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KCEP 210 > lecture 10: Multiple sclerosis > Flashcards

lecture 10: Multiple sclerosis Flashcards

1
Q

what are the systems that are involved in MS

A

neurological

immune

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2
Q

at what age does MS usually arise

A

20-40 years old

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3
Q

is MS curable

A

no

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4
Q

who is the faculty member who works with MS

A

Dr Peter Darlington

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5
Q

what is MS

A

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

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6
Q

what does the “multiple” mean in MS

A

Many scattered areas of the

brain and spinal cord are affected

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7
Q

what does the “sclerosis” mean in MS

A

Sclerosed’ or hardened

tissue in damaged areas

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8
Q

what does the immunite system attack in MS and what does that cause

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

true or false: MS cannot be hleped by meds

A

false

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10
Q

how can meds help for MS

A

1) speed recovery from attacks
2. modify the course of the disease
and symptoms

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11
Q

true or false: MS lesion can affet the brain and or the brain step

A

true

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12
Q

IN MS what happens to the myelin in nthe CNS

A

it becomes detached and destroyed

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13
Q

when the myelin sheat gets dettached and destroyed what does that create

A

this creates a lesion that may cause numbeness or tingling in parts of the body

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14
Q

true or false: MS has no loss of motor control

A

false it does

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15
Q

what is the most common CNS disease among young adults in canada

A

multiple sclerosis

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16
Q

true or false: mostly young adutls are most likelyr to get MS (during their productive years)

A

true

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17
Q

how many canadians have MS

A

55k-75k

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18
Q

how many people per 100 000 people have MS

A

166

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19
Q

what is the average age of clinical onest of MS

A

30-33

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20
Q

Avg age of clinical onset is 30–33 years of age…but the avg age of
diagnosis is 37… why is there such a delay

A

because

1) symptoms come and go
2) MS gets mixed up with other conditions
3) symtpoms may vary person to person

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21
Q

in 1936 only BLANK survived beyong 20 years after onset of illness

A

8%

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22
Q

In 1936, only 8% of patients were reported to survive beyond 20 years
after onset of illness… but a patient can now expect to live the average
population life-expectancy minus seven years… why such a change

A

better treatment and drugs
better knownldege
and MAYBE better nutirition

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23
Q

true or false: the cause of MS is known

A

false, its unknown

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24
Q

MS is consdirec a BLANK disease and what does that mean

A

autoimmune disease where the body attacks its only tissues by mistake

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25
Q

what cells are responsible for destroying myeline sheate

A

T cells and monocytes

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26
Q

what are the factors that increase the risk of developping MS

A 
age 
sex
fam history 
infections
climate
certrain autoimmune diseases
smoking 
race
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27
Q

MS ca occur at any age but mos tcommon affects what age

A

20-40

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28
Q

what gender is 2x more likely to develop MS

A

women

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29
Q

if one of ur parents or siblings has MS you are at higher or lower risk of developping iti

A

higher

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30
Q

what are some viruses that have been linked to MS

A

EPstein barr (That gives mono)

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31
Q

MS is more common in what type of climates

A

more common in countries with temperate climates (like canada eurpoe)

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32
Q

you have a slightly higher risk of dev MS if you have what autoimmune disease

A

thyroid disease
type 1 dibates
inflammatory bowel disease

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33
Q

true or false: smokers are more likely to develop a second event that confirms relaptsiting remitting MS

A

true

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34
Q

what race is at higher risk of MS

A

white people

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35
Q

do inuit populations get nire if less MS cases

A

less

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36
Q

what is the incicdece of inuit populationsn and MS

A

19 per 100000

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37
Q

what is the incidence of MS on scottinng poplation

A

200 per 100 000

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38
Q

what is the ration of white to non white people who get MS

A

2:1

39
Q

true or false: the symptoms of MS are the same for everyone

A

May differ greatly from person to person and over the course of
the disease depending on the MS type and location of the lesions
within the nervous system:

40
Q

if you have an optic nerve lesion what are the signs and symptoms

A

blurred vision

41
Q

if you have a branstem lesion what are the signs and symptoms

A

dizzinesss AND MAYBE double vision

42
Q

if you have a cerebellum and cerebrum lesion what are the signs and symptoms

A

balance problems, sppech problems, uncoordinated movements and tremors

43
Q

if you have a motor nerve tract lesion what are the signs and symptoms

A

muscle weakness, spasticity paralysis, bladder and bowel impairments

44
Q

if you have a sensory nerve tract lesion what are the signs and symptoms

A

altered sensation, numbness, pricking, and burning sensation

45
Q

what lesion causes blurred vision

A

optic nerve lesion

46
Q

what lesion causes dizziness and may cause double vision

A

brainstem

47
Q

what lesion causes balance problems, speech problems,
uncoordinated movements and
tremors

A

cerebellum and cerebrum

48
Q

what lesion causes muscle weakness, spasticity paralysis,

bladder and bowel impairments

A

motor nerve tract lesion

49
Q

what lesion causes altered sensation, numbness, prickling,

and burning sensations

A

sensory nerve tract lesion

50
Q

what symtpom is common in 78% of all patients

A

fatigue

51
Q

fatigue is common in what percentage of patients with MS

A

78

52
Q

what are the 2 mojor symtpsoms of MS

A

fatigue

tremor, lack of coordinationn, unstead gait

53
Q

when there is a MS flare up what happens to the myelin

A

it becomes inflammed

54
Q

if there is scar formation after the myelin sheath becomes inflammed, what happens

A

permentant myelin damage and loss of function

55
Q

if there is no scar formation after the myelin sheath becomes inflammed, what happens

A

complete recoverey and no loss of funciton

56
Q

what can disease modifying therapies help with.

A

decrease the severity and help against he frequency of relatpses

57
Q

MS classification is based on what two things

A

1) rate of disease progression

2) frequence of flare ups

58
Q

what are the 4 types of MS

A 
relapsing/remitting MS (RRMS)
Secondary progressive MS (SPMS)
Primary progressive MS
(PPMS)
Progressive relapsing MS
(PRMS)
59
Q

what is the most common type of MS

A

relapsing/remitting MS

60
Q

explain Relapsing Remitting MS

A 
Unpredictable but clearly defined
relapses (also known as attacks,
exacerbations or flare-ups) during
which new symptoms appear or
existing ones get worse
61
Q

true or false, in the period between relapses in relapsing MS, how is recovery

A

recovery is complete or near complete to prelapse function (remission)

62
Q

what is more severe: relapsing MS or secondary progressive MS

A

secondary progressie

63
Q

epxlain secondary progressive MS

A

Follows a diagnosis of RRMS. Over time, distinct relapses and remissions become less apparent and the disease begins to progress steadily (figure 2a), sometimes with plateaus

64
Q

about half of people with relapsing MS start to worsen within what years and what does that come with

A

within 10-20 years of dianosis and that comes with increase levls of disability

65
Q

true or false: meds can helo RRMS

A

true

66
Q

True or fals: meds can help SPMS

A

true

67
Q

which type of MS is a slow accumulattion of disability without defined relapses

A

Primary progressive MS. (PPMS)

68
Q

PPMS has defined or undefined relapses

A

no defined relapses

69
Q

true or false. in PPMS there are periods of remission and explain

A

false it May stabilize for periods of time, and even offer minor temporary improvement (figure 3b) but
overall, there are no periods ofremission. A

70
Q

what is the percentage of people with MS have primary progressive multiple scleoris

A

10 per
cent of people diagnosed with MS
have PPMS

71
Q

what is the ratrest course of MS

A

progressive relapsing MS

72
Q

what is the incidence of progressive relapsing MS

A

5%

73
Q

explain progressive relatpsing MS

A 
People with this form of MS
experience relapses with (figure 4a)
or without (figure 4b) recovery and
steadily worsening disease from the
beginning
74
Q

true or false: meds cannot help with progressive relapsing MS

A

false they can

75
Q

what is the only type of MS thaat cannot be helped by meds

A

primary progressie

76
Q

can people with MS treain

A

yes

77
Q

can exercise be harmful to MS

A

yes it can trigger flare upa

78
Q

are kceps qualified to train clients with MS

A

yes

79
Q

what does meeting the PA guidelines do for thsoe with MS

A

reduce fatigue
improve mobility
enhance elements of health related quality of life

80
Q

who are the PA guidelines for in MS

A

for adults with minimal to moderate disability resulting from either relaptsing/remitting MS or progressive forms of MS

81
Q

true or false: those with MS should consult a HC professional before behining

A

true

82
Q

if you are a physically inactive person with MS how should PA be performed

A

activities performed at lower intensity frequence and durantionn than recommeded may bring some benefit

83
Q

true or false: you should gradually increase duraction and frequency as progression towards meeting the guidelines

A

true q

84
Q

aerobic activtity and strength training are the only activtiyes that should eb done with MS

A

false, it is importatnt to include daily stretch of affected joints and muscles and balance exerceises

85
Q

how often should those with MS perform areobic and strength training

A

two times a wee

86
Q

what is the time someone with MS should do aerobic exercise

A

at least 30 minutes durinng the workout session

87
Q

what is the ampunt of sets and reps someone with MS should do in RT

A

2 sets of 10-15 reps

88
Q

how hard/intensity should aerobic exercise be for those with MS

A

moderate intensity PA (5/6 on scale of 10) and causes HR to increase
you should be able to talk but not sing a song during the actitvty

89
Q

what should the inteisty be for RT for those with MS

A

pick a resistance (free wights, pulleys bands etc) that is heavy enough to barely, but safely, finish 10-15 reps of the last set

90
Q

what are some good aerobic activites for those with MS

A

upper body exercises: arm cycling

lower body exerceises: walking, leg cycling

combined: eliptical

=aquatic

91
Q

what are some good strength training activties for those with MS

A

weight machines
free wights
cable pulleys.

92
Q

whart are the special consideration to exrcise with MS (5)

A

lower level of fitness (cardio, muscle endurance and strenght and balance)

fatigue

heatt intolerace

depression

exercise does not trigger flare ups with properly managed

93
Q

true or false and explain: those with MS have heat intolerance

A

true they have a body temp 0.5 higher

94
Q

what are the 4 effects of exercise on MS

A

1) increases aerobic capacity
2) increases muscular sttrength and endurace
3) increase QOL
4) increase independace in ADLS

KCEP 210 (14 decks)

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