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Multiple Sclerosis - Answers

1. The total area is seen by an eye when fixed on a central point.

2. CNS tumors, diabetes, hyperthyroidism, hypertension, multiple sclerosis.

3. Measuring the smallest line read on an eye chart when standing at a predetermined distance.

4. To detect changes in vision.

5. The myelin sheath is attacked and eventually destroyed.

6. The body's immune response may attack the myelin sheath in response to a virus.

7. Nerves are damaged causing interference in functions controlled by the nervous system.

8. Vision, speech, walking, writing, memory.

9. Some of the myelin may be repaired but some may disappear. Scarring may occur. Material deposited into the scars forms plaques.

10. Relapsing-remitting (RR-MS) which is a series of attacks followed by a partial or complete disappearance of symptoms.

11. PP-MS there is a gradual decline in abilities with only short periods of slight relief. In RR-MS there are long asymptomatic periods with brief periods of relapse.

12. Visual disturbances, muscle weakness, spasms, fatigue, numbness, and prickling pain or sensation in extremities.

13. A large donut-shaped x-ray machine takes x-ray images at many different angles around the body. These images are processed by a computer to produce cross-sectional pictures of the body. In each of these pictures, the body is seen as an x-ray "slice" of the body, which is recorded on a film. This recorded image is called a tomogram. "Computerized Axial Tomography" refers to the recorded tomogram "sections" at different levels of the body.  CT scans analyze internal structures of the body including the head, bone (density), spine, spinal cord and nerves, and organ anatomy.  Scans may use a contrast medium for better visualization.  CT scans may also be used to guide a radiologist in obtaining a tissue biopsy for cancer analysis.  

14. An MRI scan uses magnetism, radio waves, and a computer to produce images of body structures. A CT scan uses a series of x-rays.

15. An MRI scan produces much greater detail than a CT scan.

16. Insertion of a needle into the spinal canal to withdraw cerebrospinal fluid (CSF) for testing.

17. The plaques are caused by areas of demyelination in the nerves. Scar tissues are formed and material deposited in the scar tissue forming the plaques.

18. It may take many years for the demyelination and the scarring process to occur. The body repairs some of the myelin following an attack.

19. Steroids are used to reduce inflammation. They are nonspecific and have many side effects.  Disease-modifying therapies (DMTs) target the autoimmune process and may reduce exacerbations and even the probability of long-term disability.   DMTs include immune modifiers such as interferons. B-interferons suppress the immune system, thus reducing attacks on the myelin sheath.  Treatments such as monoclonal antibodies (natalizumab) target proteins involved in the immune attack. Other pharmaceuticals target specific types of MS or specific symptoms (see MS treatments from the link on page 3 of the Case Study).