week 7 - multiple sclerosis
Emily, 27, manager
PCx
Visual Sx L eye (blurring), colour vision less intense than normal
Mild pain on movement
PHx
UTI?
Urinary urgency
Incontinence (10 days) – 15 years ago
Tendency to drag left leg
Frequent trips + new fall
Social
Nonsmoker
Drink few glass (weekends)
Marijuana (during teenager)
OCP
Ex
Blurring of L optic disc margin
Disc pallor
afferent papillary defect (L)
deep tendon reflex (brisk) at L lower limb
plantar reflex (extensor) à upper motor neuron lesion?
MRI scan
Brian
T2 hyperintensity of anterior L optic nerve
Small T2 hyperintense lesion in corpus collosum + periventricular white matter
Small in T1 image
Thorax
Non-specific abnormality at T4 left side
CSF
Oligoclonalprotein bands (-ve in serum)
TASK
Multiple Sclerosis
a. Clinical presentation (saree)
i. Patho
b. Epidemiology (more common where? Who?) + Psychosocial (Chris)
i. Patient’s reaction
d. Crititeria for Dx (Alvin)
i. Communicating skill
e. Investigation (yazid)
i. MRI
ii. Oligoclonalproten bands
f. Management + Palliative care
(Christine)
g. Complication + Prognosis + Progression (Maze)
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