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Neuro Rehab Test 3 > MS > Flashcards

MS Flashcards

1
Q

what is the etiology of MS

A

autoimmune dz induced by viral/infectious agent causes an cytotoxic effect on myelin

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2
Q

what is the role of myelin

A

insulator and saltatory conductor to conserve energy during signal transmission

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3
Q

what is the role of oligodendrocytes

A

myelin production in CNS

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4
Q

describe the pathogenesis of plaque formation

A

demyelinated areas fill with fibrous astrocytes and proliferation of neurological tissue (gliosis) occurs resulting in plaque formation

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5
Q

what are the four most predictable areas of plaque formation in MS

A
  1. optic nerve
  2. ventricular system
  3. SC - particularly the posterior column
  4. CB peduncles
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6
Q

what is typically a first symptom of MS?

A

visual changes

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7
Q

what are the criteria for dx MS

A
  1. evidence of damage in at least 2 areas of the CNS AND
  2. damage occured at at least 2 different times AND
  3. r/o other dx
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8
Q

what three diagnostic tests are most common in the MS population

A
  1. MRI to visualize plaques in 95% of patients
  2. CSF/lumbar puncture will show inc IgG
  3. abnormal evoked potential
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9
Q

of the three diagnostic tests for MS, which is most useful for diagnosis?

A

evoked potential

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10
Q

what are the three common forms of MS

A 
RRMS (most common)
secondary progressive (SPMS)
primary progressive (PPMS)
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11
Q

Most RRMS evolves into what…

A

SPMS

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12
Q

Describe RRMS graphically

A

stepwise relapses with incomplete recovery

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13
Q

Describe SPMS graphically

A

RRMS developing into a constant attack on the myelin

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14
Q

Describe PPMS graphically

A

constant attack on the myelin

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15
Q

What two medications are most implicated in MS treatment

A

DMARDs early will save patients long term and high dose steroids to reduce the immune response

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16
Q

Define a MS exacerbation

A

New MS symptoms lasting MORE THAN 24 HOURS (usually longer) unrelated to another pathology

17
Q

define Uhthoff’s phenomenon

A

psudoexacerbation of MS symptoms lasting <24 hours

18
Q

T/F: Uhthoff’s phenomenon is caused by external heat

A

sort of true: it can be caused by either internal or external heat generation

19
Q

Neurosensory changes are very common in MS patients… What are six common pain presentations

A
  1. tic douloureux - trigeminal neuralgia
  2. Lhermitte’s sign
  3. burning/aching especially in LE (dysesthesias)
  4. hyperpathia - light touch = severe pain
  5. headaches
  6. chronic neuropathic pain
20
Q

what is Lhermitte’s sign?

A

neck flexion produces shock down the spine indicative of posterior column involvement of MS

21
Q

visual changes are common in MS… what are six common findings for visual disturbances in MS

A
  1. optic neuritis
  2. scotoma
  3. marcus gunn pupil
  4. nystagmus
  5. INO
  6. diplopia
22
Q

what is optic neuritis

A

pain behind eye with blurred vision and usually blindness in one eye

23
Q

what is scotoma

A

dark spot in the center of the visual field

24
Q

what is marcus gunn pupil?

A

related to the light reflex, both eyes dilate when a light in shined in the eye

25
Q

what in INO

A

internuclear opthalmoplegia - lateral gaze palsy in one eye and nystagmus in the other

26
Q

T/F: cognitive and autonomic changes are common in MS patients

27
Q

How is fatigue unique to MS patients

A

Lassitude - physical and mental fatigue associated with CNS pathology and is described as the most common/troubling symptom for patients

28
Q

T/F: rehab is as effective as medication in MS patients

A

false: rehab is better than meds to manage fatigue in MS patients

29
Q

Higher levels of aerobic capacity in MS patients are associated with (higher/same/lower) levels of fatigue

30
Q

is endurance exercise good for MS patients to improve aerobic capacity?

A

yes, but it requires a long term commitment according to the literature (1 year)

31
Q

T/F: exercise increases exacerbations of MS

32
Q

at what level should you exercise MS patients

A

submaximally with rest periods to prevent fatigue and overheating

33
Q

What is exercise Rx for MS patients

A

strength (standard), endurance (10-40 min 2-3x/wk)

34
Q

T/F: balance training is beneficial for MS patients

A

eh…. some/limited evidence about balance training in MS

35
Q

What are Frenkel’s exercises

A

coordination training with limited support in the literature for MS patients (includes finger to nose, heel to shin, RAM, shooting for targets, dual tasking)

36
Q

T/F: error augmentation is effective for MS patients

A

false - the CB modulates motor output in an intact system but with CB plaques from MS the patient will be unable to match motor output to sensory input effectively

37
Q

T/F: the evidence supports weighted vests/limbs to combat lacking CB error augmentation in MS patients

A

the evidence is indifferent and not strong

38
Q

MS specific outcome measures you may want to use

A

12-item MS Walking Scale; MS-QoL 54

Neuro Rehab Test 3 (12 decks)

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