ALS (Exam 4)

Question 1

Amyotrophic Lateral Sclerosis

Answer 1

A relentlessly progressive - presently incurable neurodegenerative disorder that causes muscle weakness - disability - death

Question 2

ALS: Survival

Answer 2

Median = 3-5 years

10% can liver 10 years or more

Question 3

ALS: Clinical manifestations

Answer 3

Asymmetric limb weakness

Fatigue

Dysarthria / Dysphagia

Muscle atrophy

Spasticity

Fasciculations (twitch) of face or tongue

Respiratory muscle weakness

Question 4

What is the term for twitching in face or tongue

Answer 4

Fasciculations

Question 5

Asymmetric limb weakness: Upper extremity

Answer 5

Most common presentation of ALS

Hand weakness or shoulder girdle muscles

Question 6

Asymmetric limb weakness: Lower extremity

Answer 6

Most common presentation of ALS

Begins with foot dorsiflexion

Patient begins to stumble and fall

Question 7

What is the cause of death in ALS

Answer 7

Respiratory Muscle Weakness

Question 8

ALS illness trajectory

Answer 8

Devastating because patient remains cognitively intact while wasting away

Question 9

ALS: Drug Therapy

Answer 9

Riluzole

Not a cure but does extend survial time

Question 10

ALS: Plan of Care

Answer 10

Guide patient through moderate intensity endurance-type exercises for trunk / limbs

-reduce spasticity

-physical therapy consult

Question 11

When risk for aspiration starts, it is important that we

Answer 11

maintain NPO status for our patients