MS Flashcards
what happens in the brain when someone has MS
segmental demyelination of nerve fibers of brain & spinal cord
what is the cause of MS
unknown
who does MS mostly affect
women b/w 20-50
MS is characterized by periods of ___ & ____
remission
exacerbation
what 3 patho processes characterize MS
chronic inflammation
demyelination
gliosis (scarring) in the CNS
the immune system ___ the myelin sheath
attacks
what are s/s of MS (9)
visual
motor problems
sensory problems
cerebellar problems
bowel dysfunction
bladder dysfunction
sexual dysfunction
cognitive issue
emotional problems
what are the sensory manifestations of MS (7)
numbness
tingling
pain
tremor
decreased hearing
vertigo
tinnitus
chronic neuropathic pain
lhermitte’s sign
what are motor manifestations of MS (4)
weakness or paralysis of limbs & trunk
spasticity of muscles
scanning of speech
what are the impaired bowel & bladder & functions for MS pts (4)
constipation
variable urinary problems
spastic bladder
flaccid bladder
what sexual dysfunctions can MS pts experience (3)
erectile dysfunction
decreased libido
painful intercourse
what are cognitive manifestations for MS (6)
short-term memory attention
information processing
attention
planning
visual perception
word finding
is there a definitive diagnostic test for MS
no
we can diagnose MS based on (3)
Hx
clinical manifestations
results of diagnostic tests
what are diagnostic tests we can do for MS (4)
CSF analysis
Evoked potential studies
neuropsychological testing
sexual hx
to confirm a dx of MS the pt has to have evidence of @ least __ inflammatory demyelinating lesions in @ least ___ different locations in CNS
also damage or attack occurring @ ____ ___ (>1 month apart)
all other possible ____ ruled out
2
2
different times
diagnoses
what are the goals of treatment for MS (3)
delay progression of disease
manage chronic symps
treat acute exacerbations
disease modifying drugs do what for MS (3)
decrease the frequency & severity of relapses
reduce the development of brain lesions
decrease future disability
what are disease modifying drugs I
drugs that suppress the immune sys to modify disease progression & prevent relapses
what do immunomodulator drugs do
modify disease progression & prevent relapses
what are therapeutic uses for interferon beta (3)
reduces frequency & severity of attacks
reduces # & size lesions detectable w/ MRI
delays progression of disability
what are the adverse effects of interferon beta (6)
flu-like reactions
hepatotoxicity
myelosupression
injection-site reactions
depression
suicidal thoughts
how do pts admin interferon beta
dispensed as single-use syringes & vials
what are the two immunosuppressants (disease-modifying drugs II)
mitoxantrone
cladribine
what is the therapeutic use of mitoxantrone
decrease neuro disability & clinical relapses
what are the adverse effects of mitoxantrone (9)
myelosupression - s/s of infection: fever, chills, cough
cardiotoxicity
fetal harm
reversible hair loss
injury to GI mucosa
n/v
amenorrhea
allergy symps
blue/green tint to urine & sclera
are multiple drugs used to manage MS exacerbations
yes
why are corticosteriods used for an MS pt (2)
helpful in treating acute exacerbations
reduce edema & acute inflammation
multiple drugs are used to manage ms symps which symps are (10)
detrusor hyperreflexia
flaccid bladder
constipation
fecal incontinence
depression
fatigue
spasticity
neuropathic pain
improved walking
dizziness & vertigo
nursing interventions for ms (7)
promote physical mobility
prevent injury
enhance bowel & bladder control
enhance communication
improve sensory & cognitive functions
teach about meds
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