CERTIFIED MULTIPLE SCLEROSIS SPECIALIST EXAM
PREP (CMSC) WITH COMPLETE SOLUTIONS
/.Relapse Remitting Multiple Sclerosis (RRMS) - Answer-✅Periods of acute worsening
of neurologic function, with some degree of recovery. There is o progression in
between. About 85% individuals are dx with RRMS initially
/.How often can remissions occur in RRMS? - Answer-✅Remissions can be months to
years with no new signs of disease activity. Deficits suffered during attacks or
exacerbation may totally resolve or result in ongoing deficits.
/.Secondary Progressive (SPMS) - Answer-✅Following an initial relapse remitting
course, the disease transitions in many people to a steadily progressive form with
increased loss of function. OF the 85% who start with RRMS, more than 50% will
develop SPMA within 10 years and 90% within 25 years.
/.Primary Progressive Multiple Sclerosis (PPMS) - Answer-✅Continuing worsening of
disease from onset, without distinct relapses. Approximately 10% of people are dx with
PPMS.
/.Progressive-Relapsing Multiple Sclerosis (PPMS) - Answer-✅Progressive neurologic
decline with occasional acute relapses. About 5% of people appear to have PRMS at
diagnosis.
/.Benign MS - Answer-✅Patients who have rare attacks and are minimally disables 20
years after being diagnose with MS. About 10% of MS patients experience a "benign
course" of MS.
/.Radiologically Isolated Syndrome (RIS) - Answer-✅Radiologically isolated syndrome
(RIS) is another early indicator of demyelination but with no symptoms. RIS is usually
detected incidentally in healthy people who have an MRI that shows typical MS lesions.
These people may remain asymptomatic (have no symptoms), or go on to develop CIS
or MS. Therefore, RIS may represent the earliest indicator of MS before symptoms
appear.
/.Clinically Isolated Syndrome (CIS) - Answer-✅A term that describes a first clinical
episode with features suggestive of multiple sclerosis. Usually occurs in young adults
, and affects optic nerves, brainstem, or the spinal cord. They usually recover from their
presenting episode. It is often the first manifestation of MS.
/.Advanced Disease - Answer-✅
/.Pediatric MS - Answer-✅5% of all patients with MS develop the disease before age of
18, 1% before the age of 10 years. Data suggests IFN Beta and glatiramer acetate are
safe, effective, and well tolerated I the pediatric population.
/.10 year outlook for individuals with MS
(How many utilize a cane to ambulate? What percentage require a wheelchair? How
man convert to secondary progressive phase of the disease? - Answer-✅1/2 of patients
use a cane to ambulate
15% require a wheelchair
Approximately 1/2 of patients convert to SPMS
/.Multiple Sclerosis Definition - Answer-✅The most common immune-mediated
inflammatory demyelinating disease of the central nervous system (CNS) - the brain,
spinal cord, and optic nerves- and is a leading cause of disability in young adults. It is
thought that the immune system attacks theCNS.
/.Myelin - Answer-✅Coating that surrounds the nerve fibers
/.Axons - Answer-✅Carry impulses away from the cell body
Nerve Fibers
/.How does MS get its name? - Answer-✅Damaged myelin (demyelination) forms scar
tissue (sclerosis) in multiple sites in the CNS.
/.Immune system and how it related to cause of MS - Answer-✅It may be the result of
abnormal immune response to some infectious or environmental trigger in a genetically
susceptible individual.
/.The pathologic process in MS begins in MS beginning with the activation of
__________in the periphery after they are presented with a possible virus. - Answer-
✅CD4+ T cells
/.What combination of cells produce an inflammatory response and subsequent myelin
damage through multiple mechanisms. - Answer-✅Activated CD4+ T Cells along with B
Cells, macrophages, and CD 8+ T cells interact to produce an inflammatory response.
/.innate immunity - Answer-✅Immune response to certain pathogens, which occurs in
all healthy individuals and does not require prior exposure to the pathogen. Immediate
destruction of some pathogen by phagocytic cells such as macrophage and neutrophils.
PREP (CMSC) WITH COMPLETE SOLUTIONS
/.Relapse Remitting Multiple Sclerosis (RRMS) - Answer-✅Periods of acute worsening
of neurologic function, with some degree of recovery. There is o progression in
between. About 85% individuals are dx with RRMS initially
/.How often can remissions occur in RRMS? - Answer-✅Remissions can be months to
years with no new signs of disease activity. Deficits suffered during attacks or
exacerbation may totally resolve or result in ongoing deficits.
/.Secondary Progressive (SPMS) - Answer-✅Following an initial relapse remitting
course, the disease transitions in many people to a steadily progressive form with
increased loss of function. OF the 85% who start with RRMS, more than 50% will
develop SPMA within 10 years and 90% within 25 years.
/.Primary Progressive Multiple Sclerosis (PPMS) - Answer-✅Continuing worsening of
disease from onset, without distinct relapses. Approximately 10% of people are dx with
PPMS.
/.Progressive-Relapsing Multiple Sclerosis (PPMS) - Answer-✅Progressive neurologic
decline with occasional acute relapses. About 5% of people appear to have PRMS at
diagnosis.
/.Benign MS - Answer-✅Patients who have rare attacks and are minimally disables 20
years after being diagnose with MS. About 10% of MS patients experience a "benign
course" of MS.
/.Radiologically Isolated Syndrome (RIS) - Answer-✅Radiologically isolated syndrome
(RIS) is another early indicator of demyelination but with no symptoms. RIS is usually
detected incidentally in healthy people who have an MRI that shows typical MS lesions.
These people may remain asymptomatic (have no symptoms), or go on to develop CIS
or MS. Therefore, RIS may represent the earliest indicator of MS before symptoms
appear.
/.Clinically Isolated Syndrome (CIS) - Answer-✅A term that describes a first clinical
episode with features suggestive of multiple sclerosis. Usually occurs in young adults
, and affects optic nerves, brainstem, or the spinal cord. They usually recover from their
presenting episode. It is often the first manifestation of MS.
/.Advanced Disease - Answer-✅
/.Pediatric MS - Answer-✅5% of all patients with MS develop the disease before age of
18, 1% before the age of 10 years. Data suggests IFN Beta and glatiramer acetate are
safe, effective, and well tolerated I the pediatric population.
/.10 year outlook for individuals with MS
(How many utilize a cane to ambulate? What percentage require a wheelchair? How
man convert to secondary progressive phase of the disease? - Answer-✅1/2 of patients
use a cane to ambulate
15% require a wheelchair
Approximately 1/2 of patients convert to SPMS
/.Multiple Sclerosis Definition - Answer-✅The most common immune-mediated
inflammatory demyelinating disease of the central nervous system (CNS) - the brain,
spinal cord, and optic nerves- and is a leading cause of disability in young adults. It is
thought that the immune system attacks theCNS.
/.Myelin - Answer-✅Coating that surrounds the nerve fibers
/.Axons - Answer-✅Carry impulses away from the cell body
Nerve Fibers
/.How does MS get its name? - Answer-✅Damaged myelin (demyelination) forms scar
tissue (sclerosis) in multiple sites in the CNS.
/.Immune system and how it related to cause of MS - Answer-✅It may be the result of
abnormal immune response to some infectious or environmental trigger in a genetically
susceptible individual.
/.The pathologic process in MS begins in MS beginning with the activation of
__________in the periphery after they are presented with a possible virus. - Answer-
✅CD4+ T cells
/.What combination of cells produce an inflammatory response and subsequent myelin
damage through multiple mechanisms. - Answer-✅Activated CD4+ T Cells along with B
Cells, macrophages, and CD 8+ T cells interact to produce an inflammatory response.
/.innate immunity - Answer-✅Immune response to certain pathogens, which occurs in
all healthy individuals and does not require prior exposure to the pathogen. Immediate
destruction of some pathogen by phagocytic cells such as macrophage and neutrophils.
