PCOL 13-1 Multiple Sclerosis
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Questions and Answers

Which type of Multiple Sclerosis is characterized by steadily worsening symptoms without remission?

  • PPMS (primary progressive) (correct)
  • RRMS (relapse-remitting)
  • CPMS (chronic progressive)
  • SPMS (secondary progressive)

    • Where do scars (lesions/plaques) commonly accumulate in Multiple Sclerosis?

  • White matter of the brain (correct)
  • Muscle tissue
  • Gray matter of the brain
  • Peripheral nerves

    • Why is it often hard to diagnose Multiple Sclerosis early in the disease onset?

  • Because MS only affects the peripheral nervous system
  • Because MS is a genetic disease
  • Due to the presence of definitive diagnostic tests
  • Because MS is largely idiopathic (correct)

    • What is the most common onset age for Multiple Sclerosis?

    <p>20 - 40 years</p> Signup and view all the answers

    Which risk factor is known to be causally linked to Multiple Sclerosis?

    <p>Exposure to virus (especially Epstein-Barr)</p> Signup and view all the answers

    What is the pathological hallmark to look for in the diagnosis of Multiple Sclerosis?

    <p>White matter on MRI</p> Signup and view all the answers

    What is the primary route of entry for activated T-cells and B-cells into the CNS during the neuroinflammatory response in Multiple Sclerosis?

    <p>Blood circulation from lymph nodes</p> Signup and view all the answers

    Which of the following is NOT among the increased levels of chemokines and cytokines during the neuroinflammatory response in Multiple Sclerosis?

    <p>Interleukin-7</p> Signup and view all the answers

    Which of the following statements about the approved drugs for Multiple Sclerosis treatment is accurate?

    <p>Ocrelizumab is not available on PBS and is used to treat PPMS</p> Signup and view all the answers

    Which type of cells does Interferon-β (IFN-β) primarily inhibit in Multiple Sclerosis (MS)?

    <p>T-cells</p> Signup and view all the answers

    What is the primary mechanism of action of Myelin Basic Protein Mimics in treating MS?

    <p>Promoting anti-inflammatory response in macrophages and microglia</p> Signup and view all the answers

    What is the pregnancy safety category of Interferon-β (IFN-β)?

    <p>Category D</p> Signup and view all the answers

    What is the dosing frequency of Interferon-β (IFN-β) in treating MS?

    <p>2 – 14 day intervals</p> Signup and view all the answers

    Which of the following is a known side effect of Interferon-β (IFN-β) treatment in MS?

    <p>Flu-like symptoms</p> Signup and view all the answers

    What is the primary mechanism of action of fingolimod in treating RRMS?

    <p>Preventing lymphocytes from leaving secondary lymphoid organs</p> Signup and view all the answers

    What are the potential side effects of fingolimod treatment?

    <p>Bradycardia, atrio-ventricular block, opportunistic infections, cutaneous malignancies</p> Signup and view all the answers

    How does the efficacy of fingolimod compare to Interferon-β (IFN-β) for reducing relapses in RRMS?

    <p>Comparable efficacy to INF-β for reducing relapses, possibly provides some neuroprotection</p> Signup and view all the answers

    Which medication for RRMS interferes with pyrimidine synthesis to prevent DNA replication in proliferating B and T-cells?

    <p>Teriflunomide</p> Signup and view all the answers

    Which medication for RRMS causes an antioxidant response and multiple changes in immune pathway, including increased T- and B-cell apoptosis?

    <p>Dimethyl Fumarate</p> Signup and view all the answers

    Which medication for RRMS has a pregnancy safety category of X and is associated with side effects such as hair thinning and liver enzyme changes?

    <p>Teriflunomide</p> Signup and view all the answers

    Which medication for RRMS preferentially depletes peripheral B- and T-cells lymphocytes while preserving other immune cells/blood cells?

    <p>Cladribine</p> Signup and view all the answers

    Which medication for RRMS is associated with side effects such as opportunistic infections, thyroid autoimmune effects, and malignancies?

    <p>Humanized Immunoglobulins</p> Signup and view all the answers

    Which medication for RRMS causes a significant reduction in relapse and disease progression but is associated with lymphopenia and a higher risk of severe infections and tumors?

    <p>Cladribine</p> Signup and view all the answers

    Which medication for RRMS is administered orally in short cycles and is a prodrug that is phosphorylated to an active purine nucleoside analogue?

    <p>Cladribine</p> Signup and view all the answers

    Which medication for RRMS, when administered by IV every 4 weeks, has been shown to improve relapse rates and reduce the number of new CNS lesions and brain volume loss, but has high efficacy and high risk, with pregnancy safety being unknown?

    <p>Humanized Immunoglobulins</p> Signup and view all the answers

    Which medication for RRMS targets a cell-surface molecule predominantly found on T and B cells, leading to rapid and long-lasting depletion of these cells by cytolysis?

    <p>Alemtuzumab</p> Signup and view all the answers

    Which medication for RRMS targets CD20 on B-cells only (not stem cells) and is the only available treatment for PPMS, with a cost of $40 – 50K per year (USD)?

    <p>Ocrelizumab</p> Signup and view all the answers

    Which medication for RRMS binds to the α4 subunit of integrins on leukocytes to prevent adhesion to endothelial cells, thus preventing lymphocyte migration across the blood-brain barrier?

    <p>Natalizumab</p> Signup and view all the answers

    What is the primary purpose of AHSCT (autologous haematopoietic stem cell transplant) in treating aggressive MS?

    <p>To reset the immune system</p> Signup and view all the answers

    Which treatment has been shown to have no evidence of helping those with non-active MS?

    <p>Stem Cell Treatments</p> Signup and view all the answers

    What is the primary reason for the use of NSAIDs in Alzheimer's Disease (AD) according to epidemiological studies?

    <p>To reduce AD incidence</p> Signup and view all the answers

    What is the primary shared neuroinflammatory pathway between Alzheimer's Disease (AD) and MS?

    <p>Migroglial activation</p> Signup and view all the answers

    Which type of stem cell treatments for MS remain experimental only?

    <p>AHSCT (autologous haematopoietic stem cell transplant)</p> Signup and view all the answers

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