Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Unit 11 > MS > Flashcards

MS Flashcards

1
Q

Trunk flexors and hip ABD best predictor of what?

Plantarflexors?

A

Trunk flexors and hip ABD: 6MWT

PF: gait speed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Are women or men more likely to have MS?

A

women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the most common MS diagnosis?

A

relapsing remitting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What three places does MS affect?

A

CNS, brain, optic nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Myelin sheath is scarred causing what

A

plaques and lesions which vary from person to person in number, location and frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Inflammatory response is called what?

A

exacerbation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MS is an_______ mediated disease

A

immune mediated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

As the disease progresses myelin is lost eventually causing what?

A

axon to be destroyed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Oligodendrocytes produce what

A

myelin cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are oligodendrocytes effected in MS

A

destroyed therefore there is reduced ability to remyelinate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the criteria called to make an MS diagnosis? What are the three things?

A

McDonald Criteria

MRI shows multiple plaques in at least two discrete areas, two different times, and plaques have no other explanation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

to diagnose MS what are you looking for

A

a pattern in symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Etiology of MS is….

A

unknown. But thought to be an autoimmune response to environmental trigger, bacteria/virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is MS a genetic disease

A

Not, not genetic but you are at a greater risk of first degree relative has MS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

RRMS
PPMS
SPMS
PRMS

A

RRMS: relapsing remitting
PPMS: primary progressive
SPMS: secondary progressive
PRMS: progressive relapsing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Characteristics of RRMS

A

full or near recovery after exacerbation.

Time between exacerbations is variable.

Overtime they lose a bit of function at a time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Characteristics of PPMS

A

steady decline of function overtime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Characteristics of SPMS

A

starts as RRMS and then changes to PPMS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Characteristics of PR

A

Steady decline but there are also serious exacerbations along the way

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Does MS affect memory and cognition

A

Yes in 50% of the population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Some of the biggest symptoms of MS

A

weakness, fatigue, heat sensitivity, difficulty walking, stiffness and spasms, bladder problems, memory/cognition, pain, major depressive disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A transient worsening of temporary symptoms with full recovery is called what?

What can bring one on?

A

pseudoexacerbations: due to stress, infection, overheating/overexertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is often thefirst symptom of MS

A

optic neuritis: inflammation of the optic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treatment course and outcome for optic neuritis?

A

high dose steroids

Most have full or near full recovery 1month-1yr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Characteristics of a favorable prognosis
Onset <35 yrs monoregional complete recovery after exacerbation Female
26
Characteristics of a less favorable prognosis
Onset >35 yrs Brainstem symptoms (nystagmus, tremor, ataxia, dysarthria) Frequent exacerbations Males
27
What is dysarthria
a brainstem symptom causing unclear articulation of normal linguistic speech
28
What is the treatment for acute exacerbations
high-dose IV corticosteroids (HTN, DM, OP, cataracts and ulcers are side effects)
29
What is the primary reason for departure from work in this population?
fatigue
30
What is lassitude
primary fatigue that is global unique to MS
31
What does motor fatigue look like in patients with MS
its primary fatigue: progressive decrease in motor output that worsens as activity progresses
32
Do generally help with motor fatigue and lassitude?
No these are primary fatigues organic to MS. We help with secondary fatigue
33
Talk about exercise, patient education, and medication as it related to reducing fatigue in the study we talked about
exercise (aerobic and strength) and patient education reduced fatigue more effectively than medication alone or education alone All three should be considered in fatigue management
34
What is primary weakness due to?
plaques in the motor cortex or pyramidal tracts
35
What is secondary weakness due to?
disuse!
36
What are Gabapentin (Neurontin) lyrica (pre gabalin) for?
neurogenic pain
37
Lhermitte's syndrome
electric shock type sensation triggered by forward head flexion. usually short lived but can be very intense
38
What is Uthoff phenomenon?
heat sensitivity
39
What do the drugs for MS due as far as progression of the disease
They are disease MODIFYING drugs, they SLOW the progression, however they do NOT stop progression
40
Avonex, Betaseron, Copaxone,Rebif, Tysabri are all what?
CRAB drugs: disease modifying medication
41
Whats the deal with Tysabri
its a CRAB drug (disease modifying) but there are significant side effects
42
EDSS cut off for ambulation w/o assistive device (higher than this an AD is needed)
4.0
43
5.0-9.0 on the EDSS is characterized as what?
impairments in ambulation
44
What does EDSS stand for
Extended disability status score
45
When are PT's generally brought into the picture for this patient populalation
exacerbation or change in functional status
46
What is the first part of the examination for all these patients
VITALS!
47
What is a primary concern in these individuals?
safety: make sure you assess and create interventions for balance
48
What balance test is preferred for MS population
Berg balance
49
Dizziness handicap inventory and MS functional composite should be used in what treatment environment?
Outpatient
50
Early stage of disease what is your intervention strategy
Preventative --> restorative --> compensatory
51
Middle stage of disease what is your intervention strategy
Compensatory --> preventative --> restorative
52
Late stage of disease what is your intervention strategy
Compensatory --> preventative --> restorative
53
At all disease stages what do these patients need
Education: to pt and family Psychological support Referral to other health care professionals
54
What are some of the most important preventative interventions during the early stage of MS
stretching: they have a lot of spasticity and immobility Energy conservation
55
What do restorative interventions look like in both early and middle stages of MS
Balance training: head turns, decrease BOS ROM Strength: include trunk flexors, hip ABD, PF Endurance
56
Name some compensatory interventions for middle stage of MS
orthoses, adaptive and AD Strategies for sensory loss (feel the hot water with other arm and cognitive impairments (external cues, devices, memory aids)
57
name compensatory interventions for late stage of MS
Education of caregivers on transfers and bed mobility
58
Late stage in MS the interventions are mostly what?
Preventative for more sinister complications
59
Name important preventative interventions for late stage MS
Pulmonary & skin care hygiene Anti-pressure devices Educations of caregivers on prevention of 2nd complications
60
Can you restore at every level?
Janet says yes!
61
What did individuals with MS rate their most valuable bodily functions?
Gait and vision
62
True or false, there is a ton of literature related to MS and exercise
False!
63
within 15 yrs of diagnosis approximately _____ of people with MS will require the use of a walking aid
50%
64
What intensity and kind of exercise was well tolerated in individuals with MS
moderate intensity aerobic exercise 2x a week
65
What three variables improved in the meta-analysis looking at the benefits of exercise training in PwMS?
Walking, balance fatigue: they all improved | walking had a larger effect with a supervised program
66
What kind of balance exercises in general has shown to be beneficial for this population for increasing fatigue as well as balance.
progressive! EO, EC, small BOS, moving head
67
considerations for strength training in PwMS when we know that it improves fatigue, functional capacity and power
frequent recovery breaks PRIOR to onset of fatigue greater volume Avoid limitations due to fatigue; WORK WITHIN THEIR FATIGUE Cooling prior to or during exercise to decrease fatigue during lifting
68
What muscle groups to target for strength training
Trunk flexors &Hip ABD: largest predictor of 6MWT | Plantarflexors: correlates with gait speed time
69
What kind of exercise may be most affective to combat fatigue in this population
resistance training
70
Exercise improves what two things?
mobility and fatigue
71
What kind of exercise may be most affective to combat mobility issues in this population
aerobic and resistance or a combination; there were mixed findings
72
What are the benefits of exercise on HRQOL
Health related QOL. There isn't enough evidence to support the benefits of exercise
73
BENEFITS OF EXERCISE FOR PwMS ``` Improved walking (suggest larger effect with supervised programs increase compliance) Improved fitness ``` Improved strength Improved balance (suggest greater gains in progressive program) Potential to improve fatigue (maybe best with resistance training) on HRQOL
``` Special considerations for exercise in PwMS: Heat sensitivity (pseudoexacerbations) Use fans/air conditioning Drink lots of fluids Use cooling vest Patient education ``` Fatigue Patient education Community exercise programs is great to maintain functional mobility
74
Patient education about fatigue after a PT session
Its temporary pain, we know that it helps you out, keep at it!
75
Intensity of group exercise = 13/20 RPE (somewhat hard) Outcomes: Berg balance, 10MWT (usual gait speed), 10-stair climb test, Modified Ashworth Scale, Fatigue Severity Scale, MS International QOL Questionnaire Exercise group made statistically significant gains in all outcomes No adverse events Authors recommend life-long exercise
Not a question: The study demonstrated that supervised group exercise training is effective in improving balance, functional status, spasticity, fatigue and QOL in moderately affected people with multiplesclerosis, with no worsening of their clinical status.

Unit 11 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions