Week Five - Multiple Sclerosis Flashcards

(47 cards)

1
Q

What is MS?

A

An auto-immune disorder with both inflammatory and neurodegenerative pathologies

  • affects the neurons and is heterogenous
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2
Q

What are the 2 major processes that affect MS?

A

demyelination - occurs due to inflammation

axonal disruption

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3
Q

What are the 2 white blood cells that help immune functioning?

A

B cells

T cells

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4
Q

Where do B cells develop and what do they do?

A

Develop in bone marrow and produce antibodies that ambush foreign antigens in the bloodstream.

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5
Q

Where do T cells develop and what do they do?

A

Develop in the thymus gland and direct attacks on foreign substances (eg bacteria, viruses)

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6
Q

What do T cells produce?

A

Substances called cytokines that direct responses and activities in other immune cells

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7
Q

What is MRI success at looking at MS lesions?

A

Cannot always detect small fine grain changes

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8
Q

When do MS lesions occur?

A

When there is a lot of inflammation in the brain

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9
Q

Main symptoms of MS

A
Central (unvisible) eg fatigue - most common, impairments
Visual
Speech (dysarthria), Throat (dysphagia)
Musculoskeletal
Sensation
Bowel
Urinary
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10
Q

Why do so many individuals with MS live away from the equator?

A

Because they typically have temperature intolerance - move to colder climates

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11
Q

Onset age of MS?

A

Late 20s, early 30s

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12
Q

Gender differences in MS?

A

x2 more females

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13
Q

Common misdiagnosis of MS?

A

Depression

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14
Q

What are the 4 different types of MS?

A

Progressive-relapsing
Secondary progressive
Primary progressive
Relapsing-remitting

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15
Q

What is PROGRESSIVE-RELAPSING MS associated with?

A

A steady decline since onset with superimposed attacks

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16
Q

What is SECONDARY PROGRESSIVE MS associated with?

A

Initial relapsing-remitting MS that suddenly begins to have decline without period of remission

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17
Q

What is PRIMARY PROGRESSIVE MS associated with?

A

Steady increase in disability without attacks

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18
Q

What is RELAPSING-REMITTING MS associated with?

A

Unpredictable attacks which may or may not leave permanent deficits followed by periods of remission.

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19
Q

What do we need to diagnose MS?

A

At least 2 occurrences of flare ups in the brain (space) and evidence that there are 2 distinct lesions in the brain from MRI (time)

20
Q

Why is the EDSS scale not always appropriate?

A

Too much focus on physical functioning and not enough of cognitive and invisible symptoms

21
Q

What causes MS/risk factors?

A

Interaction of

  • immunological and environmental factors (vitamin D deficiency - white collar workers)
  • personal factors (age, gender)
  • infectious factors (epstein-barr)
  • smoking
  • genetics (ethnic background - vikings disease, siblings/relative)
22
Q

Cognitive impairments occur largerly independent of what?

A

Disease duration

23
Q

Most people report what type of cognitive impairments?

A

Mild to moderate

24
Q

Do cognitive impairments occur in a uniform pattern?

A

No, they are heterogenous across people

25
Cognitive areas most affected by MS?
``` processing speed complex attention learning and memory of new things prospective memory working memory EF social cognition ```
26
What is the hallmark feature of cognitive impairments in people with MS? why?
Processing speed because it is directly related to myelin loss and irreversible damage to neurons
27
What aspects of attention are most affected?
The most complex ones - working memory - divided attention - sustained attention (directly related to fatigue
28
What is one of the most reported symptoms in MS?
Long-term memory - but more related to learning than retrieval
29
What aspects of memory are most affected?
long term | prospective
30
What are memory deficits in MS undermined by?
Slow processing speed, susceptibility to interferences, executive difficulties, and visual difficulties
31
Why do people with MS have visuospatial difficulties?
Visual disturbances due to optic nerve (optic neuritis)
32
Difficulties in visuospatial abilities can result in what? (3)
Difficulties: Organising visual information Seeing relationships between objects Proprioception
33
What characteristics are related to having more cognitive difficulties?
``` disease course gender - males temperature cannabis users smoking ``` grey matter atrophy!
34
What are some social cognition effects of MS? (5)
Pseudobular affect: uncontrollable laughing/crying out of context Emotion recognition Theory of mind: ability to see another's perspective Emotional lability Inappropriate behaviour
35
How is MS Dementia different to other dementia?
Basic language is intact Complex attention is less impaired early in the disease course Memory problems are due to retrieval and initial acquisition Orientation to place/person rarely affected
36
What are some drugs used for MS relapses?
Corticosteroids | Plasma exchange
37
What are the three types of drugs that modify progression of MS?
- immunosuppressants - immunomodulators - immune constitution therapies
38
How do immunosuppressants and immunomodulators work?
By being continuously administered and only active in suppressing relapse when they are being taken
39
How do immune constitution therapies work?
By being administered short periods of time but effectiveness lasts as it allows immune system to repair itself (closest thing to a cure)
40
What is the process of stem cell treatment/therapy?
Cells moved from bone marrow to blood stream machine collects and separates out stem cells Then frozen Chemo to fully wipe out bone marrow/immune system new cells returned via a drip recovery
41
Are there treatments for those with progressive MS?
No They need to focus on: physical therapy muscle relaxants and medications to reduce cog an phys difficulties
42
Strategies to improve memory in MS?
Techniques to increase chances of encoding/restoring - repetition/rehearsal - increased exposure - writing down - self-learning
43
Strategies to improve processing speed in MS?
Take time to repeat and learn | Have information repeated
44
Strategies to improve EF in MS?
Plan ahead Ask for help Break things down List alternatives
45
Can improved sleep quality help cognition in MS patients?
May only improve their own perception of cognitive function
46
Can high intensity training improve cognition in MS patients?
Can improve verbal memory and lowers inhibition errors
47
Concept of self in MS?
There are changes in how people describe themselves (over the disease progression)