MS

Question 1

what is multiple sclerosis?

Answer 1

is a chronic, progressive, degenerative autoimmune disorder of the CNS characterised by disseminated demyelination of nerve fibres of the brain, spinal cord, and optic nerve

Question 2

what country has the highest rates of MS in the world?

Answer 2

Canada, especially Alberta

Question 3

where does MS have high prevalence?

Answer 3

high rates in areas with temperate climates (low areas of sunlight - vitamin D)
-more prevalent in women

Question 4

onset of MS?

Answer 4

15-50 years old

Question 5

what is the cause of MS?

Answer 5

unknown

Question 6

possible precipitating factors of MS?

Answer 6

infection, trauma, emotional stress, excessive fatigue, pregnancy, and state of poor health

Question 7

what is MS characterized by?

Answer 7

characterised by chronic inflammation, demyelination and scarring of the CNS

Question 8

what is attacked in MS?

Answer 8

-the disease process consists of loss of myelin, initially the myelin sheaths of the neurons in the brain and spinal cord are attacked

Question 9

what do MS pts complain of?

Answer 9

weakness, but however the myelin can regenerate itself and symptoms disappear, resulting in a remission

Question 10

motor symptoms of MS?

Answer 10

• symtoms occur over month

- motor symptoms include: paralysis of the limbs, trunk, or head, diplopia, spasticity of the muscles

Question 11

sensory symptoms of MS?

Answer 11

• sensory abnormalities: numbness and tingling, blurred vision, vertigo, chronic neuropathic pain
• decreased hearing, ringing in ears

Question 12

why do pts experiance fatigue?

Answer 12

severe fatigue- associated with increased energy needs, decondition, depression and medication adverse effects

Question 13

what is Lhermittes sign?

Answer 13

a transient sensory symptom described as an electric shock radiating down the spine or into the limbs with flexion of the neck

Question 14

what are some cerebellar signs?

Answer 14

nystagmus- rapid involuntary movements of the eyes.
ataxia-the loss of full control of bodily movements.
dysarthria-difficult or unclear articulation of speech-
dysphagia

Question 15

bowel/ bladder symptoms?

Answer 15

• function can be affected if the sclerotic plaque is located in the area of the CNS that control elimination
• problems with defecation
• constipation
• fecal incontinence
• spastic bladder leading to urinary urgency and frequency and results in dribbling or incontinence

Question 16

diagnostic for MS?

Answer 16

• no diagnostic studies, very hard to diagnose
• diagnosis is often based off history, clinical manifestations and the presense of multiple lesions over time as measured by MRI
• no blood test

Question 17

what is the goal of therapy?

Answer 17

-slow disease progression

Question 18

drugs for exacerbations?

Answer 18

-steroids like methylprednisolone are used for acute exacerbations

Question 19

drug used for relapsing-remitting MS?

Answer 19

interferon B (bettaseron)

Question 20

what is a new promising drug for MS?

Answer 20

Natalzumab (Tysabri)
-works by inhibiting the migrations of lymphocytes thus decreasing the inflammatory process and prevent further damage to the myelin

Question 21

alternative therapy?

Answer 21

• neurological dysfunction can improve with physiotherapy and speech therapy
• excersise improves pts who are not experiencing a current exacerbation
• megavitamin therapy (vitamin B12, C, and D)
• diet consisting of low-fat, gluten free food and raw veggies

Question 22

how can excersise help a pt with MS?

Answer 22

• it decreases spasticity, increases coordination, and retrains unaffected muscle to substitute for impaired ones
• water excersise is very beneficial

Question 23

Overall goals for MS pts?

Answer 23

• maximize neuromuscular function
• maintain independence in activities of daily living for as long as possible
• manage disabling fatigue
• optimize psychosocial well-being
• adjust to illness
• reduce factors that precipitate exacerbations

Question 24

what are exacerbations of MS triggered by?

Answer 24

• infection (especially upper resp infections and UTI’s)
• trauma
• immunizations
• childbirth
• stress
• change in climate

Question 25

nursing implication’s?

Answer 25

• the nurse should help the pt identify particular trigger and develop ways to avoid them or minimize thier effects
• the nurse should assist the pt in dealing with the anxiety caused by a diagnosis of disabling illness

Question 26

what should pt teaching be focused on?

Answer 26

• building general resistance to illness, including avoiding fatigue, extremes of heat exposure to infection