Upgrade to remove ads
Only $2.99/month

Multiple Sclerosis - FP B.bmed

Terms in this set (15)

The first immune cells that get activated
Microglia
Monocytes
Macrophages
What does typical patient present as
Young adult with two or more clinically distinct episodes of CNS dysfuntion with at least patrial resolution
Nystagmus
unsychronised eye movement --> double vision
Optic Neuritis
Inflammation of the second nerve making it painful to move eye and colour desaturation
Dysarthia
Blurred speech
Lhermitte sign
electric shock like sensation that run down the back or limb or neck
Very classic of MS
What do you need to do for diagnosis
CLINICAL HISTORY

MRI brain

MRI Spinal cord

Presence of Oligoclonal bands in the CSF
--> Protein produced by b-cells, very specific for MS

Visual evoked responses
--> measuring the transmission of electricity from the beginning of the optic nerve to the back of the brain
What is Visual evoked responses
The transmission of electricity from the beginning of the optic nerve to the back of the brain
Mc Donald Criteria is used in diagnosing MS, briefly explain it
In summary, if the patient have had a lesion (with objective clinical evidence) AND another lesion happens AFTER that
and there is a dissemination in space OR oligoclonal bands in CSF

Then the patient is diagnosed to have MS

ps: the location of the lesions is important
TREATMENT

Interferons
immune modulators
Glatiramer acetate
It looks like myelin basic protein which is the antigen that get recognised by the immune cells

Therefore, it can tricks the immune resulting in less Myelin loss and Shifting T-cells (proinflam TH1 --> regulatory TH2)
Fingolimod
Traps the lymphocytes in the periphery to prevent entry to the brain

It resembles naturally occurring extracellular lipid mediator sphingosine 1-phosphate.
It binds with S1P receptor to reduce the number of receptor available that can otherwise allow the lymphocyte out of the lymph node
Natalizumab
Inhibits immune cells entry to the brain

It covers the binding site of the immune cells that required for attachment to the endothelial on the BBB
Ocrelizumab
It kills B-lymphocytes

Its a humanised-monoclonal antibody that binds to the CD20 B-cells and kill it by
Compliment
Apoptosis
Macrophage attraction
NK
Cladribine
Reducing T and B lymphocytes
Mechanism of action is unknown
THIS SET IS OFTEN IN FOLDERS WITH...