Exam Cram

Outline

Background 

Diagnosis

Diagnostic criteria: 

• two lesions seperate by time and place

This can be MRI + CSF findings as oliclonal bands represent old damage. 

History:

• Sensory lesions

• UMN > LMN lesions

Examination:

Ix

• Clinical 

• MRI

• LP

MRI can be used to monitor serial change, e.g. yearly MRI reasonable (CRP poor marker)

Differentials

Management

Acute

1.  IV Steroids

Med Reg Notes

Pregnancy

Prednisolone causes maternal weight gain, fetal macrosomnia & gestational diabetes

No management recommended where possible

Progressive Multifocal Leukoencephalopathy (PML)

• Complication of MS

• Presentation: progressive confusion, memory loss & ataxia

• CT-Head: patchy white hypodense white matter lesions

• CD4+ count: reduced

Management 

• Ocrelizumab (primary progressive)

• Fingolimod (active relapsing remitting)

• Natalizumab: active rapidly progressing

References

Page written in 2024. 

Produced off FOAM basis: free, open access, medical education. This is not clinical advice, education for multiple choice questions only! 

Produced to the best of the author's ability. Any issues please contact contact: MunroMedics@gmail.com