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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
T or F: patients with MS may have trouble swallowing
T: cause by poor coordination of muscles
26
what are some common cognition impairments with MS?
- speed of info processing - attention - executive function - verbal fluency - working memory
27
T or F: long term memory is usually affected with MS
F
28
urinary bladder dysfunction affects _____% of pts with MS
80
29
spastic bladders fail to ______ urine while flaccid bladders fail to ______ urine
store empty
30
dyssynergic bladder
a problem with coordination between the bladder contraction and sphincter relaxation
31
common bladder symptoms with MS
- urinary urgency - urinary frequency - nocturia - incontinence
32
the most common bowel symptom with MS is ________
constipation
33
3 lab tests to diagnose MS
1 - MRI 2 - evoked potential 3 - lumbar puncture
34
what kind of drug is primarily used to manage acute relapses in MS?
corticosteroids for strong anti-inflammatory effects
35
what kind of drugs are used during periods of remission of MS?
disease modifying therapeutic agents
36
what is the goal of disease-modifying therapeutic agents
to slow down immune response and decrease CNS inflammation
37
what are two injections you can get to manage spasticity
1 - botulinum toxin (botox) 2 - phenol *in conjunction with stretching
38
T or F: some spasticity may be beneficial in MS
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
T or F: strong opiods are commonly prescribed for pain in pts with MS
F: they have limited effectiveness and bad side effects
40
41
for flaccid bladders, you should limit the intake of what? what about spastic bladders?
flaccid = citrus and tomato products spastic = caffeine and alcohol, drink 8 glasses of fluid a day
42
is PT strongly supported for the MS pop?
yes
43
restorative intervention
improving indirect, modifiable impairments
44
preventative/ secondary intervention
minimizing potential complications at each disease stage
45
compensatory intervention
modifying task/environ to improve function within scope of impairments
46
maintenance therapy
occasional services to maintain CLOF *typical in late stages
47
the mini-mental status exam and symbol digit modalities test assess what
cognition
48
beck depression inventory and quality of life scales assess what
affective/psychosocial
49
nottingham sensory assessment
effect of sensory deficits on QOL
50
neurothesiometer
screens for peripheral neuropathy through vibration threshold
51
parosxysmal pain
sudden attack of symptoms
52
modified fatigue impact scale (MFIS)
addresses effects of fatigue on cognitive, physical, and psychosocial function
53
uthoff syndrome
sensitivity to temperature
54
how could you assess temperature sensitivity
- ear thermometer before, during, and after moderate intensity exercise - see if there is a correlation between temp changes and worsening of symptoms *pseudoexacerbations
55
what does 6 minute walk test assess
cardiovascular endurance
56
rating of perceived exertion is ranked from _______ to _______
0-10
57
what is the gold standard of generic measures of health status
health status questionnaire
58
PT treatment for proprioceptive loss
- 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
PT treatment for vision loss
- modify the environment (adequate lighting, reduce obstacles) - patch one eye to reduce diplopia (not all the time) - refer out if needed
60
PT treatment for sensory deficits and skin care
- Pt/caregiver education - keep skin clean/dry - inspect skin regularly - wear breathable clothing - practice regular pressure relief - proper transfer techniques
61
PT treatment for MSK pain
- stretching and exercise - massage - ultrasound - postural strengthening - correct faulty movement ** important to determine cause of pain
62
what could you wear to prevent Lhermitte's sign
cervical colalr
63
is exercise safe for pts with MS
YES *important to implement exercise early and avoid sedentary lifestyle
64
should pts exercise in periods of relapse
no, they should wait until remission is evident
65
T or F: pts with MS need frequent breaks during exericse
T: increasing body temp too much could cause an exacerbation
66
what kind of training has proven to be effective in the MS population
circuit training
67
T or F: in MS exercising to fatigue is contraindicated
T
68
aerobic conditioning recommendations for MS
30 mins 3-5x a week on alternate days
69
you should limit aerobic exercise to ______ to ___% of HR max
60-85
70
what can you do in PT to help with bladder control
strengthen pelvic floor muscles
71
energy ______ techniques are important for patients with MS
conservation *collaborate with OT
72
is increased tone more common in the LE or UE with MS
LE
73
what are some ways we can help manage spasticity
cryotherapy, hydrotherapy, proper positioning, splints, ther-ex, stretching
74
how should exercises be performed to manage spasticity
SLOWLY, focus on expanding ROM
75
weighted assistive devices and braces to help control ataxic movements are what kind of therapy (compensatory, restorative)?
compensatory

Adult Neuro One (10 decks)

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