Multiple Sclerosis

Question 1

dysarthria

Answer 1

slow, slurred speech

Question 2

diplopia

Answer 2

double vision

Question 3

nystagmus

Answer 3

rapid eye movement d/t weak EOMs

Question 4

initial symptoms of MS

Answer 4

vague - weakness, fatigue, changes in vision

Question 5

relapsing-remitting

Answer 5

periods of exacerbation and recovery

Question 6

primary-progressive

Answer 6

steady gradual deterioration

Question 7

secondary-progressive

Answer 7

begins relapsing-remitting, then steadily deteriorates

Question 8

progressive-relapsing

Answer 8

exacerbations with only partial recovery - no return to baseline

Question 9

aggravating factors

Answer 9

fatigue, stress, overexertion, hot showers/baths, infection, trauma

Question 10

visual s/s of MS

Answer 10

diplopia, blurred vision, nystagmus

Question 11

diplopia tx

Answer 11

eye patch, alternate every few hours

Question 12

musculoskeletal s/s

Answer 12

gait/balance problems, muscle spasticity - potential for paralysis, severe fatigue, intention tremors

Question 13

bowel s/s

Answer 13

constipation

Question 14

bladder s/s

Answer 14

spastic - urgency, frequency, dribbling, incontinence
flaccid - no sensation to void

Question 15

cognitive s/s

Answer 15

difficulty w short term memory, attention, information processing, word finding

Question 16

dx of MS

Answer 16

no specific tests - r/o other diseases through testing - CSF
MRI may show plaques

Question 17

natalizumab

Answer 17

anti-inflammatory, increased risk of infection

Question 18

med for MS exacerbations

Answer 18

corticosteroids - prednisone

Question 19

side effects of corticosteroids

Answer 19

increased glucose, decreased wound healing

Question 20

bethanechol

Answer 20

used for flaccid bladder, helps prevent UTIs

Question 21

oxybutynin

Answer 21

used for spastic bladder, helps prevent UTIs

Question 22

diazepam & baclofen

Answer 22

muscle relaxants, help w ROM

Question 23

dalfampridine

Answer 23

nerve conduction enhancer

Question 24

meds for fatigue

Answer 24

methylphenidate, amantadine

Question 25

how can PT/OT help

Answer 25

improves daily function, decreases spasticity, increases coordination, retrains muscles to compensate for impaired ones

Question 26

bladder dysfunction interventions

Answer 26

medications, may need indwelling or straight cath or bladder pacemaker, increase fluids, prophylactic abx

Question 27

constipation interventions

Answer 27

lubiprostone to increase motility, increase activity, fluids, & fiber

Question 28

visual changes interventions

Answer 28

eye patch for diplopia, corrective lenses, have pt move head side to side for peripheral vision loss