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adult neuro test 3 > MS > Flashcards

MS Flashcards

1
Q

MS is a _________ disease that primarily affect the _____

A

immune-mediated

CNS

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2
Q

True or False?
Research suggests that MS may be the result of an abnormal autoimmune response to some infection or environmental trigger in a genetically susceptible individual

A

true

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3
Q

MS is an inflammatory disease that destroys?

A

areas of myelin in the CNS, primarily white matter

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4
Q

what is the most common area in the CNS that MS attacks?

A

optic nerve

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5
Q

in MS, ________ become rreversibly damaged as a result of the inflammation, even early in the disease

A

axons

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6
Q

damage areas become

A

slclerotic

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7
Q

90% of pts are diagnosed between ____ and _____

A

16-60

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8
Q

true or false

men have a more aggressive version and it more prevalent compared to women

A

False
women to men 2-3:1
However male form appears to be more aggressive

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9
Q

MS is prevalent in ______ zones

A

temperates zones

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10
Q

True or False

First degree relative with MS = greater risk of developing MS

A

True

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11
Q

most common S/S of MS?

A 
Fatigue (88%)
Difficulty walking (87%)
Bowel & bladder problems (65%)
Pain and other sensory changes (60%)
Visual disturbances (58%)
Cognitive problems (44%)
Tremors (41%)
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12
Q

what are examples of cognitive problems that MS pts have trouble with?

A

dual to multi-tasking
difficulty following detailed instructions
decreased ST memory

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13
Q

what are other common symptoms?

A 
nystagmus
speech difficulty
incoordination
weakness 
spasticity
muscle spasms
sexual dysfunction
emotional instability
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14
Q

Initials attacks of MS are often _______, ___ and _______

A

transient
mild
self-limited

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15
Q

How to Diagnosis MS?

A

Clinical attacks
MRI
CSF (elevated gamma globulin levels and possibly WBC)
+ Evoked Potentials ( Central N. conduction testing )

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16
Q

what are some factors that seem to predict a more favorable MS course?

A

Female
onset before 35
monoregional vs polyregional attacks
complete recover after an exacerbation, leaving little or no residual impairment

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17
Q

what are some factors that seem to predict a poor prognosis of MS?

A

Male gender
Onset after age 35
Brainstem symptoms such as nystagmus, tremor, ataxia, and dysarthria
Poor recovery following exacerbations
Frequent attacks
African-Americans (less likely to have MS, but more likely to have a more progressive form of the disease)

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18
Q

what are some covert symptoms of MS?

A 
fatigue
pain
vision
bowel and bladder
paresthesias
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19
Q

what are the 4 categories of MS established by the National Multiple Sclerosis Society?

A

Relapsing-remitting
Primary-progressive
Secondary-progressive
Progressive-relapsing

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20
Q

what is the most common form of MS at the time of initial diagnosis?

A

Relapsing-Remitting MS

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21
Q

Relapsing-Remitting MS makes up ______ % of MS

A

85

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22
Q

Relapsing-Remitting MS has clearly define ______ with periods of ______

A

flare-ups

remissions

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23
Q

_____ % of relapsing-remitting MS develop Secondary-Progressive MS within ______ years

A

50

10

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24
Q

Explain the course of Secondary-Progressive MS

A

Initial Relapsing-Remitting course followed by progression with or without occasional relapses, minor remissions with some recovery and plateau

25
_________ MS is relatively rare only making up 10% of MS
Primary-Progressive MS
26
true or false Primary-Progressive MS has a disease progression without plateaus or with occasional plateau and temporary minor improvements possible
true
27
true or false | with Primary-Progressive MS, a person has to have an attack to have an increase in disabilityTr
False | Steady increase in disability without “attacks”
28
Progressive-Relapsing MS is the rarest of on ___% of pts getting it?
5%
29
True or False | Progressive-Relapsing MS is progressive from onset
true
30
Progressive-Relapsing MS has clear acute relapses, ____ or _____ full recovery
with or without
31
what are the 5 categories of treatment for MS?
``` Treatment of acute exacerbations Symptom management Disease modification Rehabilitation Psychosocial support ```
32
what are factors triggering a relapse of MS?
``` often unpredictable infections physical and emotional stress heat can transiently increase symptoms Last trimester of pregnancy offers a natural protection against a relapse ```
33
true or false | vaccine are not safe for MS patients?
Influenza vaccines are safe; no vaccines have been found to increase relapse incidence
34
pool recommended temp for MS pts is ______ degrees
<85
35
____-____% increased risk for relapse after a delivery of baby
20-40
36
with acute relapse management, natural improvement occurs over _____-____ weeks
4-12
37
corticosteroids help by?
attempts to end the attack sooner and leave fewer permanent lesions
38
true or false | corticosteroids have evidence that is decreases the extent of overall disability
False | Little evidence that these medications alter the extent of disability or overall course of the MS.
39
what are the goals of managing MS?
Reduce frequency of relapses Reduce progression of disability Reduce number and volume of brain lesions
40
what is Avonex?
For treatment of all relapsing forms of MS and for a single clinical episode if MRI is consistent with MS Weekly IM injection
41
what is adverse reactions of Avonex?
Flulike symptoms after injection | Depression, mild anemia, elevated liver enzymes, allergic reactions, heart problems
42
what is Rebif?
For all relapsing forms of MS | 3x/week IM injection
43
what are the adverse reactions of Rebif?
Flulike symptoms | Injection site reactions, liver abnormalities, depression, allergic reactions, low red or white blood cell counts
44
what is Betaseron & Extavia?
For the treatment of all relapsing forms of MS Every other day subcutaneous injection
45
what are the adverse reactions of Betaseron & Extavia?
Flulike symptoms after injection Injection site reactions Allergic reactions, depression, elevated liver enzyme levels, low white blood cell counts
46
what is a precaution of Betaseron & Extavia?
Should not be given to patients with severe and untreated depression due to increased risk of suicide associated with this treatment
47
what is copaxone?
For the treatment of relapsing/remitting MS Daily subcutaneous injection
48
what are the adverse reactions of Copaxone?
njection site reactions Vasodilation, chest pain, anxiety, palpitations, shortness of breath, flushing (5-10 min after injection; no known long-term effects)
49
what is Novantrone (Serono)?
For worsening relapsing/remitting MS and for progressive relapsing or secondary progressive MS 4x/year IV infusion
50
_______ is generally recommended for individuals with an inadequate response to, or are unable to tolerate other MS drugs
Tysabri (Natalizumab)
51
Tysabri (Natalizumab) is taken every _____ weeks by ____ ______
4 weeks | IV infusion
52
adverse reactions of Tysabri (Natalizumab) include?
increased risk of progressive multifocal leukoencephalopathy (PML), infusion reactions, headache, fatigue, joint and limb pain, abdominal discomfort, diarrhea, and rash
53
what do PTs need to do/know about MS pts?
General knowledge pertaining to medication side effects Coordination of treatment and medication schedules Make note of changes in patient’s performance
54
PT treatment for MS pts compose of?
``` Support coordinated care & patient empowerment Wellness and health promotion Fatigue Weakness Spasticity Balance/Vestibular Coordination Sensory Problems Ambulation and Mobility Activities of Daily Living ```
55
what are reasons MS pts may have fatigue that can be addressed?
``` decrease sleep poor diet deconditioning movement limitations depression neuromuscular conditions body core temp emotional stress ```
56
true or false | Rising of core body temp increases conduction velocity
False | slows it
57
true or false | while heat might aggravate common symptoms, there is no link to causing an exacerbation of the disease
true
58
what is something a person with MS can use to help against heat sensitivity?
cooling garments

adult neuro test 3 (7 decks)

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