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z_MS1_Neuro Study > GF6: Neuro Multiple Sclerosis > Flashcards

GF6: Neuro Multiple Sclerosis Flashcards

1
Q

What is Multiple Sclerosis (MS)?

A
  • an autoimmune disease that causes progressive demyelation of neurons
  • Loss of myelin affects motor, sensory and autonomic fibers
  • Can cause muscle spasms and stiffness
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2
Q

What are the dx tests for MS?

A
  • MRI: will show plaque on brain and spinal cord
  • EMG (Electromyography) to evaluate muscle electrical activity
  • Lumbar puncture: will show high levels of antibodies
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3
Q

What are the results of the dx tests that will confirm dx of MS?

A

Sclerotic brain plaques in white matter

Elevated gamma globulin in CSF

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4
Q

What are the s/s of MS?

A
  • Muscle spasticity
  • Ataxia
  • Urinary retention
  • Hyperreflexia of extremeties
  • Decreased concentration
  • Fatigue
  • Double vision, blurry or darka
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5
Q

What are the 4 “S’s” to avoid triggering MS flare ups?

A
  • Stress (exercise, surgery, injury)
  • Sickness (or sepsis)
  • Smoking
  • Sun (extreme heat)
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6
Q

What are some ways to promote independence for an MS pt?

A
  • Teach self care ADLS, but don’t do for them
  • Gait training if walking is affected
    • Teach 1st
    • Then offer cane, walker, wheel chair. In that order
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7
Q

What is the goal of pharmacological tx for MS?

A

Lengthen remission and shorten exacerbation

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8
Q

What is the pharmacological tx for MS?

A
  • IVIG: body attacks IVIG instead
  • Interferon: interferes with body attacking itself
  • Steroids: to decrease swelling
  • Muscle relaxants (baclofen): for muscle spasms
  • Cyclosporine: immunosuppressant (most important)
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9
Q

What is the teaching for cyclosporine?

A

Report any signs of infection and bleeding

NOT for pregnant clients

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10
Q

True or False

PTs w/ MS should be bathed in hot water

A

False, It can cause a flare up

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11
Q

Where should a client rest to avoid fatigue w/ MS?

A

Rest in an airconditioned room

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12
Q

What are the clinical manifestations that indicate MS?

A

Charcot’s triad

Lhermitte’s sign

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13
Q

What is Charcot’s triad?

A
  • Nystagmus
    • Involuntary rhythmic side-to-side, up and down or circular motion of the eyes
  • Intention tremor
    • Involuntary, rhythmic muscle contractions (oscillations) that occur during a purposeful, voluntary movement.
  • Dysarthria
    • occurs when the muscles you use for speech are weak or you have difficulty controlling them
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14
Q

What is Lhermitte’s sign?

A

Electric shock like sensation radiating down spine into extremities when neck is flexed

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15
Q

What results from a spinal tap indicate MS?

A
  • Increased protein, T-cells and IgG
  • Presence of oligoclonal bands
  • 95% of MS pts have abnormal IgG antibody
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16
Q

A pt has a PET scan. What glucose information is indicative of MS?

A

Decreased glucose uptake

17
Q

True or False

MS is more common in females and is genetic.

A

True

18
Q

How does MS affect hearing?

A

Tinnitus and decreased hearing

19
Q

What are the cognitive manifestations of MS?

A
  • Short term memory
  • Short attention span
  • Difficulty w/ info processing and planning
  • Altered visual perception
  • Word finding
20
Q

How does MS affect the GI system?

A
21
Q

MS onset is generally in what age range?

A

20-40 yrs

22
Q

True or False

MS weakness of limbs, trunk and head can progress to paralysis

A

True

23
Q

How does the relapsing – remitting cycle progress?

A

Severity of symptoms gradually advances after every exacerbation (like set of stairs)

24
Q

How does secondary progressive MS advance?

A

A few relapse -remitting cycles will be followed by a steady ramp up of severity in symptoms

25
Q

How does progressive – relapsing MS advance?

A

Each relapse will be followed by a steady increase of symptoms (ramp between exacerbations)

26
Q

What are the sfx of immunomodulators?

A
  • Flu-like reaction
  • Hepatotoxicity
  • Myelosuppression
  • Injection site reactions
  • Depression
  • Neutralizing antibiotics
27
Q

Immunosuppressants are given after a…

A

Steroid

28
Q

DDAVP (desmopression) is given for bladder dysfunction for which type of pts?

A

Diabetes inspidius

29
Q

What is dysesthesia?

A

Generic term for a cutaneous symptom–such as pruritus, burning, tingling, stinging, anesthesia, hypoesthesia, tickling, crawling, cold sensation, or even pain often caused by nerve trauma, impingement, or irritation

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