blue
what does an MS patient usually look like
White woman in her 20-40
but really anyone
What are some possible causes of MS?
Viral infection
other autoimmune diseases
environmental
genetic- HLA DRB1- 1501
Vit D deficiency - reduces th1 proinflammatory cytokines
what are the differences between oligodendrocytes and schwan cells
Oligo- CNS, multiple at a time
Schawn- PNS, one at a time
Draw the different types of neurons
Bipolar, pseudo unipolar, multipolar
Draw what happens during MS
myelin :(
perform Lhermittes test
neck flexion while sitting down. positive would be an electric shock sensation down the spine and extremities
what are the common symptoms and clinical features of MS
optic neuritis
Lhermitte sign
fatigue
motor deficits
sensory deficits
bowel/ baldder dysfucntion
What is the McDonald diagnostic criteria
lesions and different areas at different times. 2/4 areas.
periventricular, cortical or juxtacortical, infratentoral, spinal cord
CN I and II. they are myelinated by oligodendrocytes.
What are some differential diagnoses to MS?
Fibromyalgia, VItamin B12 deficiency, Guillan Barre, Lupus, migraines
what lab information alone can be enough for diagnosis of MS?
Oligoclonla bands in CSF
How does multiple sclerosis affect fertility and pregnancy?
Not enough research but there are drugs that have pregnancy contraindications and must be on birth control.
fingolimod crosses placenta, receptor is needed for angiogenesis. IFN B may lead to preterm birth
what is Uhthoff's Phenomenon?
When someone with MS is exposed to heat symptoms are exacerbated
what type of HSR is MS and who is involved
t4HSR against myelin basic protein CD8+
CD4+, th1 and th17
macrophages
B cells
IFN gamma is heavily involved in recruitment
are you likely to see lymphocytes in the CNS in healthy individuals?
usually not, BBB prevents this
What layers do you go through during a lumbar puncture?
Skin, subcutaneous tissue, (supraspinous ligament, interspinous ligament), ligaments flavum, dura mater, arachnoid mater, subarachnoid space(Pia)
Name 3 major gyri in the cerebrum and their function
precentral- primary motor cortex
postcenral gyrus- primary somatosensory
superior temporal gyrus- auditory
inferior frontal gyrus- motor speech
what are the different "types" of MS
relapsing remitting
primary progressive
secondary progressive
clinically isolated
active means ongoing inflammation. old means "plaque" as in scarring and gliosis.
how does pregnancy effect the patients MS?
you are in a state of immune suppression whole pregnant to protect the fetus. Estrogen has anti inflammatory properties.
No flares during pregnancy
fingolimod and natalizumab block similar cellular processes, what are the differences?
nat blocks interns needed for chemotaxis and vessel exiting.
fingolimod inhibits her migration from lymph to circulation
What are the 3 types of medical treatment an MS patient will need?
for acute attacks, prevention, and symptom relief
What are the diagnostic uses and differences between T1, T2 weighted MRIs and FLAIR images? With or without contrast.
T1 you can see active lesions, T2 you can see old and new lesions.
FLAIR; fluid attenuated inversion recovery. Like a t2 but suppresses fluid and highlights lesion.
contract gadolinum
explain the process during vision loss in optic neuritis
:)
What are some explanations to the hyperexcitabiliy seen in neurons with MS
Improper conductance, lack of inhibition, glutamate release by microglia and macrophages