directed at components of the CNS.
ANSWER -Activated CD4+ T Cells along
6. Inflammation leads to demyelination as well as
with B Cells, macrophages, and CD 8+ T cells
axonal degeneration followed by chronic
interact to produce an inflammatory response.
neurodegeneration.
innate immunity - ANSWER -Immune Gadolinium enhancement on MRI is seen in... -
response to certain pathogens, which occurs in
ANSWER -early states of the most
all healthy individuals and does not require prior
demyelinating lesions in patients with RRMS and
exposure to the pathogen. Immediate destruction
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Complete Solutions
Relapse Remitting Multiple Sclerosis (RRMS) - syndrome (RIS) is another early indicator of
ANSWER -Periods of acute worsening of demyelination but with no symptoms. RIS is
neurologic function, with some degree of usually detected incidentally in healthy people
recovery. There is o progression in between. who have an MRI that shows typical MS lesions.
About 85% individuals are dx with RRMS initially These people may remain asymptomatic (have
no symptoms), or go on to develop CIS or MS.
Therefore, RIS may represent the earliest
How often can remissions occur in RRMS? - indicator of MS before symptoms appear.
ANSWER -Remissions can be months to
years with no new signs of disease activity.
Deficits suffered during attacks or exacerbation Clinically Isolated Syndrome (CIS) -
may totally resolve or result in ongoing deficits. ANSWER -A term that describes a first
clinical episode with features suggestive of
multiple sclerosis. Usually occurs in young adults
Secondary Progressive (SPMS) - and affects optic nerves, brainstem, or the spinal
ANSWER -Following an initial relapse cord. They usually recover from their presenting
remitting course, the disease transitions in many episode. It is often the first manifestation of MS.
people to a steadily progressive form with
increased loss of function. OF the 85% who start
with RRMS, more than 50% will develop SPMA Advanced Disease - ANSWER -
within 10 years and 90% within 25 years.
Pediatric MS - ANSWER -5% of all patients
Primary Progressive Multiple Sclerosis (PPMS) - with MS develop the disease before age of 18,
ANSWER -Continuing worsening of 1% before the age of 10 years. Data suggests
disease from onset, without distinct relapses. IFN Beta and glatiramer acetate are safe,
Approximately 10% of people are dx with PPMS. effective, and well tolerated I the pediatric
population.
Progressive-Relapsing Multiple Sclerosis
(PPMS) - ANSWER -Progressive 10 year outlook for individuals with MS
neurologic decline with occasional acute (How many utilize a cane to ambulate? What
relapses. About 5% of people appear to have percentage require a wheelchair? How man
PRMS at diagnosis. convert to secondary progressive phase of the
disease? - ANSWER -1/2 of patients use a
cane to ambulate
Benign MS - ANSWER -Patients who have 15% require a wheelchair
rare attacks and are minimally disables 20 years Approximately 1/2 of patients convert to SPMS
after being diagnose with MS. About 10% of MS
patients experience a "benign course" of MS.
Multiple Sclerosis Definition - ANSWER -
The most common immune-mediated
Radiologically Isolated Syndrome (RIS) - inflammatory demyelinating disease of the central
ANSWER -Radiologically isolated nervous system (CNS) - the brain, spinal cord,
1/8
, Multiple Sclerosis Certified Specialist Exam Questions with
Complete Solutions
and optic nerves- and is a leading cause of of some pathogen by phagocytic cells such as
disability in young adults. It is thought that the macrophage and neutrophils.
immune system attacks theCNS.
adaptive immunity - ANSWER -Antibodies
Myelin - ANSWER -Coating that surrounds that are produced to pathogens serve as an
the nerve fibers immunologic memory. Compromised primarily of
lympthocytic B cells, which produce the
antibodies that attach to specific antigens and T
Axons - ANSWER -Carry impulses away cells.
from the cell body
Nerve Fibers
Risks of the immune system - ANSWER -
Discomfort and collateral damage resulting from
How does MS get its name? - ANSWER - inflammation. Damage to self resulting from
Damaged myelin (demyelination) forms scar hypersensitivity or autoimmunity.
tissue (sclerosis) in multiple sites in the CNS.
The immune mechanisms thought to contribute to
Immune system and how it related to cause of the development of MS (6 steps) -
MS - ANSWER -It may be the result of ANSWER -1. TH1 cells are
abnormal immune response to some infectious stimulated/activated in the periphery by
or environmental trigger in a genetically presentation with antigens (possibly by a virus).
susceptible individual. 2. Once activate these cells rapidly increase in
numbers and release cytokines and
metalloproteinases that break down and
The pathologic process in MS begins in MS extracellular matrix of the blood brain barrier.
beginning with the activation of __________in 3. Once in the CNS, TH2 cells are presented with
the periphery after they are presented with a myelin protein that is similar to the antigen
possible virus. - ANSWER -CD4+ T cells presented in the periphery.
4. The reactivated T cells along with B cells,
macrophages, and CD8+ t cells interact to
What combination of cells produce an produce an inflammatory response resulting in
inflammatory response and subsequent myelin myelin damage.
damage through multiple mechanisms. - 5. Cells interact to produce an inflammatory
response directed at components of the CNS.
ANSWER -Activated CD4+ T Cells along
6. Inflammation leads to demyelination as well as
with B Cells, macrophages, and CD 8+ T cells
axonal degeneration followed by chronic
interact to produce an inflammatory response.
neurodegeneration.
innate immunity - ANSWER -Immune Gadolinium enhancement on MRI is seen in... -
response to certain pathogens, which occurs in
ANSWER -early states of the most
all healthy individuals and does not require prior
demyelinating lesions in patients with RRMS and
exposure to the pathogen. Immediate destruction
2/8
