MS Flashcards
What is MS?
Progressive, autoimmune, demyelination of the CNS (brain, spinal cord, CN I and CN II)
What is the most common cause of non-traumatic disability beginning in young adults?
MS
MS is more common in (males/females)
females 20-40 y/o
(true/false) MS is more prevalent in those who live close to the equator for at least 15 years.
FALSE (less prevalent)
Women who took a ____ supplement (mostly from a multivitamin) reduced their risk of MS by 40% compared to those that didn’t take supplements
vitamin D supplement
What are s/s of MS?
- N/T
- B/B dysfunction
- pain
- decreased balance
- fatigue
- decreased cognition
- heat sensitivity
- visual dysfunction
- weakness
- sexual dysfunction
- spasticity
- ambulatory dysfunction
- depression
What is the most common and most disabling symptom of those with MS?
Fatigue
What is often one of the first impairments for those with MS?
Visual dysfunction (optic neuritis) causing blurriness, decreased vision, and/or diplopia
(true/false) Nystagmus is permanent in those with MS.
FALSE (temporary)
What test was once used to help diagnose MS through testing heat sensitivity?
bath tub test
–> Hyperthermia creates a (usually) temporary worsening of clinical signs present in an estimated 60% to 80% of those with MS.
(true/false) sexual dysfunction has a much larger detrimental impact on the mental health aspects of HrQoL than severity of physical disability.
true
Those with MS are at increased risk for ______ Neuralgia which is a stabbing type of pain on the side of the face.
trigeminal neuralgia
What is a sign that can be observed in some with MS when the neck is flexed and an electrical shock is passed down through the posterior column?
Lhermitte’s sign
(true/false) most MS patients with depression have medication for management of symptoms.
FALSE
(true/false) Brain volume correlates better with cognitive performance than lesion volume.
true
definition: appearance of a new lesion on a second scan, regardless of the timing in relation to the initial scan OR simultaneous presence of asymptomatic gadolinium enhancing and non-enhancing lesions on a single scan
Dissemination in time
definition: at least two T2 lesions present
dissemination in space
What are the 4 classifications of MS?
- clinically isolated syndrome (CIS)
- relapsing-remitting (RRMS)
- Primary progressive (PPMS)
- Secondary progressive (SPMS)
definition: the FIRST episode of neuro symptoms caused by inflammation and demyelination in the CNS. The episode must last for 24 hrs for further testing to determine presence of MS.
clinically isolated syndrome (CIS)
–> If those with CIS have a brain lesion as evidenced by MRI, they have a 60-80% risk for a future diagnosis of MS.
Approximately 80% of those with MS are initially diagnosed with ______ MS yet most eventually convert to secondary progressive.
Relapsing remitting MS
definition: MS that is characterized by a slow progressive course with possible plateaus or small changes in rate but overall, a progression.
primary progressive MS (PPMS)
(true/false) PPMS has early episodes of relapsing and remission
FALSE
What is the second most common type of MS?
Secondary progressive (SPMS)
SPMS patients may have lower levels of inflammatory lesion formation than RRMS that is thought to be due to what possibility?
axonal loss.
(true/false) those with SPMS typically started as relapsing-remitting.
true
What scan can depict areas of permanent damage or “black holes?
T1 scan
–> There is a significant correlation between baseline disability and hypointense lesion load
A T1 scan with _____ contrast dye depicts new lesions representing active inflammation (past 6-8 wks).
gladiolum
What scan depicts the total amount of chronic lesion area?
T2 scan/T2 FLAIR
What diagnostic tool has variable sensitivity and specificity in diagnosis of MS and there continues to be a discord between lesion location and clinical presentation?
MRI
What criteria do you need for Dx of MS?
- Dissemination in time
- Dissemination in space
- Other causes of s/s must be ruled out
- Attacks/relapses/exacerbations must last 24 hours without fever and/or infection
(true/false) Dx of MS CAN be used through only clinical findings
true
Exacerbation treatment focuses on decreasing the duration & intensity of the attack as well as promoting recovery via _________ medications.
anti-inflammatory meds
The National MS Society and the American Academy of Neurology endorse the use of steroids for (acute/chronic) treatment of MS
acute treatment
What are treatment options for chronic phase MS?
- vitamin D
- DMA (disease modifying agents)
- symptom management
(true/false) Recent research states that vitamin D may be favorable for preventing the progression of MS
true
Why are disease modifying agents not for everyone?
They reduce the frequency and/or severity of clinical attacks as well as delay conversion to MS for those with CIS.
What medications can help with optic neuritis by combating diplopia?
steroids
What medication is neurologic pain often treated with when MS is present?
Neurontin
What medication is acute neurologic pain often treated with when MS is present?
Carbamazepine
What medications can assist with decreasing spasticity?
baclofen, zanaflex, and dantrolene
What medications can improve fatigue in those with MS?
stimulants
anti-depressants
