Prometric > Multiple Sclerosis + Seizures > Flashcards

Multiple Sclerosis + Seizures Flashcards

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1
Q

autoimmune disorder where the immune system attacks and destroys myelinated axons in the CNS

A

Multiple Sclerosis (MS)

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2
Q

What is damaged in MS?

A

The insulating covers (myelin sheath) of nerve cells in the brain and spinal cord.

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3
Q

What are the demyelinating lesions of MS called?

A

Plaques

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4
Q

What is a characteristic cellular infiltration in MS?

A

Perivenular infiltration of lymphocytes and macrophages.
حول الوريد

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5
Q

Name three risk factors for MS.

A
  1. Genetic factors (HLA-DRB1).
  2. Viral infections like Epstein-Barr virus (EBV).
  3. Vitamin D deficiency.
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6
Q

How does Vitamin D reduce the risk of MS?

A

regulates immune response by decreasing proinflammatory cytokines and increasing anti-inflammatory cytokines.

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7
Q

How is MS typically diagnosed?

A

Based on signs and symptoms,
supported by brain imaging (MRI),
laboratory testing (CSF),
and lumbar puncture.

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8
Q

What is a common early sensory symptom of MS?

A

Sensory loss (Paresthesia).

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9
Q

What is a motor symptom of MS related to the spinal cord?

A

Muscle cramping secondary to spasticity.

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10
Q

What autonomic symptoms can MS cause?

A

Bladder, bowel, and sexual dysfunction.

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11
Q

What is Charcot’s triad?

A

Cerebellar symptoms of dysarthria (scanning speech),
nystagmus,
and intention tremor.

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12
Q

What is Relapsing-Remitting MS (RRMS)?

A

Recurrent attacks
where neurologic deficits appear
and resolve completely

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13
Q

What is Primary Progressive MS (PPMS)?

A

Function declines
without remission
after initial symptoms.

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14
Q

What is Secondary Progressive MS (SPMS)?

A

Patients with RRMS convert to a progressive form with increasing disability over years.

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15
Q

What is Progressive-Relapsing MS (PRMS)?

A

Progressive worsening from the beginning with occasional relapses. The disease continues to worsen between attacks.

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16
Q

What are the primary aims of MS therapy?

A

Returning function after an attack,
preventing new attacks,
and preventing disability.

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17
Q

What are the two aspects of MS medication?

A

1.Immunomodulatory/Disease-Modifying Therapies (DMTs).
2. Symptomatic Therapies.

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18
Q

What is the first-line treatment for an acute MS relapse?

A

Corticosteroids (e.g., IV Methylprednisolone or Oral Prednisone).

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19
Q

What is a second-line treatment for severe MS attacks if steroids fail?

A

Plasma Exchange (Plasmapheresis).

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20
Q

What is the mechanism of action of Interferon-beta?

A

Binds to specific receptors,
suppressing T-cell activity,
downregulating antigen presentation,
and modulating cytokines.

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21
Q

What is the benefit of Interferon-beta?

A

Reduces relapses by ~30%
and has a safe profile,
making it a first-line treatment.

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22
Q

An Interferon beta-1a conjugated to polyethylene glycol to decrease injection frequency

A

Peginterferon β-1a

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23
Q

What is the use of Peginterfe?

Study These Flashcards
A

to decrease injection frequency (every two weeks).ron β-1a

24
Q

What are common side effects of Interferon-beta?

Study These Flashcards
A

Skin reactions at injection site,
flu-like symptoms,
leukopenia,
and elevated liver enzymes.

25
Antibodies that develop in some patients after 6-18 months of treatment, which can reduce the drug's effectiveness.
Neutralizing Antibodies (NAbs)
26
A synthetic polypeptide used to reduce the frequency of relapses in MS.
Glatiramer Acetate
27
What are side effects of Glatiramer?
Injection site reactions (lipodystrophy), flu-like symptoms, palpitations, anxiety, and shortness of breath.
28
What is Dimethyl Fumarate (DMF) used for?
To reduce relapse rate and delay disability progression in MS.
29
What are side effects of DMF?
Skin flushing, GIT effects (pain, diarrhea, nausea), and lymphocytopenia.
30
How can skin flushing from DMF be managed?
Aspirin may be used to block this effect.
31
It is a sphingosine-1-phosphate receptor modulator that prevents activation of T cells.
mechanism of action of Fingolimod
32
What are monitoring parameters for Fingolimod?
ECG, BP, CBC, eye exam, liver enzymes.
33
What are contraindications for Fingolimod?
Coronary artery disease, heart failure, AV block, pregnancy, and live attenuated vaccines.
34
The active metabolite of Leflunomide
is Teriflunomide used for relapsing forms of MS.
35
What pharmacological agents can be used for MS-related fatigue?
Amantadine, Methylphenidate, and Fluoxetine.
36
What are first-line drugs for primary pain in MS?
Tricyclic antidepressants.
37
What is the first-line treatment for spasticity in MS?
Baclofen and Tizanidine.
38
What is the only FDA-approved medication for improving walking in MS?
Dalfampridine (4-Aminopyridine), a potassium channel blocker.
39
What class of drugs is used for bladder dysfunction in MS?
Antimuscarinics (e.g., Oxybutynin, Solifenacin).
40
What is used for sexual dysfunction in MS?
PDE5 Inhibitors (e.g., Sildenafil, Tadalafil).
41
Why is Vitamin D level critical for MS patients?
It plays a critical role in immune response and modulation.
42
has important value in oligodendrocytes regeneration in MS
Omega-3
43
A simple partial seizure that occurs a few seconds prior to a generalized seizure.
Aura stage of a seizure
44
The seizure itself is called
Ictus stage
45
The recovery period after the seizure, which may involve headache, fatigue, confusion, etc.
Postictal stage
46
Name three common triggers for seizures.
Stress, lack of sleep, alcohol.
47
Name three drugs that can lower the seizure threshold.
Bupropion, Clozapine, Tramadol (and others like Theophylline, Lithium, Quinolones).
48
What are the two main types of seizures?
Focal-Onset Seizures and Generalized-Onset Seizures
49
What happens in a Tonic-Clonic seizure?
Tonic phase (stiffness, loss of consciousness) followed by Clonic phase (rhythmic jerking).
50
What are two common occurrences during a Tonic-Clonic seizure?
Tongue biting and urinary incontinence.
51
What are Absence seizures?
Brief periods of impaired consciousness (10-30 seconds) without motor symptoms, common in children.
52
Brief, shock-like jerking of a muscle or group of muscles.
Myoclonic seizures
53
Any seizure lasting >5 minutes or more than one seizure within 5 minutes without returning to normal.
Status Epilepticus (SE)
54
What is the first-line initial treatment for Status Epilepticus?
IV Lorazepam
55
What are second-line treatments for Status Epilepticus if initial treatment fails?
IV Fosphenytoin, Valproic Acid, or Levetiracetam.
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