lecture 10: Multiple sclerosis Flashcards
what are the systems that are involved in MS
neurological
immune
at what age does MS usually arise
20-40 years old
is MS curable
no
who is the faculty member who works with MS
Dr Peter Darlington
what is MS
MS is a chronic, progressive disease
that leads to increasing disability in
most individuals
what does the “multiple” mean in MS
Many scattered areas of the
brain and spinal cord are affected
what does the “sclerosis” mean in MS
Sclerosed’ or hardened
tissue in damaged areas
what does the immunite system attack in MS and what does that cause
Immune system attacks the myelin
sheath causing communication
problems between the brain and the
rest of the body
true or false: MS cannot be hleped by meds
false
how can meds help for MS
1) speed recovery from attacks
2. modify the course of the disease
and symptoms
true or false: MS lesion can affet the brain and or the brain step
true
IN MS what happens to the myelin in nthe CNS
it becomes detached and destroyed
when the myelin sheat gets dettached and destroyed what does that create
this creates a lesion that may cause numbeness or tingling in parts of the body
true or false: MS has no loss of motor control
false it does
what is the most common CNS disease among young adults in canada
multiple sclerosis
true or false: mostly young adutls are most likelyr to get MS (during their productive years)
true
how many canadians have MS
55k-75k
how many people per 100 000 people have MS
166
what is the average age of clinical onest of MS
30-33
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
because
1) symptoms come and go
2) MS gets mixed up with other conditions
3) symtpoms may vary person to person
in 1936 only BLANK survived beyong 20 years after onset of illness
8%
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
better treatment and drugs
better knownldege
and MAYBE better nutirition
true or false: the cause of MS is known
false, its unknown
MS is consdirec a BLANK disease and what does that mean
autoimmune disease where the body attacks its only tissues by mistake
what cells are responsible for destroying myeline sheate
T cells and monocytes
what are the factors that increase the risk of developping MS
age sex fam history infections climate certrain autoimmune diseases smoking race
MS ca occur at any age but mos tcommon affects what age
20-40
what gender is 2x more likely to develop MS
women
if one of ur parents or siblings has MS you are at higher or lower risk of developping iti
higher
what are some viruses that have been linked to MS
EPstein barr (That gives mono)
MS is more common in what type of climates
more common in countries with temperate climates (like canada eurpoe)
you have a slightly higher risk of dev MS if you have what autoimmune disease
thyroid disease
type 1 dibates
inflammatory bowel disease
true or false: smokers are more likely to develop a second event that confirms relaptsiting remitting MS
true
what race is at higher risk of MS
white people
do inuit populations get nire if less MS cases
less
what is the incicdece of inuit populationsn and MS
19 per 100000
what is the incidence of MS on scottinng poplation
200 per 100 000
what is the ration of white to non white people who get MS
2:1
true or false: the symptoms of MS are the same for everyone
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:
if you have an optic nerve lesion what are the signs and symptoms
blurred vision
if you have a branstem lesion what are the signs and symptoms
dizzinesss AND MAYBE double vision
if you have a cerebellum and cerebrum lesion what are the signs and symptoms
balance problems, sppech problems, uncoordinated movements and tremors
if you have a motor nerve tract lesion what are the signs and symptoms
muscle weakness, spasticity paralysis, bladder and bowel impairments
if you have a sensory nerve tract lesion what are the signs and symptoms
altered sensation, numbness, pricking, and burning sensation
what lesion causes blurred vision
optic nerve lesion
what lesion causes dizziness and may cause double vision
brainstem
what lesion causes balance problems, speech problems,
uncoordinated movements and
tremors
cerebellum and cerebrum
what lesion causes muscle weakness, spasticity paralysis,
bladder and bowel impairments
motor nerve tract lesion
what lesion causes altered sensation, numbness, prickling,
and burning sensations
sensory nerve tract lesion
what symtpom is common in 78% of all patients
fatigue
fatigue is common in what percentage of patients with MS
78
what are the 2 mojor symtpsoms of MS
fatigue
tremor, lack of coordinationn, unstead gait
when there is a MS flare up what happens to the myelin
it becomes inflammed
if there is scar formation after the myelin sheath becomes inflammed, what happens
permentant myelin damage and loss of function
if there is no scar formation after the myelin sheath becomes inflammed, what happens
complete recoverey and no loss of funciton
what can disease modifying therapies help with.
decrease the severity and help against he frequency of relatpses
MS classification is based on what two things
1) rate of disease progression
2) frequence of flare ups
what are the 4 types of MS
relapsing/remitting MS (RRMS) Secondary progressive MS (SPMS) Primary progressive MS (PPMS) Progressive relapsing MS (PRMS)
what is the most common type of MS
relapsing/remitting MS
explain Relapsing Remitting MS
Unpredictable but clearly defined relapses (also known as attacks, exacerbations or flare-ups) during which new symptoms appear or existing ones get worse
true or false, in the period between relapses in relapsing MS, how is recovery
recovery is complete or near complete to prelapse function (remission)
what is more severe: relapsing MS or secondary progressive MS
secondary progressie
epxlain secondary progressive MS
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
about half of people with relapsing MS start to worsen within what years and what does that come with
within 10-20 years of dianosis and that comes with increase levls of disability
true or false: meds can helo RRMS
true
True or fals: meds can help SPMS
true
which type of MS is a slow accumulattion of disability without defined relapses
Primary progressive MS. (PPMS)
PPMS has defined or undefined relapses
no defined relapses
true or false. in PPMS there are periods of remission and explain
false it May stabilize for periods of time, and even offer minor temporary improvement (figure 3b) but
overall, there are no periods ofremission. A
what is the percentage of people with MS have primary progressive multiple scleoris
10 per
cent of people diagnosed with MS
have PPMS
what is the ratrest course of MS
progressive relapsing MS
what is the incidence of progressive relapsing MS
5%
explain progressive relatpsing MS
People with this form of MS experience relapses with (figure 4a) or without (figure 4b) recovery and steadily worsening disease from the beginning
true or false: meds cannot help with progressive relapsing MS
false they can
what is the only type of MS thaat cannot be helped by meds
primary progressie
can people with MS treain
yes
can exercise be harmful to MS
yes it can trigger flare upa
are kceps qualified to train clients with MS
yes
what does meeting the PA guidelines do for thsoe with MS
reduce fatigue
improve mobility
enhance elements of health related quality of life
who are the PA guidelines for in MS
for adults with minimal to moderate disability resulting from either relaptsing/remitting MS or progressive forms of MS
true or false: those with MS should consult a HC professional before behining
true
if you are a physically inactive person with MS how should PA be performed
activities performed at lower intensity frequence and durantionn than recommeded may bring some benefit
true or false: you should gradually increase duraction and frequency as progression towards meeting the guidelines
true q
aerobic activtity and strength training are the only activtiyes that should eb done with MS
false, it is importatnt to include daily stretch of affected joints and muscles and balance exerceises
how often should those with MS perform areobic and strength training
two times a wee
what is the time someone with MS should do aerobic exercise
at least 30 minutes durinng the workout session
what is the ampunt of sets and reps someone with MS should do in RT
2 sets of 10-15 reps
how hard/intensity should aerobic exercise be for those with MS
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
what should the inteisty be for RT for those with MS
pick a resistance (free wights, pulleys bands etc) that is heavy enough to barely, but safely, finish 10-15 reps of the last set
what are some good aerobic activites for those with MS
upper body exercises: arm cycling
lower body exerceises: walking, leg cycling
combined: eliptical
=aquatic
what are some good strength training activties for those with MS
weight machines
free wights
cable pulleys.
whart are the special consideration to exrcise with MS (5)
lower level of fitness (cardio, muscle endurance and strenght and balance)
fatigue
heatt intolerace
depression
exercise does not trigger flare ups with properly managed
true or false and explain: those with MS have heat intolerance
true they have a body temp 0.5 higher
what are the 4 effects of exercise on MS
1) increases aerobic capacity
2) increases muscular sttrength and endurace
3) increase QOL
4) increase independace in ADLS
