ATI Unit 2 MS, ALS, MG

Question 1

MS, ALS, MGMS

Answer 1

multiple sclerosis, amyotrophic lateral sclerosis, and myasthenia gravis are neurodegenerative conditions that affect voluntary muscle control
MS + ALS = nerve damage in brain/spinal cord
MG = problems at neuromuscular junction

MS - autoimmune, development of plague in white matter of CNS damaging myelin sheath
ALS - disease of upper/lower motor neurons characterized by muscle weakness atrophy then paralysis/death, no autonomic or sensory or cognitive changes
MG - antibody breakdown of ACl

Question 2

MS symptoms

Answer 2

• most common is relapse/remission type, initial findings are vagued
• doesn’t necessarily shorten lifespan

relapse triggers like infection, cold, trauma, stress, fatigue, temp extremes

manifestations

• all muscle stuff
• communication troubles
• remember vision changes = Uhthoff’s sign:temporary worsening of vision after trigger)

Question 3

what is ALS

Answer 3

• also known as Lou Gehrig’s disease, muscle neurons deteriorate
• cause of death is usually respiratory paralysis

Question 4

findings for ALS

Answer 4

• muscle stuff - usually begins on one part of the body
• hyperreflexia
• increased creatine kinase (CK-BB)
• biopsy shows reduction in number of motor neurons

Question 5

so what’s major concern with ALS

Answer 5

airway! duh

complications are pneumonia and resp failure (may need mechanical ventilation)

Question 6

medication for ALS

Answer 6

riluzole (Rilutek) - glutamate antagonist prevents neuromuscular break down, adds 2-3 months of life

baclofen (Lioresal) as an antispasmodic

Question 7

myasthenia gravis stuff

Answer 7

• do a Tensilon test by administering edrophonium (Tensilon) and seeing if muscular strenght occurs - reverse with atropine
• drooping eyelid, resp failure, muscle stuff, urinary stuff

Question 8

what can happen with medications of myathenia gravis

Answer 8

• you take cholinesterase inhibitors
  when not enough or MG becomes exacerbated then a myasthenic crisis occurs (rep muscle weakness and mechanical vent, myasthenic findings like weakness incontinence fatigue, hypertension, decrease with tensilon test)
• when over medicated can cause a cholinergic crisis (muscle twitchin to point of rep muscle weakness, hypersecreation NVD, hypermotility like ab cramps, hypotension, tensilon no positive effect and can worse findings, decrease with med like atropine since it’s cure for edrophonium/Tensilon)