10 - Multiple Sclerosis Flashcards

1
Q

systems involved in MS

A

Neurological and immune

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2
Q

Incidence (when MS strikes)

A

20 to 40 years old

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3
Q

Is it curable?

A

No, but we can try to slow it down as it is a progressive condition

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4
Q

Definition of multiple sclerosis

A

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

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5
Q

Multiple =

A

many scattered areas of the brain and spinal cord are affected

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6
Q

Sclerosis =

A

“sclerosed” or hardened tissue in damaged area

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7
Q

No cure but the medications can help to do 2 things

A
  1. speed recovery from attacks

2. modify the course of the disease and symptoms

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8
Q

Simple explanation of MS

A

Immune system attacks the myelin sheath causing communication problems between the brain and the rest of the body

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9
Q

In MS, the protective coating on nerve fibers (myelin) in the CNS becomes ____ and ____. This creates a lesion that may cause numbness, tingling, or pain in parts of the body (+ loss of motor control)

A

detached, eventually destroyed

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10
Q

____ to ____ Canadians have MS

A

55 000 to 75 000

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11
Q

Cost of MS to the Canadian economy per year

A

More than 1 billion $

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12
Q

Difference with stroke (age, health, economy…)

A

People with stroke are usually older and will eventually die as people with MS are younger so they will live longer on medication with the disease = $$$ for the economy

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13
Q

Average age of clinical onset of MS

A

30-33 years old

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14
Q

Average age of diagnosis of MS

A

37 years old

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15
Q

Why such a delay between the onset age and diagnosis? (3)

A
  • symptoms come and go
  • MS gets mixed up with other conditions
  • symptoms vary from one person to another
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16
Q

Causes of MS

A

Unknown

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17
Q

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

A

autoimmune

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18
Q

Risk factors of MS

A

There is no single risk factor that provokes MS, but several factors are believed to contribute to the overall risk

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19
Q

Factors increasing the risk of developing MS (8)

A
Age
Sex
Family history
Certain infections
Climate
Certain autoimmune diseases
Smoking
Race
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20
Q

Age factor

A

Mostly affects people between 20 and 40 years old (but can affect anyone)

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21
Q

Sex factor

A

Women are about twice as likely as men are to develop MS

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22
Q

Family history factor

A

If one of your parents or siblings has had MS, you are at higher risk of developing the disease

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23
Q

Certain infections factor

A

Epstein-Barr, infectious mononucleosis

24
Q

Climate factor

A

Far more common in countries with temperate climates (ex: europe, canada, new zealand, south australia, etc.)

25
Certain autoimmune diseases factor
Slightly higher risk if you have thyroid disease, type 1 diabetes or inflammatory bowel disease
26
Smoking factor
More
27
Race factor
``` White people (Northern European descent) at higher risk People of Asian, African or Native American descent have the lowest risk ```
28
Incidence per populations (scottish/canadian VS inuit)
Very high for us | Lower for inuit because they eat a lot of fish that contains omega 3
29
Do we exercise during period of flare-ups?
NO
30
Symptoms of MS/lesions locations - Optic nerve lesion
causes blurred vision
31
Symptoms of MS/lesions locations - Brain stem lesion
dizziness and may cause double vision
32
Symptoms of MS/lesions locations - Cerebellum and cerebrum lesions
balance problems, speech problems, uncoordinated movements and tremors
33
Symptoms of MS/lesions locations - Motor nerve tract
muscle weakness, spasticity paralysis, bladder and bowel impairments
34
Symptoms of MS/lesions locations - Sensory nerve tract
altered sensation, numbness, prickling, and burning sensations
35
Other symptoms of MS
Fatigue (78% of all patients) | Tremor, lack of coordination or unsteady gait
36
MS walking pattern
Lack of opposition of arms and legs
37
Disease modifying therapies (immunosuppressants drugs) can help (2)
Decrease severity | Decrease frequency of relapses
38
MS classification is based on (2)
Rate of disease progression and frequency of flare-ups
39
Types of MS (4)
Relapsing/remitting MS (RRMS) Secondary progressive MS (SPMS) Primary progressive MS (PPMS) Progressive-relapsing MS (PRMS)
40
Most common type of MS
Relapsing/remitting MS
41
Relapsing/remitting MS
- Unpredictable but clearly defined relapses during which new symptoms appear or existing ones get worse - In the period between relapses, recovery is complete or nearly complete to pre-relapse function
42
Secondary progressive MS
- Follows a diagnosis of RRMS. Overtime, distinct relapses and remissions become less apparent and the disease begins to progress steadily (plateaus) - 1/2 of people with RRMS start to worsen within 10-20 years of diagnosis (increasing the disability)
43
Primary progressive MS
- Slow accumulation of disability, without defined relapses | - May stabilize for periods of time, but overall, there are no periods of remission
44
Approximately ___% of people diagnosed with MS have PPMS
10%
45
People with this type of MS will die before the predicted age of the population because their respiratory muscle will eventually fail
Primary progressive MS
46
Rarest course of MS (about 5% of MS cases)
Progressive-relapsing MS
47
Progressive-relapsing MS
Experience relapses with or without recovery and steadily worsening disease from the beginning
48
who are the guidelines for?
With minimal to moderate disability resulting from either relapsing remitting or progressive forms of multiple sclerosis
49
Frequency? aerobic vs strength training
2 times per week
50
Duration? aerobic vs strength training
30 minutes of aerobic activity during each workout session | Gradually work up to doing 2 sets of 10-15 reps of each exercise for strength training
51
Intensity? aerobic vs strength training
Moderate-intensity (5-6 RPE), can still talk but not sing a song during the activity Pick a resistance that you can barely but safely finish 10-15 reps of the last set
52
Mode of training? aerobic vs strength training
Arm cycling, walking, leg cycling, elliptical trainer Weight machines, free weights, cable pulleys Aquatic exercises (Other mode)
53
What component is missing in the guidelines?
Flexibility
54
MS vs exercise - special considerations (4)
- Lower level of fitness - Fatigue - Heat intolerance - Depression - Exercise does not trigger periods of exacerbation when properly managed
55
Effects of exercise on MS
Increase aerobic capacity Increase muscular strength and endurance Increase quality of life Increase independence in ADLs