MS Flashcards
Which systems does MS effect?
a. the brain
b. spinal cord
c. brainstem
d. all of the above
all of the above
Which specific cranial nerve does MS have a primary effect on?
a. glossopharyngeal nerve
b. optic nerve
c. olfactory nerve
d. trigeminal nerve
optic nerve
Incidence of MS increases from teens to age 35 and then decreases (true/false)
true
Incidence of MS increases from teens to age _ and then decreases
a. 25
b. 35
c. 45
d. 55
35
Prevalence of MS in greater in males than females (true/false)
false
What population has the greatest prevalence of MS?
a. caucasian males
b. Hispanic males
c. Latino females
d. caucasian females
caucasian females
_ causes scarring and hardening known as _ of nerve fibers
Demyelination
sclerosis
Slowing nerve impulses causes what specific symptoms
weakness
numbness
pain
vision loss
What are the possible causes of MS?
probable autoimmune
genetic predisposition
environmental influence
vitamin D deficiency
The clinical course of MS is predictable (true/false)
false
Disease process is _ throughout course but symptoms may have periods of _ and _
progressive
relapse and remission
What is usually the first clinical symptom of MS?
a. balance issues
b. fatigue
c. visual impairment
d. pain
visual impairment
What are the common symptoms associated with visual impairment?
blurred vision
double vision
red or green color distortion
blindness in one eye
Cold exacerbates symptoms temporarily (true/false)
false
_ typically exacerbates symptoms temporarily
a. cold
b. heat
c. hot water
d. cold water
heat
What factors exacerbate relapse?
a. poor sleep
b. inactivity
c. infections and stress
d. heat
infections and stress
There are no adverse effects on the course of pregnancy (true/false)
true
What typically happens with symptoms when a patient is pregnant?
symptoms stabilize or get better
Relapse of MS is common after childbirth within _ months
a. 2 months
b. 3 months
c. 6 months
d. 9 months
3 months
Medications are _ during pregnancy with MS
contraindicated
What is the most common clinical symptom found with patients?
a. motor impairment
b. sensory impairment
c. depression
d. fatigue
fatigue
What motor impairments are seen with the clinical course of MS?
weakness
balance and gait disturbance
tremor
increased tone - 75% have spasticity
MS patients experience bowel/bladder dysfunction (True/false)
true
The tension attained at any moment between the origin and the insertion of a muscle, the tension is determined partly by mechanical factors and the degree of motor unit activity
a. tone
b. hypertonicity
c. spasticity
d. none of the above
tone
The sensation of (increased) resistance is felt as one manipulates a joint through a range of motion at a slow velocity, with the subject attempting to relax
a. tone
b. hypertonicity
c. spasticity
d. none of the above
hypertonicity
A velocity-dependent increase in the tonic stretch reflex with exaggerated tendon jerks resulting from hyperexcitability of the stretch reflex as one component of the upper motor neuron syndrome
a. tone
b. hypertonicity
c. spasticity
d. none of the above
spasticity
List the core set of movement tasks
sitting sit to stand, stand to sit, floor to stand, stand to floor standing walking, floor mobility step up/step down reach, grasp and manipulation
What neuromuscular movement system diagnosis is most often present with MS?
a. cognitive deficit and sensory selection and weighting deficit
b. force production deficit and hypokinesia
c. sensory detection deficit and movement pattern coordination deficit
d. force production deficit and sensory detection deficit
force production deficit and sensory detection deficit
Task-Oriented Training approach should be challenging and engagement with attention to solve the motor problem (true/false)
true
Tasks should not be interesting for the patient to want to participate (true/false)
false
Communication, coordination and documentation identify
a. intervention to address cognitive deficits
b. direct intervention
c. indirect intervention
d. none of the above
indirect intervention
Indirect intervention education should include
cognitive dysfunction compensatory strategies family education home program and energy conservation skincare
Intervention for weakness is identified as
a. direct intervention
b. indirect intervention
c. fatigue intervention
d. medical management
direct intervention
Strengthening exercises, strategy training, general conditioning and fitness, assistive devices/adaptive equipment, orthotics are described as
a. indirect intervention
b. direct intervention
c. weakness intervention
d. TOT
direct intervention
Energy conservation, conditioning, cooling, avoid by reducing stress, assistive devices, and adaptive equipment are interventions to treat
a. hypertonicity
b. balance
c. sensory deficit
d. fatigue
fatigue
Conditioning reduces fatigue (true/false)
true
Stretching, cold, splints, and tone reducing techniques are interventions to treat
a. hypertonicity and spasticity
b. balance
c. sensory deficit
d. fatigue
hypertonicity
Motor and sensory strategies, functional training, work core muscles, large fluid/smooth movements, feedback and visual cues are used for what intervention
a. hypertonicity
b. balance
c. sensory deficit
d. fatigue
balance
Which type of MS is most commonly seen?
a. relapsing-remitting MS
b. primary progressive MS
c. secondary progressive MS
d. progressive-relapsing MS
Relapsing-remitting MS
Which type of MS is the rarest?
a. relapsing-remitting MS
b. primary progressive MS
c. secondary progressive MS
d. progressive-relapsing MS
primary progressive MS
This type of MS is acute attacks with full or partial recovery in between
a. relapsing-remitting MS
b. primary progressive MS
c. secondary progressive MS
d. progressive-relapsing MS
relapsing-remitting MS
This type of MS is an unremitted progression of the disease
a. relapsing-remitting MS
b. primary progressive MS
c. secondary progressive MS
d. progressive-relapsing MS
primary progressive MS
This type of MS is relapsing and remitting in the beginning, followed by progressive with or without remissions
a. relapsing-remitting MS
b. primary progressive MS
c. secondary progressive MS
d. progressive-relapsing MS
secondary progressive MS
This type of MS is progression with acute episodes that may or not recover from acute
a. relapsing-remitting MS
b. primary progressive MS
c. secondary progressive MS
d. progressive-relapsing MS
progressive-relapsing MS
A patient relapsing-remitting MS will show
a. unremitting progression of the disease or with minor improvements and temporary plateaus
b. acute attacks with full or partial recovery in between
c. relapsing-remitting at the beginning followed by progressive with or without remissions
d. progression with acute episodes that may or may not recovery from acute relapse
acute attacks with full or partial recovery in between
An african-American born in the South who moved to Minnesota at age three has the same risk factor as if he were born in Minnesota
a. true
b. false
true
A pt with primary progressive MS will show
a. unremitting progression of the disease or with minor improvements and temporary plateaus
b. acute attacks with full or partial recovery in between
c. relapsing-remitting at the beginning followed by progressive with or without remissions
d. progression with acute episodes that may or may not recovery from acute relapse
unremitting progression of the disease or with minor improvements and temporary plateaus
A pt with secondary progressive MS will show
a. unremitting progression of the disease or with minor improvements and temporary plateaus
b. acute attacks with full or partial recovery in between
c. relapsing-remitting at the beginning followed by progressive with or without remissions
d. progression with acute episodes that may or may not recover from acute relapse
relapsing-remitting at the beginning followed by progressive with or without remissions
A pt with progressive-relapsing MS will show
a. unremitting progression of the disease or with minor improvements and temporary plateaus
b. acute attacks with full or partial recovery in between
c. relapsing-remitting at the beginning followed by progressive with or without remissions
d. progression with acute episodes that may or may not recover from acute relapse
progression with acute episodes that may or may not recover from acute relapse
A pregnant woman with MS
a. is at risk of exacerbation during pregnancy
b. may have improvements of symptoms during pregnancy with relapse afterwards
c. is highly likely to have a baby with congenital MS
d. is able to take usual MS medications during pregnancy
may have improvements of symptoms during pregnancy with relapse afterwards
A female patient at the age of 25 with one system attack and complete recovery will have a
a. poor prognosis
b. better prognosis
c. prognosis cannot be predicted
d. average prognosis
better prognosis
A male with a multisystem attack, brainstem symptoms, poor recovery after exacerbations and a high frequency of attacks has a
a. poor prognosis
b. better prognosis
c. prognosis cannot be predicted
d. average prognosis
poorer prognosis
Nystagmus, temor, ataxia are
a. spinal cord symptoms
b. optic nerve symptoms
c. brainstem symptoms
d. neurological symptoms
brainstem symptoms
What is classified as a high frequency of attacks?
a. 2 relapses in 1 year
b. 5 relapses in 1 year
c. 5 relapses in 2 years
d. 2 relapses in 3 years
5 relapses in 2 years
A first and single acute demyelinating and/or inflammatory lesion in the CNS with a duration of at least 24 hours
a. relapse-remitting MS
b. symptom of MS
c. MS during pregnancy
d. clinical isolated syndrome
clinical isolated syndrome
What intervention can be used to treat fatigue?
a. disease-modifying agents
b. medications
c. anti-inflammatory corticosteroids
d. energy conservation techniques
energy conservation techniques
The diagnosis is based on
clinical exam
MRI
evoked potentials
lumbar puncture and CSF analysis
An attack that is the first attack which can be monofocal or multifocal, it is mild and resolves without treatment is describing
clinical isolated syndrome (CIS)
63% of patients who experience a CIS develop MS (true/false)
true
Patients are not normally on disease-modifying agents (true/false)
false
A patient with no fatigue or thermosensitivity is at what level of disability
a. EDSS level 0
b. EDSS level 1-2
c. EDSS level 3-5
d. EDSS level 6-7
EDSS level 0
A patient with limited fatigue and heat sensitivity; minor balance or gait problems is at what level of disability
a. EDSS level 0
b. EDSS level 1-2
c. EDSS level 3-5
d. EDSS level 6-7
EDSS level 1-2
A patient with limited gait; may have spasticity, weakness, ataxia, balance problems is at what level of disability
a. EDSS level 6-7
b. EDSS level 1-2
c. EDSS level 3-5
d. EDSS level 8-9
EDSS level 3-5
A patient that cannot participate in all daily activities; short-distance aided walking only is at what level of disability
a. EDSS level 3-5
b. EDSS level 1-2
c. EDSS level 8-9
d. EDSS level 6-7
EDSS level 6-7
A patient that is bedridden is what level of disability
a. EDSS level 8-9
b. EDSS level 3-5
c. EDSS level 6-7
d. EDSS level 0
EDSS level 8-9
What is the best to work on to improve balance and coordination?
functional training
What are the determinants of functional gait?
stance phase stability clearance in swing swing phase pre-positioning adequate step length energy conservation
Can the limb support the body weight and respond to ground reaction forces describes
a. clearance in swing
b. stance phase stability
c. swing phase pre-positioning
d. adequate step length
stance phase stability
Can the swing limb clear the surface with minimal risk of trips describes
a. clearance in swing
b. stance phase stability
c. swing phase pre-positioning
d. adequate step length
clearance in swing
Is the foot positioned for initial contact/loading?
a. energy conservation
b. stance phase stability
c. swing phase pre-positioning
d. adequate step length
swing phase pre-positioning
Is there sufficient motor control of both limbs to advance the swing limb?
a. clearance in swing
b. stance phase stability
c. swing phase pre-positioning
d. adequate step length
adequate step length
Is the energy cost of walking too high for functional mobility?
a. energy conservation
b. stance phase stability
c. swing phase pre-positioning
d. adequate step length
energy conservation
This type of training program includes full exertion, aerobic and resistive exercise, no extreme sports
a. none
b. all of the levels
c. minimal disability
d. moderate disability
none
This type of training program is monitored exercise program including strengthening and endurance using a variety of exercise types, precooling if heat-sensitive, avoid overtraining
a. none
b. all of the levels
c. minimal disability
d. moderate disability
minimal disability
This type of training program is deficit-driven exercise protocols including strengthening and endurance training using methods tolerated, walking, cycle ergometry, precooling if needed
a. none
b. all of the levels
c. minimal disability
d. moderate disability
moderate disability
This training program includes movement preservation, stretching, targeted strengthening needed for task specific training
a. moderate disability
b. severe disability
c. bedridden
d. all of the levels
severe disability
This training program is primarily passive movements to maintain motion, breathing exercises
a. moderate disability
b. severe disability
c. bedridden
d. all of the levels
bedridden
A majority of patients experience what two motor impairment symptoms?
balance and gait disturbance
increased tone
An CIS resolves with treatment (true/false)
false
What is the first step to implementing a strengthening program?
a. functional strength
b. strengthen unaffected muscles
c. stretch
d. balance activities
stretch first
