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kcep final > Multiple Sclerosis > Flashcards

Multiple Sclerosis Flashcards

1
Q

what are the systems involved with Ms

A

neuro and immune

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2
Q

at what age does ms strike

A

20 to 40 yo

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3
Q

is ms curable

A

no but it can be slowed down (degenerative)

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4
Q

is ms more common in men or women

A

women > men

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5
Q

what member of our faculty does ms research

A

Dr. Peter Darlington

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6
Q

why does Kayla (athlete with ms) fall down in the video

A

because of fatigue and loss of sensation

she can’t feel her legs bc of swelling, raise in body temp and no more transmission of motor connection

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7
Q

what is ms and what does the name stand for

A

ms is a chronic, progressive disease that leads to increasing disability in most individuals

multiple: many scattered areas of the brain and sc are affected
sclerosis: “sclerosed” or hardened tissue in damaged areas

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8
Q

what happens with the immune system in ms

A

immune system attacks the myelin sheath causing communication problems btw the brain and the rest of the body

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9
Q

how can meds help ms

A
  1. speed recovery from attacks

2. modify the course of the disease and symptoms

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10
Q

what can be bad about ms meds

A

they can lower the immune system but the benefits far out-weight the side effects

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11
Q

Ms lesions can affect what structures and what can be lost because of it

A

it can affect the brain and/or the sc

loss of motor control

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12
Q

myelin damage and the nervous system

A

In ms, the protective coating on nerve fibers (myelin) in the cns becomes detached and eventually destroyed. This creates a lesion that may cause numbness, pain ot tingling in parts of the body + loss of motor control.

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13
Q

why is it important to know about ms

A

bc its the most common cns disease among young adults in canada

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14
Q

how many canadians have ms and from what ages

A

55 000 to 75 000 canadians have ms or 166 people/ 100 000

from 20 to 40 yo

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15
Q

____ are spent each year on medical expenses and special services. Lost productivity adds to the financial toll.

A

Billions of dollars

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16
Q

average age of clinical onset and average age of dx

A

30-33 but average dx is 37

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17
Q

why is there a delay in the age of clinical onset and the dx

A

bc symptoms come and go, ms gets mixed up w other conditions and symptoms vary from person to person

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18
Q

in ___ , only __ of patients were reported to survive beyond __ years after onset of illness, but a patient can now expect to live ___

A

1936
8%
20
the average population life-expectancy minus 7 years

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19
Q

what are the causes of ms and what is it considered as

A

unknown

ms is considered an autoimmune disease in which the body’s immune system attacks its own tissues by mistake

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20
Q

what do T-cells and monocytes do

A

they work together to fight invaders bu they can get confused and start to attack the body itself by destroying the myelin sheath

21
Q

what are the factors that increase the risk of ms (8)

A
  • age
  • sex (women > men)
  • family history
  • certain infections (Epstein-barr)
  • climate (more common in temperate climate; canada, northern usa, new zealand, southeastern australia and europe)
  • certain autoimmune diseases (thyroid disease, type 1 diabetes or inflammatory bowel disease)
  • smoking
  • race (white northen european descent > asian, african or native american)
22
Q

what are the incidences for inuits, scottish, canada and white/vs/no-white people

A

inuit; very low
scottish and canada; very high
more white > not white

23
Q

s/s optic n lesion

A

blurred vision

24
Q

s/s brain stem lesion

A

dizziness and may cause double vision

25
Q

s/s cerebellum and cerebrum lesion (4)

A

balance problems, speech problems, uncoordinated mvts and tremors

26
Q

s/s motor n tract lesion (4)

A

m. weakness, spasticity paralysis, bladder and bowel impairments

27
Q

s/s sensory n tract lesion (4)

A

altered sensation, numbness, prickling and burning sensations

28
Q

symptoms of ms differ greatly from person to person and over the course of the disease depending on

A

MS type and location of the lesion within the ns

29
Q

other symptoms of ms

A

fatigue (78% of patients)

tremor, lack of coordination or unsteady gait

30
Q

ms walking patterns

A

lack of opposition of arms and legs

usually a stronger and more stable side, will cause the patient to take shorter and faster steps on less stable side

31
Q

what is the course of the disease

A

exacerbation (flare-up, attacks and relapse)
will lead to either remission or myelin becoming inflamed and myelin inflammation can lead to either no scar formation then complete recovery and no loss of function or scar formation which will lead to permanent myelin damage and loss of function

32
Q

what can disease modifying therapies help with and what meds are used

A

decrease of severity and frequency of relapses

immunosuppressant drugs

33
Q

what is ms classification based on

A

rate of disease progression and frequency of flare-ups

34
Q

what is relapsing/remitting ms (RRMS) (3)

A
  • most common type
  • unpredictable but clearly defined relapses during which new symptoms appear or existing ones get worse
  • in the period btw relapses, recovery is complete or nearly complete to pre-relapse function (remission)
35
Q

what is secondary progressive MS (SPMS)

A
  • some people stay in this stage for a long time
  • follows a dx of RRMS, over time, distinct relapses and remissions become less apparent and the disease begins to progress steadily sometimes w plateaus
  • about 1/2 of people with RRMS start to worsen within 10-20 years of dx, often with increasing levels of disability
36
Q

what is primary progressive MS (PPMS)

A
  • will die before they are supposed to
  • slow accumulation of disability without defined relapses
  • may stabilize for periods of time, and even offer minor temporary improvement but overall, there are no periods of remission, about 10% of people with MS have PPMS
37
Q

what is progressive relapsing MS (PRMS)

A
  • as severe as primary but with flare ups
  • rarest course of MS, occurring in only 5% of all MS cases
  • people with this form of MS experience relapses with or without recovery and steadily worsening disease from the beginning
38
Q

can people with MS train, can exercise be beneficial/harmful?

A

yes they can train
can be beneficial if done correctly
can be harmful if too much too fast

but overall beneficial > harmful

39
Q

how can the guidelines help

A

people w MS who have mild to moderate disability who meet the guidelines will have reduced fatigue, improved mobility and enhance elements of health-related quality of life

40
Q

who are the guidelines for

A

minimal to moderate disability resulting from either relapsing, remitting or progressive forms of MS

41
Q

who can train MS people

A

KCEPs, qualified exercise professional

42
Q

what can physically inactive MS people do

A

activities performed at a lower intensity, frequency and duration than recommended may bring some benefits

43
Q

what can be done to meet the guidelines

A

gradually increasing duration, frequency, and intensity as a progression towards meeting the guidelines

44
Q

guidelines: how often

A

aerobic: 2 times / week

strength training: 2 times / week

45
Q

guidelines: how much

A

aerobic: at least 30 min during each workout sesh

strength training: 2 sets of 10-15 reps of each exercise

46
Q

guidelines: how hard

A

aerobic:
-mod intensity pa is usually 5 or 6 on a scale of 10 and causes HR to go up
-as a general rule, if you’re doing mod-intensity pa you can talk, but not sing a song during the activity
strength training:
-pick a resistance (free weights, cable pulleys, bands, etc) heavy enough that you can barely, but safely, finish 10-15 reps of the last set

47
Q

guidelines: how to

A

aerobic activities:

  • upper body exercises; arm cycling
  • lower body exercises; walking, leg cycling
  • combined upper and lower body exercises; elliptical trainer

strength training activities for upper and lower body:

  • weight machines
  • free weights
  • cable pulleys

other types of exercises that can bring benefits:
-aquatic exercises

48
Q

what are special considerations concerning MS vs exercise (5)

A
  • lower level of fitness; cardiovascular, muscular strength and endurance (decreased balance)
  • fatigue
  • heat intolerance (higher than 0.5°)
  • depression
  • exercise does not trigger periods of exacerbation when properly managed
49
Q

Effects of exercise on people with ms

A

increase aerobic capacity, m. strength and endurance, quality of life, independence in ADL

kcep final (9 decks)

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