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adult neuro test 3 > MS > Flashcards

MS Flashcards

1
Q

MS is a _________ disease that primarily affect the _____

A

immune-mediated

CNS

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2
Q

True or False?
Research suggests that MS may be the result of an abnormal autoimmune response to some infection or environmental trigger in a genetically susceptible individual

A

true

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3
Q

MS is an inflammatory disease that destroys?

A

areas of myelin in the CNS, primarily white matter

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4
Q

what is the most common area in the CNS that MS attacks?

A

optic nerve

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5
Q

in MS, ________ become rreversibly damaged as a result of the inflammation, even early in the disease

A

axons

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6
Q

damage areas become

A

slclerotic

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7
Q

90% of pts are diagnosed between ____ and _____

A

16-60

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8
Q

true or false

men have a more aggressive version and it more prevalent compared to women

A

False
women to men 2-3:1
However male form appears to be more aggressive

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9
Q

MS is prevalent in ______ zones

A

temperates zones

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10
Q

True or False

First degree relative with MS = greater risk of developing MS

A

True

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11
Q

most common S/S of MS?

A 
Fatigue (88%)
Difficulty walking (87%)
Bowel & bladder problems (65%)
Pain and other sensory changes (60%)
Visual disturbances (58%)
Cognitive problems (44%)
Tremors (41%)
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12
Q

what are examples of cognitive problems that MS pts have trouble with?

A

dual to multi-tasking
difficulty following detailed instructions
decreased ST memory

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13
Q

what are other common symptoms?

A 
nystagmus
speech difficulty
incoordination
weakness 
spasticity
muscle spasms
sexual dysfunction
emotional instability
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14
Q

Initials attacks of MS are often _______, ___ and _______

A

transient
mild
self-limited

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15
Q

How to Diagnosis MS?

A

Clinical attacks
MRI
CSF (elevated gamma globulin levels and possibly WBC)
+ Evoked Potentials ( Central N. conduction testing )

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16
Q

what are some factors that seem to predict a more favorable MS course?

A

Female
onset before 35
monoregional vs polyregional attacks
complete recover after an exacerbation, leaving little or no residual impairment

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17
Q

what are some factors that seem to predict a poor prognosis of MS?

A

Male gender
Onset after age 35
Brainstem symptoms such as nystagmus, tremor, ataxia, and dysarthria
Poor recovery following exacerbations
Frequent attacks
African-Americans (less likely to have MS, but more likely to have a more progressive form of the disease)

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18
Q

what are some covert symptoms of MS?

A 
fatigue
pain
vision
bowel and bladder
paresthesias
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19
Q

what are the 4 categories of MS established by the National Multiple Sclerosis Society?

A

Relapsing-remitting
Primary-progressive
Secondary-progressive
Progressive-relapsing

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20
Q

what is the most common form of MS at the time of initial diagnosis?

A

Relapsing-Remitting MS

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21
Q

Relapsing-Remitting MS makes up ______ % of MS

A

85

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22
Q

Relapsing-Remitting MS has clearly define ______ with periods of ______

A

flare-ups

remissions

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23
Q

_____ % of relapsing-remitting MS develop Secondary-Progressive MS within ______ years

A

50

10

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24
Q

Explain the course of Secondary-Progressive MS

A

Initial Relapsing-Remitting course followed by progression with or without occasional relapses, minor remissions with some recovery and plateau

25
Q

_________ MS is relatively rare only making up 10% of MS

A

Primary-Progressive MS

26
Q

true or false
Primary-Progressive MS has a disease progression without plateaus or with occasional plateau and temporary minor improvements possible

A

true

27
Q

true or false

with Primary-Progressive MS, a person has to have an attack to have an increase in disabilityTr

A

False

Steady increase in disability without “attacks”

28
Q

Progressive-Relapsing MS is the rarest of on ___% of pts getting it?

A

5%

29
Q

True or False

Progressive-Relapsing MS is progressive from onset

A

true

30
Q

Progressive-Relapsing MS has clear acute relapses, ____ or _____ full recovery

A

with or without

31
Q

what are the 5 categories of treatment for MS?

A 
Treatment of acute exacerbations
Symptom management
Disease modification 
Rehabilitation
Psychosocial support
32
Q

what are factors triggering a relapse of MS?

A 
often unpredictable
infections
physical and emotional stress
heat can transiently increase symptoms
Last trimester  of pregnancy offers a natural protection against a relapse
33
Q

true or false

vaccine are not safe for MS patients?

A

Influenza vaccines are safe; no vaccines have been found to increase relapse incidence

34
Q

pool recommended temp for MS pts is ______ degrees

A

<85

35
Q

____-____% increased risk for relapse after a delivery of baby

A

20-40

36
Q

with acute relapse management, natural improvement occurs over _____-____ weeks

A

4-12

37
Q

corticosteroids help by?

A

attempts to end the attack sooner and leave fewer permanent lesions

38
Q

true or false

corticosteroids have evidence that is decreases the extent of overall disability

A

False

Little evidence that these medications alter the extent of disability or overall course of the MS.

39
Q

what are the goals of managing MS?

A

Reduce frequency of relapses
Reduce progression of disability
Reduce number and volume of brain lesions

40
Q

what is Avonex?

A

For treatment of all relapsing forms of MS and for a single clinical episode if MRI is consistent with MS

Weekly IM injection

41
Q

what is adverse reactions of Avonex?

A

Flulike symptoms after injection

Depression, mild anemia, elevated liver enzymes, allergic reactions, heart problems

42
Q

what is Rebif?

A

For all relapsing forms of MS

3x/week IM injection

43
Q

what are the adverse reactions of Rebif?

A

Flulike symptoms

Injection site reactions, liver abnormalities, depression, allergic reactions, low red or white blood cell counts

44
Q

what is Betaseron & Extavia?

A

For the treatment of all relapsing forms of MS

Every other day subcutaneous injection

45
Q

what are the adverse reactions of Betaseron & Extavia?

A

Flulike symptoms after injection
Injection site reactions
Allergic reactions, depression, elevated liver enzyme levels, low white blood cell counts

46
Q

what is a precaution of Betaseron & Extavia?

A

Should not be given to patients with severe and untreated depression due to increased risk of suicide associated with this treatment

47
Q

what is copaxone?

A

For the treatment of relapsing/remitting MS

Daily subcutaneous injection

48
Q

what are the adverse reactions of Copaxone?

A

njection site reactions
Vasodilation, chest pain, anxiety, palpitations, shortness of breath, flushing (5-10 min after injection; no known long-term effects)

49
Q

what is Novantrone (Serono)?

A

For worsening relapsing/remitting MS and for progressive relapsing or secondary progressive

MS 4x/year IV infusion

50
Q

_______ is generally recommended for individuals with an inadequate response to, or are unable to tolerate other MS drugs

A

Tysabri (Natalizumab)

51
Q

Tysabri (Natalizumab) is taken every _____ weeks by ____ ______

A

4 weeks

IV infusion

52
Q

adverse reactions of Tysabri (Natalizumab) include?

A

increased risk of progressive multifocal leukoencephalopathy (PML), infusion reactions, headache, fatigue, joint and limb pain, abdominal discomfort, diarrhea, and rash

53
Q

what do PTs need to do/know about MS pts?

A

General knowledge pertaining to medication side effects

Coordination of treatment and medication schedules

Make note of changes in patient’s performance

54
Q

PT treatment for MS pts compose of?

A 
Support coordinated care & patient empowerment
Wellness and health promotion
Fatigue
Weakness
Spasticity
Balance/Vestibular
Coordination
Sensory Problems
Ambulation and Mobility
Activities of Daily Living
55
Q

what are reasons MS pts may have fatigue that can be addressed?

A 
decrease sleep
poor diet
deconditioning
movement limitations
depression
neuromuscular conditions
body core temp
emotional stress
56
Q

true or false

Rising of core body temp increases conduction velocity

A

False

slows it

57
Q

true or false

while heat might aggravate common symptoms, there is no link to causing an exacerbation of the disease

A

true

58
Q

what is something a person with MS can use to help against heat sensitivity?

A

cooling garments

adult neuro test 3 (7 decks)

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