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Med Surg 2 > 58 - Multiple Sclerosis > Flashcards

58 - Multiple Sclerosis Flashcards

1
Q

multiple sclerosis

A

chronic, progressive, degenerative disorder of the CNS characterized by disseminated demyelination of nerve fibers of the brain + spinal cord

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2
Q

MS is characterized by…

A

disseminated demyelination of brain + spinal cord

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3
Q

MS age of onset

A

bw 20-35

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4
Q

___ yrs + older have a more progressive disease

A

50

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5
Q

MS sex as a risk factor

A

women>men

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6
Q

MS etiology

A

genetically susceptible + environmental exposure
(infection, smoking, phys injury, emo stress, excessive fatigue, pregnancy)
autoimmune process driven by activated T cells

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7
Q

the role is ___ as a cause is controversial

A

pathogens

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8
Q

MS is marked by 3 processes

A

1 chronic inflammatn
2 demyelinatn
3 gliosis in CNS

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9
Q

MS pathology

A

T cells in systmc circltn go to CNS> disrupt BBB> antigen-antibody rxn in CNS> inflammatory response> axon demyelinatn

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10
Q

when nerve fiber is unaffected, ____________. however, myelin sheath can _____

A

transmission of impulses still occurs;

still regenerate

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11
Q

when underlying axon is damaged, _____

A
  • impulse is disrupted
  • nerve functn is lost permanently
  • glial scar tissue replaces damaged tissue
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12
Q

gliosis

A

glial scar tissue replaced damaged tissue> formation of hard rigid plaques> found throughout white matter of CNS

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13
Q

avg life expectancy after onset of symptoms is…

A

25 yrs

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14
Q

MS symptoms vary bc…

A

of the spotty distribution in the CNS

-it depends on the areas involved

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15
Q

the first symptom is often…

A
  • blurred or double vision
  • red/green color distortion
  • blindness in one ye
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16
Q

MS symptoms

A
  • ocular
  • extremity weaknss
  • problms w coordination/balance
  • partial/cmplte paralysis
  • numb/tingling
  • Lhermitte’s sign
  • cerebellar signs
  • disabling fatigue
17
Q

Lhermitte’s sign

A

temporary sensory symptom described as an electric shock going down the spine or into limbs w neck flexion

18
Q

cerebellar signs

A
  • nystagmus
  • ataxia (no coordinatn)
  • dysarthria (slurrd spch)
  • dysphagia (diffct swallng)
19
Q

diabling fatigue can be worsened by

A
  • heat
  • humidity
  • deconditioning
  • medication
20
Q

bowel + bladder function

A
  • constipation
  • spastic bladder
  • flaccid bladde
21
Q

spastic bladder

A

bladder is too small + cntractn unchecked

-urgency + frequency + dribbling + INCONTINENCE

22
Q

flaccid bladder

A

lesion w reflex arc of bladder center

  • urinary RETENTION bc loss of sensation (no urge no pain)
  • may have urgency + frequency
23
Q

MS + sex dysfunction

A
  • erectile dysfunctn
  • decr libido
  • difficulty w orgasm
  • painful intercourse
  • decr vaginal lubricatn
24
Q

MS + cognitive dysfunction

A
  • short term memry attntn
  • info processng
  • planning
  • vsual perceptn
  • word finding
  • Intelect remains unchanged
25
Q

In MS, intellect remains intact such as.

A
  • long term memry
  • converstnl skills
  • reading comprhnsn
26
Q

MS diagnostic tests

A
  • CSF analysis
  • CT scan
  • MRI/MRS
27
Q

an MRI of brain + spinal cord in MS may show…

A
  • plaque
  • inflammation
  • atrophy
  • tissue breakdwn
  • tissue destrctn
28
Q

CSF analysis in MS may show..

A
  • incr igG

- oligoclonal banding

29
Q

3 criterias to be diagnosed w MS

A

1 2 or more inflammatry demyelinating lesins at 2 diff locations
2 damage/attack occurring at 2 diff times
3 all other possible diagnoses ruled out

30
Q

immnunomodulator drug therapy

A

B interferon to decr progressn + prevent relapse

31
Q

B interferon

nursing actns

A
  • rotate injections sites
  • asses for depressn/suicidl
  • flu like symptm are common in beginng
32
Q

tremors that become unmanageable are often treated w….

A

thalamotomy or deep brain stimltn

33
Q

nurologic symptm sometimes improves w…

A

phys + speech therapy

-exercise decr spasticity, incr coordinatn, retrains unaffected muscles to act for impaired ones

34
Q

triggers that may cause worsening..

A
  • infectn esp upper resp or UTI
  • trauma
  • immunization
  • childbirth
  • stress
  • climate change
35
Q

in an acute exacerbatn, client may be…

A

immobile + confined to bed

36
Q

complications of immobility

A
  • resp
  • UTI
  • pressure injuries
37
Q

to prevent triggers, pt should avoid…

A
  • fatigue
  • extreme hot/cold
  • exposure ot infectn
38
Q

____ may help to decr spaticity

A

anticholinergics

Med Surg 2 (13 decks)

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