Quiz
Multiple Sclerosis - Presentation, Diagnosis & Management
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1Multiple Sclerosis is a condition whereby the [blank_start]myelin sheathes[blank_end] of [blank_start]CNS tracts[blank_end] are broken down. Lesions also appear in the [blank_start]CNS[blank_end], and these are referred to as [blank_start]plaques[blank_end].
- Amyelin sheathes
- Baxons
- Ccell bodies
- Ddendrites
- ECNS tracts
- FPNS neurons
- Gplaques
- Hcysts
- Iaggregates
- JCNS
- KPNS
2Multiple Sclerosis affects [blank_start]only CNS tracts[blank_end]
- Aonly CNS tracts
- Bonly PNS neurons
- Cboth CNS tracts and PNS neurons
3Multiple Sclerosis is more prevalent in ...
- AFemales
- BMales
4Multiple Sclerosis tends to initially present ...
- Ain the teens
- Bbetween 30 and 40 years of age
- Cin those over 50 years of age
5To be specific, Multiple Sclerosis is the loss of the cells that produce myelin in the CNS, known as [blank_start]oligodendrocytes[blank_end]
- Aoligodendrocytes
6Multiple Sclerosis tends to cause pyramidal dysfunction. This can cause such things as spasticity, weakness and increased tone. What is the main tract of the pyramidal tract group?
[blank_start]Corticospinal tract[blank_end]- ACorticospinal tract
7The pyramidal dysfunction associated with Multiple Sclerosis tends to cause spasticity/weakness/etc to the [blank_start]extensors[blank_end] of the upper limbs and the [blank_start]flexors[blank_end] of the lower limbs
- Aextensors
- Bflexors
- Cflexors
- Dextensors
8Which visual condition is present in 50% of MS sufferers, and is the first sign of MS in 20% of sufferers?
[blank_start]Optic neuritis[blank_end]- AOptic neuritis
9How does Optic Neuritis present? (2 right answers)
- AAcute onset pain in eye upon eye movement
- BCentral blurriness/visual loss
- CPeripheral blurriness/visual loss
- DRed eye
- EFloaters in visual field
10In most cases, optic neuritis is a self-resolving condition given a few months.
- ARichtig
- BFalsch
11Some multiple sclerosis patients describe an intense pain of the face that can be triggered simply by light touch of the face. This condition is typically caused by impingement of one of the cranial nerves by a blood vessel, and is called [blank_start]Trigeminal Neuralgia[blank_end].
- ATrigeminal Neuralgia
12Trigeminal Neuralgia only tends to affect 2-4% of MS patients. These patients are typically treated using an anticonvulsant called
- ASodium Valproate
- BCarbamazepine
- CLamotrigine
- DAcetazolamide
- EDiazepam
13What are the main two cerebellar manifestations of Multiple Sclerosis?
- AAtaxia
- BTremor
- CSlurred speech
- DDizziness
- EHeadaches
14Multiple Sclerosis can cause CNVI palsy. How would this present?
- AInability to abduct the eyes, causing diplopia
- BInability to gaze downwards, causing diplopia
- CNegative pupillary light reflex
15In addition to this, Multiple Sclerosis can also cause difficulty in adduction of the eyes. This occurs when a plaque forms in the Medial Longitudinal Fasciculus and presents as Nystagmus of the [blank_start]abducting[blank_end] eye and is called [blank_start]Internuclear Ophthalmoplegia[blank_end]
- Aabducting
- Badducting
- CInternuclear Ophthalmoplegia
- DChronic Progressive Ophthalmoplegia
- EInternal Ophthalmoplegia
1670-80% of Multiple Sclerosis sufferers have lower urinary tract problems. The most common are [blank_start]increased[blank_end] frequency and [blank_start]urge[blank_end] incontinence.
- Aincreased
- Bdecreased
- Curge
- Dstress
- Eoverflow
17Amantadine is a drug commonly prescribed to Multiple Sclerosis patients suffering from
- AFatigue
- BSpeech Impairment
- CSexual Issues
- DEmotional Issues (e.g. Depression)
18For a diagnosis of Multiple Sclerosis to be confirmed, the patient must have suffered at least 2 episodes suggestive of demyelination.
- ARichtig
- BFalsch
19Name the criteria typically used to diagnose multiple sclerosis.
The [blank_start]McDonald[blank_end] Criteria- AMcDonald
20Which imaging study should be conducted in order to diagnose Multiple Sclerosis?
- AMRI
- BCT
- CX-ray
21Multiple Sclerosis may also be diagnosed by means of lumbar puncture to look for inflammation in the CNS. The CSF is tested for oligoclonal bands of [blank_start]IgG[blank_end] on electrophoresis, which are inflammation markers found in 75–85% of people with Multiple Sclerosis.
- AIgG
- BIgA
- CIgE
22In the most basic sense, acute exacerbations of multiple sclerosis are treated by the following:
Mild: [blank_start]Symptomatic treatment[blank_end]
Moderate: [blank_start]Oral steroids[blank_end]
Severe: Admit & give [blank_start]IV Steroids[blank_end]- ASymptomatic treatment
- BWatchful waiting
- CNo treatment
- DOral steroids
- EOral anticonvulsants
- FOral antidepressants
- GIV Steroids
- HIV Anticonvulsants
- IIV Antiepileptics
23Baclofen is a medication used to treat ... in MS patients
- ASpasticity
- BSensory Symptoms
- CLower Urinary Tract Dysfunction
- DFatigue
24Sensory symptoms caused by MS (pain, paraesthesia, numbness, etc) can be treated by the following:
Anti convulsant, e.g. [blank_start]Gabapentin[blank_end]
Anti depressant, e.g. [blank_start]Amitriptyline[blank_end]- AGabapentin
- BAmitriptyline
- CAmantadine
25The lower urinary tract dysfunction caused by multiple sclerosis can be treated by a Vasopressin Analogue called ...
- ADesmopressin
- BTerlipressin
- CCarbopressin
26Despite this, the most common long term management of lower urinary tract dysfunction in multiple sclerosis patients is...
- APelvic floor muscle training
- BCatheterisation
- CAnticholinergics e.g. Oxybutynin
27If an individual is thought to be at risk of developing MS or has two relapses of the condition, disease modifying therapy can be prescribed.
Match each first line therapy to it's description.
[blank_start]Interferon Beta[blank_end]: Balances expression of pro- and anti-inflammatory agents in the brain & reduces number of inflammatory cells crossing the blood brain barrier.
[blank_start]Glitiramer Acetate[blank_end]: Shifts the population of T cells from pro-inflammatory Th1 T-cells to regulatory Th2 T-cells that suppress the inflammatory response.- AInterferon Beta
- BGlitiramer Acetate
- CInterferon Gamma
28How are Interferon Beta & Glitiramer Acetate (Copaxone) administered in MS patients?
- ASubcutaneous/Intramuscular
- BIntravenous
- CSublingual
- DOral
29In patients with highly active multiple sclerosis, whereby interferon beta and Copaxone are ineffective, what is the second line disease modifying agent that should be given?
- AFingolimod
- BMitoxantrone
30Second line treatment can also come in the rather expensive form of monoclonal antibodies. Drugs such as Natalizumab are able to reduce the ability of inflammatory immune cells to attach to and pass through the cell layers lining the
- ABlood-brain barrier
- BWhite matter tracts of the brain (e.g. internal capsule)
- CGrey matter areas of the brain affected by MS such as the basal ganglia
- Dmyelin sheathes of CNS tracts
31The presence of which Human Leukocyte Antigen predisposes to multiple sclerosis?
- AHLA B27
- BHLA DR2
- CHLA D45
- DHLA BR7
32Which type of multiple sclerosis is the most common?
- ARelapsing Remitting
- BPrimary Progressive
- CSecondary Progressive
- DProgressive Relapsing
33Match the MS types to its definition:
[blank_start]Relapsing Remitting MS[blank_end] = Bouts of disease which occur months/years apart. Between these bouts there is no worsening in the patient's disability.
[blank_start]Secondary Progressive MS[blank_end] = Starts like relapsing remitting however then becomes a linear, constant attack on the myelin.
[blank_start]Primary Progressive MS[blank_end] = A constant attack on the myelin of the CNS - no bouts, just a constant disease state.
[blank_start]Progressive Relapsing[blank_end] = Bouts of disease which occur months/years apart. Between these bouts there is a progressive worsening of the condition.- AProgressive Relapsing
- BPrimary Progressive MS
- CSecondary Progressive MS
- DRelapsing Remitting MS
34Charcot's triad is indicative of Multiple Sclerosis. This consists of ...
- ADysarthria
- BNystagmus
- CIntention Tremor
- DChorea
- EMyoclonus
- FLhermitte's Sign
- GIncontinence
35[blank_start]Lhermitte's[blank_end] sign = Electric shock-like jerk which potentiates down the spine and radiates into the limbs when an individual bends their neck forwards.
- ALhermitte's
36Baclofen is a muscle relaxant used to treat [blank_start]muscle spasticity[blank_end]
- Amuscle spasticity
- Bintention tremor
- Cincontinence
- Ddysarthria
Informationen
- Beschreibung
- Multiple Sclerosis lectures (Parts 1 & 2) given on 18/09/2018 https://en.wikipedia.org/wiki/Multiple_sclerosis_signs_and_symptoms#Internuclear_ophthalmoplegia is really good for a walkthrough of MS symptoms
- Autor
- Matthew Coulson
- Sprache
- English
- Aufrufe
- 73
- Schlagwörter
- Bewertung
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