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cd 3303 > MS > Flashcards

MS Flashcards

1
Q

MC early S&S of MS

A

Blurred/double vision
Red-green color distortion
Blindness in one eye

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2
Q

Progressed S&S of MS

A 
M weakness in extremities
Difficulty with coordination/balance
Impaired walking & standing
Paresthesia
Speech impediments, tremors, dizziness
Hearing loss
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3
Q

Approximately ____% of people with MS have cognitive impairment including difficulty concentrating, attention/memory, poor judgement, and depression.

A

50

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4
Q

What are the 4 patterns of MS progression?

A
  1. Single incident with complete recovery
  2. Relapsing remitting
  3. Secondary progressive (what relapsing remitting usually turns into after a period of time)
  4. Primary progressive
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5
Q

Pathophysiology of MS

A

Immune system attacks myelin coating around nerves in CNS, causing development of plaques at multple sites in CNS

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6
Q

Which population is MC diagnosed with MS?

A

Females 20-40yo

People livign in developed areas, especially at increased latitude

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7
Q

True or false: individuals who move to more northern latitude at any age increase the risk of developing MS

A

False - only if you move before age 15

Individuals over 15 yoa moving to a
more northern latitude will have the
same risk for MS as the people in
their country of origin

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8
Q

Name 4 modifiable risk factors of MS

A

Smoking
Obesity in adolescence
Low vitD
Exposure to epstein-barr virus

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9
Q

MC symptoms of MS

A 
Fatigue (90%)
Depression (50%)
Cognitive and emotional changes (40%)
Peripheral visual symptoms
ED (40%)
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10
Q

When conducting a systems review of a patient suspected of having MS, what are 6 body functions which should be focused on?

A 
Cognition
Vision
Sensory
Motor
Sphincter dysfunction
Energy levels
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11
Q

Name the specific questionnaire which is used for assessing MS

A

Expanded Disability Status Scale

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12
Q

What are 5 components of a bed-side neurological exam for someone suspected of having MS?

A

CNs (DAN)
CASE
Gait & Balance (mBESS, tandem gait stance, observation)
Rapid alternating movements & point-to-point movements
Peripheral neuro exam (DTR, motor, sensory)

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13
Q

What are some changes you would anticipate in the gait of an individual with MS?

A 
Decreased speed
Shorter strides
Increased double-support time
Lack of cross-crawl coordination
Parachuting arm motion
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14
Q

Which muscle is the quickest to atrophy in the leg in association with MS?

A

VMO

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15
Q

The expanded disability status scale (EDSS) measures impairment in which 8 functional systems?

A

Pyramidal (muscle weaness/difficulty moving limbs)
Cerebellar (ataxia, loss of balance, coordination, tremor)
Brainstem (problems with speech, swallowing, nystagmus)
Sensory (numbness/loss of sensation)
Bowel/bladder function
Visual function
Cerebral function (difficulty with thinking and memory)
Other (chewing, swallowing, self-care, driving, GI function, resp function, energy levels_

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16
Q

What is the criteria for using the first section (1.0-4.5) of the EDSS?

A

Individual with MS who is able to walk without any aid

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17
Q

If an individual has impaired walking, how should you use the EDSS?

A

Use the second section (5.0-9.5)

18
Q

What is the swinging light test?

A

Tests for relative afferent pupillary defects
Shine light in unaffected eye and note normal constriction BL
Quickly swing light to shine in affected eye and note weaker pupillary response

19
Q

A lesion in the MLF associated with MS can lead to which symptom?

A

Internuclear opthalmoplegia (affected eye fails to adduct with lateral gaze)

20
Q

Name of the type of pain experienced by individuals with MS characterized by burning and gnawing pains in the extremities

A

Neuropathic

21
Q

What are paroxysmal symptoms (seen in association with MS)?

A

Temproary recurring episodes of slurred speech, incoordination, muscle spasms, painful/stabbing sensations

Caused by abnormal electrical impulses in acutely demyelinating lesions

22
Q

What kind of tremor is seen in associated with MS?

A

Intention tremor

23
Q

What are the MC bowel and bladder dysfunctions seen in associated with MS?

A

Urinary retention and frequency

Faecal incontinence is rare

24
Q

What is Uhthoff’s phenomenon? Why does this happen?

A

Increase in core body temperature (caused by hot bath, fever, vigorous exercise) resulting in exacerbation of MS symptoms - can unmask “silent” lesions

Pathophysiology: prolongs inaxtivation of voltage-gated sodium channels causing poor conduction

25
Q

What 3 tests can be done to diagnose MS?

A
  1. MRI: ID sclerotic lesions, swelling, atrophy of brain tissue
  2. Evoked potentials: measures speed of nerve impulse conduction in pathways of CNS (will be reduced in MS due to myelin damage)
  3. Lumbar puncture: test CSF for myelin breakdown and antibody proteins associated with CNS inflammation
26
Q

What is the name of the antibody proteins found in the CSF of individuals with MS which are known to be present with inflammation in the CNS?

A

Oligoclonal bands

27
Q

What does the term “dissemination in time and space” mean? What is it used for?

A

Dissemination in space: evidence of scarring in at least 2 separate areas of CNS
Dissemination in time: evidence that plaques occured at different points in time

Used for identifying MS pattern of progression

28
Q

What are the 7 lag times that contribute to delayed diagnosis of MS?

A

Symptom: subclinical, incubation, injury to symptom delay
Physician: onset-to-medical visit
Imaging: Time to takes to book, complete assessment, receive report
Referral: Time to takes to book, complete assessment, receive report
Laboratory: Time to takes to book, complete assessment, receive report
Management: Communication, appointments, fax, file work
Diagnostic lag time: onset-to-diagnosis

29
Q

True or false: chiropractors are able to make a diagnosis of MS as it is an MSK condition

A

False - can have as differential but clinical guidelines, lab testing, and imaging is required

30
Q

What is the MS prodrome?

A

Early set of S&S that indicate onset of a disease; precedes more obvious/typical symptoms that enable dx

Still controversial if one exists

31
Q

Name 4 ddxs of MS

A

SLE
Lyme disease
HIV
Subacute combined degeneration

32
Q

When is treatment of MS most effective?

A

Early, inflammatory phase (not later, neurodegenerative phase)

33
Q

Which progression pattern of MS is MC treated with disease-modifying agents?

A

Relapsing forms

34
Q 
Which of the following CAM therapies has sufficient evidence for treatment of MS:
A) Biofeedback
B) Cannabinoids
C) Reflexology
D) Music therapy
E) Low-fat diet with omega-3 supplementation
F) Hypnosis
G) Yoga
H) Reflexology
I) Bee venom
A

Cannabinoids
Reflexology
Bee venom
Low-fat diet with omega-3

35
Q

What is the natural history of MS?

A

Very unpredictable! (Hallmark of MS is its unpredictability)
1/3 have a very mild course
1/3 have moderate course
1/3 become more disabled

36
Q

Positive prognostic factors of MS

A 
Female
Onset before age 35
Mainly sensory symptoms
Monofocal (not multifocal) episodes
Complete recovery following relapse
37
Q

What are 6 serious complications of MS?

A 
Urosepsis (Untreated UTI)
Pulmonary dysfunction
Skin breakdown
Untreated depression
Osteoporosis
38
Q

Individuals with MS tend to have a hypokinetic lifestyle. What are 3 serious complications of a hypokinetic lifestyle?

A
  1. Sarcopenia
  2. Dysmotility syndrome (>=3 of: osteoporosis, falls in preceding year, low lean mass, slow gait speed, low grip strength, obsesity/high fat mass)
  3. Frailty syndrome (>=3 of: weakness, slowness, low level of physical activity, self-reported exhaustion, unintentional weight loss)
39
Q

What are the 4 components of core strength?

A
  1. Diaphragm strength
  2. Abdominal muscle strength
  3. Back extensor muscle strength
  4. Pelvic floor muscle strength
40
Q

What exercise can be used to assess core strength?

A

Double-leg hip lift (assesses muscle strength, flexion/extension capacity, and neuromuscular control of core stability in a single plane)

cd 3303 (24 decks)

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