GENERAL PURPOSE: To provide information on issues related to MS. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Outline the epidemiology, pathophysiology, diagnosis, and types of MS. 2. Recognize signs and symptoms of MS. 3. Select options in the management of MS.
1. Which statement about the incidence of MS is accurate?
a. It affects men twice as often as women.
b. It affects women three times more often than men.
c. It affects both sexes equally.
2. There's an increased incidence and prevalence of MS in people who live
a. at increased northern distance from the equator.
b. on or near the equator.
c. at increased southern distance from the equator.
3. Although MS isn't considered a hereditary condition, there's an overall familial recurrence rate of approximately
a. 20%.
b. 30%.
c. 40%.
4. Relapses or flares in MS happen when T cells cause damage to which cells in the CNS?
a. ependymal cells
b. astrocytes
c. oligodendrocytes
5. Flares are newly appearing neurologic symptoms in the absence of an infection or fever that last longer than at least
a. 24 hours.
b. 72 hours.
c. 1 week.
6. The most common type of MS is
a. PPMS.
b. SPMS.
c. RRMS.
7. What can occur over time secondary to continued damage in the white and gray matter of the CNS?
a. intracranial hemorrhage
b. cerebral atrophy
c. brainstem herniation
8. Which statement is consistent with the diagnosis of CIS?
a. All patients with CIS eventually go on to develop MS.
b. The patient has neurologic symptoms for at least 48 hours that point to possible MS.
c. Neurologic symptoms are followed by a complete or partial recovery.
9. Patients with RRMS converted to SPMS within how many years after developing RRMS?
a. 1 to 5 years
b. 10 to 15 years
c. 25 to 30 years
10. Which statement about PPMS is accurate?
a. Relapses and remissions can occur as often as every month.
b. It affects men more than women at a rate of 4:1.
c. It starts to affect patients in their late 30s.
11. Charcot neurologic triad occurs from a breakdown in communication between neurons in which region of the brain?
a. cerebellum
b. corpus callosum
c. thalamus
12. The first part of Charcot neurologic triad is
a. seizures.
b. difficulty reading and writing.
c. nystagmus.
13. Optic nerve plaques can cause
a. color distortion.
b. scotomas.
c. flashes.
14. The second factor in Charcot neurologic triad is
a. poor cognitive abilities.
b. intention tremor.
c. decreased alertness.
15. The dysarthria that occurs in people with MS results from plaques in the
a. amygdala.
b. hypothalamus.
c. brainstem.
16. Lhermitte sign is an electric shock type of sensation that moves down the spine with
a. neck flexion.
b. arm abduction.
c. shoulder shrugging.
17. ANS disorders that can stem from spinal cord involvement in MS include
a. hair loss.
b. incontinence.
c. loss of the sense of smell.
18. One of the most common complaints in patients with MS is
a. excruciating muscle pain.
b. memory problems.
c. unrelenting fatigue.
19. Which statement about lassitude is accurate?
a. It's just a reflection of laziness.
b. It often occurs around the same time each day.
c. It occurs after intense physical activity.
20. Uhthoff phenomenon is a temporary worsening of MS symptoms caused by
a. an increase in temperature.
b. high-stress situations.
c. a change in medications.
21. MS is diagnosed by
a. genetic testing.
b. an acetylcholine level.
c. MRI.
22. An injectable immunomodulator that has antiviral properties and may modify the course of MS is
a. fostamatinib.
b. interferon beta-1a.
c. ecallantide.
23. Which of the following is an oral immunomodulator with antioxidant properties that helps protect brain cells and the spinal cord?
a. fingolimod
b. rilonacept
c. siltuximab
24. Mitoxantrone may increase the risk of
a. leukemia.
b. suicidal ideation.
c. renal failure.
25. The first monoclonal antibody approved for the management of MS is
a. abciximab.
b. natalizumab.
c. bezlotoxumab.
26. Ocrelizumab is approved to treat all of the following except
a. RRMS.
b. early PPMS.
c. SPMS.
27. The use of cannabinoids in patients with MS may decrease
a. the inflammation of optic neuritis.
b. the severity of sleep disorders.
c. neuropathic pain.
28. Which alternative therapy may increase the quality of life in some patients with MS?
a. yoga
b. meditation
c. tai chi
29. What benefit of dalfampridine has been demonstrated in patients with MS?
a. improved concentration
b. decreased muscle spasticity
c. improved walking speed
30. When injected into specific muscles, what substance has been shown to improve dystonia?
a. onabotulinum toxin A
b. C1 esterase inhibitor recombinant
c. 6-mercaptopurine
31. Baclofen works by inhibiting the transmission of nerve cells in the brain to allow for
a. improvement in tinnitus.
b. decreased nocturia.
c. muscle relaxation.
32. Amantadine and modafinil are medications approved for patients with primary MS to treat
a. dizziness.
b. fatigue.
c. skin numbness.