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Module 4 > MS > Flashcards

MS Flashcards

1
Q

MS

A

NO CURE -
Characterized by segmental demyelination of nerve fibers of brain and spinal cord
Periods of remission and exacerbation more progressive hen diagnosed at age >50 affects most women between 20-50
Enviromental factors (temperate climates)
Plaque formation on spinal cord and brain (seen on MRI)

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2
Q

Causes MS

A

No known causes but can be Infection smoking physical injury emotional stress excessive fatigue pregnancy poor state of health genetic component
Mostly occurs in women

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3
Q

With women who get diagnosed with MS after 50

A

No signs of remission and excerbations
But have progressive deterioration in some pt

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4
Q

Clinical manifestations

A

Chronic progressive deterioration in some pt (women older than 50)
Remissions and exacerbations in others
Overall trend progressive detestation in neuro function
Plaque build up on spinal cord and brain ( CNS) (on MRI)

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5
Q

Tremors in MS

A

Intestional tremors

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6
Q

Why does it take so long to get diagnosed with MS

A

Vague symptoms in the beginning,not enough to seek medical treatment
Will rule everything out before you get diagnosed with MS

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7
Q

Multiple sclerosis s/s common

A

Visual (blurred or double, blindness in one eye)
Motor problems- gait difficulties/assisted devices
Sensory problems(facial numbness ,
Inkling)
Cerebella’s problems
Bowel,bladder and sexual
Cognitive
Emotional problems

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8
Q

Death in MS pt

A

Not because of MS but from immobility , or pneumonia

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9
Q

Sensory manifestations

A

Numbness pain tremor
Decrease hearing
Chronic neuro pain
Llermitte’ssign

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10
Q

Motor manifestations

A

Weakness or paralysis
Spasticity of muscles
Scanning of speech

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11
Q

Impaired bowel and bladder functions

A

Spastic bladder
Constipation

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12
Q

Sexual dysfunction

A

Erectile dysfunction
Decrease libido
Painful intercourse

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13
Q

Cognitive manifestations

A

Short term memory attention
Info processing
Attention , planning
Visual perception word finding

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14
Q

MS diagnostic studies

A

No definitive test for MS
H&P , clinical manifestations and result of diagnostic test
MRI
CSF analysis
Evoked potential studies
Neuropsychological testing
Sexual history

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15
Q

For diagnosis of MS

A

Evidence of at least 2 inflammatory demyelination’s lesions in at least 2 different locations within the CNS
Damage or an attack occurring at different times (usually > 1 month apart)
All other diagnosis must be ruled out

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16
Q

MS medical management

A

No cure
Goal is to delay progression of disease manage chronic symptoms and treat acute exacerbations

17
Q

Immunomodulaators (disease modifying drugs I)

A

Interferon beta-1a
Interferon bet-1b
Glatiramer acetate
Teriflunamide

18
Q

Interferon beta

A

Is a naturally occurring glycoprotein with antiviral , antiproliferative , antimmunomodulatory actions

Reduced the frequency and severity of attacks
Reduces the number and size of lesions detectable with MRI

Delays progression of disability
Given subq or IM injections

19
Q

Adverse effects and drug interactions INterferon beta

A

Flu like reactions
Hepatotoxicity (liver function test,CBC)
Myelosuppression
Injection - site reactions
Depression
Suicidal thoughts
Drug reactions

20
Q

PREPERATION dosage and admin of interferon beta

A

Dispense as single use syringes and vials

21
Q

Disease modifying drugs II
Immunosuppressant

A

Only one approved by the US food and drug admin
Mitoxantrone

22
Q

Mitoxantrone

A

More toxic than immunommodulators
Produce greater suppression of immune function
Originally developed to treat cancer can delay time to relapse and time of disability progression

23
Q

Therapeutic use of mitoxantrone

A

Decreases neuro disability and clinical relapses

Binds with DNA and inhibits topoisomerase

24
Q

Adverse effects and drug interactions

A

Myelosuppression (monitor fever chills and cough inform physician immediately )
Cardio toxicity
Fetal harm
Reversible hair loss, injury to GI ucosa n&V
Amenorrhea , allergy symptoms and blue green tint to urine and Sclera

25
Q

Drug therapy for MS

A

Corticosteroids
Prednisone and methylprednisolone
Medication to manage symptoms (bowel dysfunction , etc)

26
Q

Medication for spastic muscles

A

Backlafin

27
Q

Medication for neuropathic pain

A

Gabapentin

28
Q

Medication to help with walking

A

Dalfampridine

29
Q

Nursing interventions

A

Promote physical mobility
Prevent injury
Enhance bowel and bladder control
Enhance communication
Improve sensory and cognitive function
Teach about medications
Educate family
Gait training

30
Q

Interproffesional care

A

Surgery
Dorsal column electrical stimulation
Intrathecal baclofen pump

31
Q

Therapy for MS

A

Water therapy

32
Q

Psychological

A

Anger anxiety depression acceptance

33
Q

Social system

A

Family
Financially
Friends

34
Q

Counseling

A

Individual
Family
support group

Module 4 (47 decks)

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