Multiple Sclerosis Overview Quiz

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Questions and Answers

Which of the following is NOT a proposed cause of Multiple Sclerosis?

Bacterial or viral infection

Pesticides

Genetics (correct)

Central nervous system immune response

What is the most common neurological disease impacting young Canadian adults?

Stroke

Multiple Sclerosis (correct)

Alzheimer's Disease

Parkinson's Disease

What are the two main components that are damaged in MS?

Nerves and dendrites

Blood vessels and glial cells

Axons and myelin sheath (correct)

Synapses and neurotransmitters

What is the defining characteristic of MS that helps in its diagnosis?

Presence of lesions in various parts of the brain and spinal cord over time (D) Signup and view all the answers

Which of the following symptoms is NOT commonly associated with MS?

Loss of appetite (D) Signup and view all the answers

Why is MRI used to diagnose MS?

To detect inflammation and damage in the brain and spinal cord (D) Signup and view all the answers

Which of these features are NOT a characteristic of MS?

A single, localized lesion that remains static over time (B) Signup and view all the answers

Which of the following statement is TRUE about MS?

MS is an autoimmune disease affecting the central nervous system (A) Signup and view all the answers

Which of the following factors is NOT considered a potential risk factor for multiple sclerosis?

Human papillomavirus (HPV) infection (A) Signup and view all the answers

What is the term used to describe the presence of two or more protein bands of a specific immunoglobulin (IgG) in cerebrospinal fluid (CSF) that have similar intensity compared to the concurrent serum sample?

Oligoclonal banding (A) Signup and view all the answers

What is the primary function of gadolinium enhancement in magnetic resonance imaging (MRI) of MS patients?

Identifying areas of active inflammation and a compromised blood-brain barrier (A) Signup and view all the answers

What type of immune cells are primarily responsible for invading the central nervous system (CNS) and initiating inflammation in MS patients?

T cells (C) Signup and view all the answers

Which of the following statements accurately describes the role of vitamin D in relation to MS?

Vitamin D has immunomodulatory effects in the brain and may play a role in reducing the inflammatory impact of MS. (C) Signup and view all the answers

Which of the following is NOT a key feature of acute MS lesions?

Increased production of oligodendrocytes (A) Signup and view all the answers

What is the primary mechanism by which Epstein-Barr virus (EBV) is thought to contribute to the development of MS?

EBV-specific T cells or antibodies may falsely recognize and attack CNS auto-antigens, leading to an autoimmune response. (D) Signup and view all the answers

What is the role of microglia in the development of MS?

Microglia can contribute to both neuroinflammation and neuroprotection depending on their activation state. (D) Signup and view all the answers

What is the primary function of visual-evoked potentials (VEPs) in the diagnosis of MS?

VEPs measure the speed at which electrical signals travel along the optic nerve. (A) Signup and view all the answers

What is the main difference between MS lesions that are visible on MRI and those that do not cause symptoms?

Symptomatic lesions affect critical areas of the brain, while asymptomatic lesions are located in less vital areas. (B) Signup and view all the answers

Which of the following statements accurately describes the role of the blood-brain barrier (BBB) in MS?

The BBB is disrupted in MS, allowing immune cells and inflammatory mediators to enter the CNS. (C) Signup and view all the answers

In a spinal tap, what is the presence of oligoclonal banding in the cerebrospinal fluid (CSF) typically indicative of?

Multiple sclerosis (B) Signup and view all the answers

What is the primary distinction between the inflammatory and environmental causes of multiple sclerosis (MS)?

Inflammatory causes involve immune system dysfunction, while environmental causes relate to external factors. (D) Signup and view all the answers

Based on the provided content, what is the primary function of T cells in the development of MS?

T cells directly attack and destroy oligodendrocytes, the cells responsible for producing myelin. (A) Signup and view all the answers

Which of the following describes the likely effect of migrating from a low-risk to a high-risk area for MS before adolescence?

Increased risk of developing MS (A) Signup and view all the answers

What is considered the main purpose of a spinal tap when diagnosing MS?

To detect the presence of oligoclonal banding in the cerebrospinal fluid (A) Signup and view all the answers

What is a "dark zone" or "black hole" observed in MS plaques on MRI?

An area of axonal loss (B) Signup and view all the answers

Study Notes

Multiple Sclerosis (MS) Overview

MS affects approximately 100,000 Canadians, with women being diagnosed more often than men (a ratio of more than three times).
MS is the most common neurological disease in young adults (aged 15 to 40) in Canada.
MS symptoms include loss of balance, impaired speech, severe fatigue, double vision, and paralysis.
Possible causes of MS include bacterial or viral infection, pesticides, and the central nervous system's immune response.

MS Symptoms

Abnormal sensations: "Pins and needles" sensation
Bladder problems
Difficulty walking: Muscle weakness or spasms
Dizziness
Fatigue: Weak muscles, slowed thinking, or sleepiness
Muscle spasms: Mild stiffness to severe, painful spasms

MS Symptoms (detailed)

Vision problems: Blurred vision, double vision, or paralysis of eye muscles
Muscle stiffness: Lack of balance and coordination; loss of dexterity and fine movement
Fatigue

Types of MS

Relapsing-Remitting MS (RRMS): Short periods of worsening or relapses, followed by recovery periods. 85% of diagnosed MS are initially RRMS.
Secondary-Progressive MS (SPMS): Slow, steady progression with or without relapses; most RRMS will transition to SPMS eventually
Primary-Progressive MS (PPMS): Steady worsening from the start without periodic relapses or remissions; 10% of MS are PPMS.
Progressive-Relapsing MS (PRMS): Steadily worsening from the start with episodic flare-ups with or without remissions. 5% of MS is PRMS.

Diagnosing MS

A diagnosis requires evidence of disease activity in both time and space.
MRI scans often reveal enlarging focal lesions (white spots) over time.
Gadolinium enhancement in MRI scans identifies compromised blood-brain barriers or lesions with active inflammation.
Spinal tap (lumbar puncture) is used for diagnosis; often shows an elevated level of oligoclonal banding and elevation of myelin basic proteins.
Visual-evoked potentials (VEPs) detect conduction latency delays that are longer in those with MS (the time it takes for signals to reach the brain). However, conduction can be affected by unrelated conditions like tumors.

Causes of MS (Environmental factors)

MS risk is higher in people living above 40° latitude in the Northern Hemisphere—correlated largely with Vitamin D deficiency.
Movement from high-risk to low-risk areas during adolescence reduces MS risk, whereas moving from low-risk to high-risk areas increases it.
A deficiency of vitamin D might play a substantial role.
Infections with measles, human herpes virus-6, Epstein-Barr virus, and Chlamydia pneumoniae may increase the risk of MS. 90% of MS patients have also experienced Epstein-Barr virus infections like mononucleosis.

Causes of MS (Other Factors)

Genomic and epigenetic, and regulatory events like gene rearrangements, messenger RNA splicing, retroviral sequences, methylation, and microRNAs affect the development of MS.
Genome-wide allelic variants, consisting of single nucleotide polymorphisms, copy number variations, insertion/deletion polymorphisms, and disease-related genes, have been discovered to be associated with MS.

MS: Inflammatory Causes

MS is considered an autoimmune disease, driven by the presence of T cells that recognize oligodendrocyte myelin-specific antigens.
T cells cross the blood-brain barrier and release pro-inflammatory cytokines.
In acute MS lesions, demyelination of axons, the activation of microglia, and the infiltration of immune (T) cells into the central nervous system (CNS) are prominent. The infiltrates mainly consist of T-cells and macrophages.
An array of inflammatory agents is expressed within acute MS lesions.

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Description

Test your knowledge on Multiple Sclerosis (MS), a common neurological disease affecting many Canadians. This quiz covers its symptoms, potential causes, and demographics. Gain a better understanding of how MS impacts young adults and the challenges they face.