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Adult Neuro One > MS > Flashcards

MS Flashcards

1
Q

Is MS more common in males or females

A

females
*predominantly caucasian

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2
Q

what age is the typical onset of MS

A

20-50

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3
Q

is MS inherited

A

no

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4
Q

MS is an _______ disease

A

autoimmune

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5
Q

what happens pathophysiologically with MS?

A

abnormal immune mediated response attacks myeline, oligodendrocytes, and nerve fibers in the CNS and causes a damaging inflammatory cascade
*this slows neural transmission and eventually blocks nerve conduction

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6
Q

what happens after an acute inflammatory attack of MS

A

remaining oligodendrocytes repair damaged myelin but as the disease progresses more and more oligodendrocytes are damages so anti-inflammatory responses are less effective

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7
Q

what are glial scars

A

scar tissue created by the astrocytes that fill in the area by demyelination

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8
Q

what are the four different forms of MS?

A

1 - clinical isolated syndrome
2 - relapsing - remitting
3 - secondary progressive
4 - primary progressive

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9
Q

what is the most common form of MS?

A

relapsing-remitting

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10
Q

clinical isolated syndrome

A
  • single episode of inflammatory demyelination
  • symptoms last > 24hrs
  • could become MS
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11
Q

relapsing remitting MS

A
  • discrete attacks followed by periods of no exacerbation
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12
Q

secondary progressive MS

A

begins with relapsing-remitting but then progresses to steady and irreversible worsening of neurologic function

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13
Q

primary progressive MS

A

nearly continuous neurologic deterioration from onset of symptoms

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14
Q

what are some factors that could cause an exacerbation/relapse of MS?

A
  • infection
  • disease of major organ system
  • stress (physical or mental)
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15
Q

An MS exacerbation lasts greater than ____ hours

A

24
*less than 24 hrs is a pseudoexacerbation
(ex. adverse reaction to heat)

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16
Q

symptoms vary greatly with MS, but what are some typical early symptoms

A
  • minor visual disturbances
  • paresthesias
  • weakness
  • fatigability
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17
Q

approximately ___% of patients with MS experience pain. how is the pain often described?

A

80%
intense, sharp, shooting, burning
*often acute, sudden onset
*headaches are common

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18
Q

Lhermitte’s sign

A

flexion of the neck produces a shock-like sensation down the spine and into the LEs
*sign of dorsal column damage in spinal cord

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19
Q

internuclear ophthalmoplegia

A

causes lateral gaze palsy on affected side

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20
Q

MS causes ______ motor neuron signs

A

upper

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21
Q

fatigue is _____ while fatigability is _______

A

subjective
objective

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22
Q

what could cause coordination and balance deficits in pts with MS

A
  • cerebellar involvement (ataxia)
  • somatosensory involvement (decreased sensation in feet)
  • vestibular involvement
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23
Q

T or F: patients with MS may have trouble with speech

A

T: could be caused by muscle weakness, spasticity, tremor, or ataxia

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24
Q

dysphonia

A

changes in vocal quality (hoarseness, hypernasal)

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25
Q

T or F: patients with MS may have trouble swallowing

A

T: cause by poor coordination of muscles

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26
Q

what are some common cognition impairments with MS?

A
  • speed of info processing
  • attention
  • executive function
  • verbal fluency
  • working memory
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27
Q

T or F: long term memory is usually affected with MS

A

F

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28
Q

urinary bladder dysfunction affects _____% of pts with MS

A

80

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29
Q

spastic bladders fail to ______ urine while flaccid bladders fail to ______ urine

A

store
empty

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30
Q

dyssynergic bladder

A

a problem with coordination between the bladder contraction and sphincter relaxation

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31
Q

common bladder symptoms with MS

A
  • urinary urgency
  • urinary frequency
  • nocturia
  • incontinence
32
Q

the most common bowel symptom with MS is ________

A

constipation

33
Q

3 lab tests to diagnose MS

A

1 - MRI
2 - evoked potential
3 - lumbar puncture

34
Q

what kind of drug is primarily used to manage acute relapses in MS?

A

corticosteroids for strong anti-inflammatory effects

35
Q

what kind of drugs are used during periods of remission of MS?

A

disease modifying therapeutic agents

36
Q

what is the goal of disease-modifying therapeutic agents

A

to slow down immune response and decrease CNS inflammation

37
Q

what are two injections you can get to manage spasticity

A

1 - botulinum toxin (botox)
2 - phenol
*in conjunction with stretching

38
Q

T or F: some spasticity may be beneficial in MS

A

T: they may use it to compensate for muscle weakness
*however, surgery may be considered if the spasticity is so sever the limb innonfunctional

39
Q

T or F: strong opiods are commonly prescribed for pain in pts with MS

A

F: they have limited effectiveness and bad side effects

40
Q
A
41
Q

for flaccid bladders, you should limit the intake of what? what about spastic bladders?

A

flaccid = citrus and tomato products
spastic = caffeine and alcohol, drink 8 glasses of fluid a day

42
Q

is PT strongly supported for the MS pop?

A

yes

43
Q

restorative intervention

A

improving indirect, modifiable impairments

44
Q

preventative/ secondary intervention

A

minimizing potential complications at each disease stage

45
Q

compensatory intervention

A

modifying task/environ to improve function within scope of impairments

46
Q

maintenance therapy

A

occasional services to maintain CLOF
*typical in late stages

47
Q

the mini-mental status exam and symbol digit modalities test assess what

A

cognition

48
Q

beck depression inventory and quality of life scales assess what

A

affective/psychosocial

49
Q

nottingham sensory assessment

A

effect of sensory deficits on QOL

50
Q

neurothesiometer

A

screens for peripheral neuropathy through vibration threshold

51
Q

parosxysmal pain

A

sudden attack of symptoms

52
Q

modified fatigue impact scale (MFIS)

A

addresses effects of fatigue on cognitive, physical, and psychosocial function

53
Q

uthoff syndrome

A

sensitivity to temperature

54
Q

how could you assess temperature sensitivity

A
  • ear thermometer before, during, and after moderate intensity exercise
  • see if there is a correlation between temp changes and worsening of symptoms *pseudoexacerbations
55
Q

what does 6 minute walk test assess

A

cardiovascular endurance

56
Q

rating of perceived exertion is ranked from _______ to _______

A

0-10

57
Q

what is the gold standard of generic measures of health status

A

health status questionnaire

58
Q

PT treatment for proprioceptive loss

A
  • increase use of other sensory systems
  • use feedback such as tapping or verbal cues
  • heighten any residual function by loading through exercise, bands, weight, or use a pool
59
Q

PT treatment for vision loss

A
  • modify the environment (adequate lighting, reduce obstacles)
  • patch one eye to reduce diplopia (not all the time)
  • refer out if needed
60
Q

PT treatment for sensory deficits and skin care

A
  • Pt/caregiver education
  • keep skin clean/dry
  • inspect skin regularly
  • wear breathable clothing
  • practice regular pressure relief
  • proper transfer techniques
61
Q

PT treatment for MSK pain

A
  • stretching and exercise
  • massage
  • ultrasound
  • postural strengthening
  • correct faulty movement
    ** important to determine cause of pain
62
Q

what could you wear to prevent Lhermitte’s sign

A

cervical colalr

63
Q

is exercise safe for pts with MS

A

YES
*important to implement exercise early and avoid sedentary lifestyle

64
Q

should pts exercise in periods of relapse

A

no, they should wait until remission is evident

65
Q

T or F: pts with MS need frequent breaks during exericse

A

T: increasing body temp too much could cause an exacerbation

66
Q

what kind of training has proven to be effective in the MS population

A

circuit training

67
Q

T or F: in MS exercising to fatigue is contraindicated

A

T

68
Q

aerobic conditioning recommendations for MS

A

30 mins 3-5x a week on alternate days

69
Q

you should limit aerobic exercise to ______ to ___% of HR max

A

60-85

70
Q

what can you do in PT to help with bladder control

A

strengthen pelvic floor muscles

71
Q

energy ______ techniques are important for patients with MS

A

conservation
*collaborate with OT

72
Q

is increased tone more common in the LE or UE with MS

A

LE

73
Q

what are some ways we can help manage spasticity

A

cryotherapy, hydrotherapy, proper positioning, splints, ther-ex, stretching

74
Q

how should exercises be performed to manage spasticity

A

SLOWLY, focus on expanding ROM

75
Q

weighted assistive devices and braces to help control ataxic movements are what kind of therapy (compensatory, restorative)?

A

compensatory

Adult Neuro One (10 decks)

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