Used for treatment of acute MS relapses - promote recovery from acute demyelinating event.
What are glucocorticoids? Would you use these in treatment of GBS? (5 bonus points)
Key diagnostic tool to confirm demyelination.
What is an MRI? In MS, brain MRI is abnormal 95-99% of the time, although several other disease states are associated with a similar pattern.
The most common of the demyelinating diseases.
What is Multiple Sclerosis (MS)? Name the most prevalent subtype (70-85% of cases) for 10 bonus points.
Sleeves of lipoprotein plasma membranes of these cells wrap around axons in the PNS.
What are Schwann cells?
This man authored the tale of the great white whale - narrated by a man named Ishmael.
Who is Herman Mehlville?
What are glucocorticoids? Would you use these in treatment of GBS? (5 bonus points)
What is plasmapheresis?
The principal viral demyelinating disease in humans.
What is Progressive Multifocal Leukoencephalopathy? Name the virus and the condition a patient would need to be in to contract it. (20 bonus points)
The most prevalent symptom at onset for patients with MS (34%).
What is sensory disturbance? Explain why a patient may experience sensory disturbance with a demyelinating disease like MS for 20 bonus points.
Most commonly noted are paresthesias, as well as a 'squeezing sensation around the limbs'. Additionally, a common manifestation is unilateral numbness that spreads bilaterally and upwards over time, indicating spinal cord involvement.
Lhermitte is useful to localize to the cervical spinal cord. Sensory disturbances from MS flares generally resolve but occasionally evolve into chronic neuropathic pain.
Fatigue is common as well.
Perivenular plaques give rise to the distinct appearance of these lesions. Hint: Named after a Scottish pathologist.
What are Dawson fingers? Typically, multiple areas of high signal intensity are present on T2-weighted imaging and have a round or ovoid appearance. Often located in the corpus callosum and periventricular, juxtacortical, deep white matter and subcortical white matter.
This waxy substance extracted from the head cavity of a specific whale species was a hot commodity of the seas as early as the 17th century.
What is spermaceti (sperm oil)?
One of two treatment options considered for GBS, this medication requires at least 1000 donors for production.
What is IVIG? IVIG is the pooling of plasma extracted and purified from at least 1000 donors. Undetermined mechanism of action in GBS patients, but one theory besides preventing autoantibody attack on myelin is that the high IgG concentration accelerates the destruction of IgG.
Inflammatory condition resulting from demyelination of the optic nerve; degrades vision in one or both eyes.
What is optic neuritis? The initial inflammatory event in 15-20% of patients with MS.
Acute idiopathic autoimmune demyelinating disease of the PNS characterized by acute flaccid ascending neuromuscular paralysis.
What is Guillain-Barre Syndrome?
The common findings in CSF for patients with GBS.
What are increased protein and normal to elevated leukocytes?
This man was the first to circumnavigate the globe by ship.
Who is Ferdinand Magellan?
Cytokines secreted by immune cells that inhibit viral replication.
What are interferons? While IFN-gamma worsens the disease, the potent regulatory function of IFN on the immune system and its anti-inflammatory properties appears to be beneficial for some MS patients. risk for liver function abnormalities, leukopenia, thyroid disease, and possibly depression
THE TREASURY PRINTS MORE BILLS IN THESE 2 DENOMINATIONS THAN ANY OTHER
What are the $1 and the $20?
Diagnosis of MS relies on p_____ r_______. Hint: Machine learning
What is pattern recognition? Let's say a patient developed optic neuritis, and several months later developed cerebellar ataxia. Recognizing the pattern of acute attack, remission, and secondary attack in a different location is essential to diagnosing MS. Subtract 10 if you get this wrong.
This many weeks after onset of weakness, abnormal findings in nerve conduction studies are most pronounced in patients with GBS.
What is 3-4 weeks?
The fastest fish in the ocean.
What is the sailfish?
Monoclonal antibody used in treatment of MS to bind to lymphocytes, monocytes, basophils, and eosinophils.
What is Natalizumab? Prevents lymphocyte binding to the vascular endothelium and reduces inflammation.
ON JULY 20, 1999 IT WAS 30 YEARS SINCE THIS MAN SAID, 'HOUSTON... THE EAGLE HAS LANDED'
Who is Neil Armstrong?
Characteristic demyelination and remyelination of affected axons in this disease result in an 'onion-bulb' deformity of axons on biopsy - the disease lasts >8 weeks unlike GBS and has often has >3 relapses during those eight weeks.
What is Chronic Inflammatory Demyelinating Polyneuropathy?
This cutaneous nerve provides sensation to the posterolateral aspect of the distal third of the leg and the lateral aspect of the foot, heel, and ankle - is commonly untouched specifically in GBS.
What is the sural nerve?
This easternmost country of Europe led great voyages during the Age of Discoveries in the 15th and 16th centuries.
What is Portugal?